Computer network homecare demonstration: a randomized trial in persons living with AIDS
Computer network homecare demonstration: a randomized trial in persons living with AIDS
复制标题
DOI：
10.1016/s0010-4825(98)00029-8
复制
发表时间：
1998-09-01
影响因子：
7.7
通讯作者：
Flatley-Brennan, P
中科院分区：
文献类型：
--
作者：
Flatley-Brennan, P
目的：随着基于互联网的医疗保健应用的增加，确定其对患者的可接受性以及使用可能产生的结果至关重要。这项随机实地调查展示了一个专门的计算机网络——计算机链接（ComputerLink）在艾滋病患者（PLWA）中的使用情况和效果。
假设：本研究旨在确定为艾滋病患者设计的基于家庭的计算机网络是否会被使用，以及它是否会减少社会隔离，提高决策的信心和技能，同时不会导致艾滋病患者健康状况出现差异性下降。
干预措施：将Wyse 30终端放置在私人家庭中，通过1200波特的调制解调器连接到一个公共访问计算机网络。艾滋病患者可使用的服务包括在线电子百科全书、公共和私人通信以及一个决策支持系统；所有服务都由一名注册护士协调。
设计：一项为期六个月的随机试验涉及57名居住在社区的艾滋病患者；其中31人在实验组。平均年龄为33岁，93%为男性，61%为白人，34%有工作，平均受教育年限为13.5年。有6名参与者失访。
结果：在研究期间，对该系统的访问次数达到8449次。每位参与者的平均访问次数为192次，中位数为129次。平均访问时长为12分钟。艾滋病患者在每次使用过程中使用两项服务。一阶假设检验显示实验组和对照组参与者之间没有显著差异。事后探索表明，一旦控制了参与者的抑郁水平，使用该系统确实减少了社会隔离，并且决策信心随着访问次数的增加而提高。
结论：计算机网络为向居家的个人提供医疗服务提供了可行的替代方案。通信服务比其他服务使用得更广泛，这表明干预的主要机制是同伴联系。与其他实验类似，系统的使用提高了决策的信心，但没有提高技能。互联网是接触居家患者并为他们提供信息、通信和决策帮助的一条有前途的途径。（C）1998年由爱思唯尔科学有限公司出版。保留所有权利。
Purpose: As Internet-based health care applications grow, it is important to determine their acceptability to ill persons and the likely outcomes resulting from their use. This randomized field investigation demonstrated the use and effects of a specialized computer network, the ComputerLink, among persons living with AIDS (PLWA). Hypothesis: This study was designed to determine whether a home-based computer network designed for people with AIDS (PLWA) would be used and whether it would reduce social isolation and improve confidence and skill in decision making without causing differential decline in health status among PLWA. Intervention: Wyse 30 terminals were placed in private homes, linked via a 1200 baud modem to a public access computer network. Services available to PLWA included an on-line electronic encyclopedia, public and private communication and a decision support system; all services were coordinated by a registered nurse. Design: A six-month randomized trial involved 57 community-dwelling PLWA; 31 were in the experimental group. Mean age was 33, 93% were male, 61% white, 34% working, 13.5 mean years education. Six participants were lost to follow-up. Results: 8449 accesses to the system were made during the study period. Mean number of access per participant was 192, the median, 129. Duration of access averaged 12 min. PLWA used two services during each session. First order hypotheses testing revealed no significant difference between experimental and control group participants. Post hoc exploration indicated that use of the system did reduce social isolation once participants levels of depression were controlled and that decision making confidence improved as a function of number of accesses. Conclusion: Computer networks provide feasible alternatives for the delivery of health services to home-bound individuals. Communication services were used more extensively than other services, suggesting that the primary mechanism of intervention is peer contact. Similar to other experiments, system use improves confidence, though not skill, in decision making. The Internet represents a promising pathway to reaching home-bound patients and providing them with information, communication and decision assistance. (C) 1998 Published by Elsevier Science Ltd. All rights reserved.