Development of a Telenursing System for Home Oxygen Therapy Patients and an Educational Program for Telenurses.

我们为慢性呼吸衰竭患者开发了家庭氧疗生命管理远程护理系统（LMS-HOT），以预防呼吸衰竭急性加重并及早发现。LMS-HOT由护理监控中心管理的四个系统组成：患者家中用于身心自我评估的互联网终端；采用基于文献的算法进行远程监控，触发个性化的响应信息；支持交互和护理系统的服务器；以及指导患者遵守医嘱的教育系统。五名志愿者（第六名由于其他疾病在第6天退出）使用该系统超过两个月（总共953天的经验）。他们的自我监测数据、系统反应和患者对健康相关生活质量SF-36的反应以及关于使用LMS-HOT的陈述为我们的评估提供了数据。患者提交了876份报告。当一个或多个参数触发…多个紧急警报时，确定了701个可能的恶化事件，总发生率为80%。在可能的加重事件中，67.1%被判定为紧急事件；每位患者的急诊次数各不相同（4/55、48/230、301/340、71/79、164/172）。触发当日SpO_2、峰值流量、脉率、收缩压、体温、Borg评分、日总分均显著降低。没有人再次住院。2 . HR-QOL （SF36）在生理相关功能（RP）、体痛（BP）、活力（VT）方面均有改善，但变化无统计学意义3 .患者反映LMS-HOT减轻了日常生活中的焦虑，在早期解决了问题，提高了自我护理意识，并提供了安全感。使用LMS-HOT在家中维持患者的费用是通常再入院住院时间的25%。2006-2007年，我们组织了两次远程教学研讨会，有146人参加（37.7%是护士，29.5%是其他卫生专业人员，32.9%是其他人员）。87.5%的人给予肯定评价。我们准备了一本远程教学教材，分发给每个参与者。少

We developed the Life Management Telenursing System for Home Oxygen Therapy (LMS-HOT) for chronic respiratory failure patients to prevent acute exacerbation of respiratory failure and detect it early.LMS-HOT consists of four systems administered by the nursing monitoring center : internet terminals in the patient's home for physical and mental self-assessment ; telemonitoring with literature-based algorithms that trigger individualized response messages; the server supporting the interactions and care system; and educational systems to guide patient compliance.Five volunteers (a sixth withdrew at day 6 due to another disease) used this system for more than two months (total 953 days experience). Their self-monitoring data, system responses, and patient responses to the Health-Related QOL SF-36 and statements about using LMS-HOT provided data for our evaluation.1. Patients submitted 876 reports. 701 possible exacerbation episodes were identified when one or more parameters triggered the … More emergency alarm, an over-all incidence rate of 80%. Of the possible exacerbation episodes, 67.1% were judged to be emergencies ; the number of emergencies per reports per patient varied (4/55, 48/230, 301/340, 71/79, 164/172). On the day of triggering parameters were significantly lower for SpO_2, peak flow, pulse rate, systolic blood pressure, body temperature, Borg scale score, and daily total points. There were no hospital readmissions.2. HR-QOL (SF36) was improved in function related to physical (RP), body pain (BP), vitality (VT) but changes were not statistically significant.3 The patients reported that LMS-HOT alleviated anxieties in daily life, resolved problems at early stage, improved self-care consciousness, and provided a sense of security.4. The cost of maintaining a patient at home using LMS-HOT was 25% of a usual readmission hospital stay.5. We organized two telementoring seminars in 2006-2007 attended by 146 people (37.7% nurses ; 29.5% other health professionals ; 32.9% others). 87.5% gave positive evaluations. We prepared a telementoring textbook and distributed it to each participant. Less