Nursing interventions in a telemonitoring program.
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ABSTRACT:
SUBMITTER: Wakefield BJ
PROVIDER: S-EPMC3598432 | biostudies-literature | 2013 Mar
REPOSITORIES: biostudies-literature
Publications
Nursing interventions in a telemonitoring program.
Wakefield Bonnie J BJ Scherubel Melody M Ray Annette A Holman John E JE
Telemedicine journal and e-health : the official journal of the American Telemedicine Association 20130128 3
<h4>Background</h4>The use of telemonitoring of patients with chronic illness in their homes is growing. Current literature does not describe what types of patient problems are addressed by nurses in these programs and what actions are taken in response to identified problems. This study defined and analyzed patient problems and nursing actions delivered in a telemonitoring program focused on chronic disease management.<h4>Subjects and methods</h4>Data were drawn from a clinical trial that evalu ...[more]
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Project description:ObjectiveThe role of telemonitoring interventions (TIs) for chronic obstructive pulmonary disease (COPD) has been studied in many systematic reviews (SRs) and meta-analyses (MAs), but robust conclusions have not been reached due to wide variations in scopes, qualities, and outcomes. The aim of this overview was to determine the effectiveness of TIs on COPD patients.MethodsPubMed, EMBASE, Web of Science, and Cochrane Library were searched for all reviews on the topic of TI in treating COPD from inception to July 8, 2019, without restrictions on language. According to the inclusion and exclusion criteria, the retrieved literature studies were screened to select SRs and MAs of randomized control trials (RCTs) that evaluated the effects of TIs in COPD patients. The methodological quality of SRs and MAs was assessed with the AMSTAR-2 tool, and the strength of evidence was assessed with the grades of recommendations, assessment, development, and evaluation (GRADE) system for concerned outcomes in terms of mortality, quality of life (SGRQ total scores), exercise capacity (6MWD), and exacerbation-related outcomes (hospitalizations, exacerbation rate, and emergency room visits).ResultsOur overview included eight SRs and MAs published in 2011 to 2019, from 95 RCTs involving 10632 participants. After strict evaluation by the AMSTAR-2 tool, 75% of the SRs and MAs in this overview had either low or critically low methodological quality. The effects of TIs for COPD on mortality, quality of life, exercise capacity, and exacerbation-related outcomes are limited, and all of these outcomes scored either low or very low quality of evidence on the GRADE system.ConclusionsThere might be insufficient evidence to support the effectiveness of TIs for COPD currently, but the results of this overview should be interpreted dialectically and prudently, and the role of TIs in COPD needs further exploration.
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Project description:BackgroundTelemonitoring enables care providers to remotely support outpatients in self-managing chronic heart failure (CHF), but little is known about the usability and patients' willingness to engage with this technology.ObjectiveThis study aims to evaluate feedback from patients with CHF following participation in the Innovative Telemonitoring Enhanced Care program for CHF (ITEC-CHF) study.MethodsThe telemonitoring intervention consisted of three components: remote weight monitoring, structured telephone support, and nurse-led collaborative care. Participants were provided with electronic weighing scales (W550; ForaCare), and a computer tablet (Galaxy Tab A; Samsung). They were asked to weigh themselves on the provided scales daily. Telemonitoring was integrated with a personal assistance call service and a nurse care service according to their workflows in usual care. Feedback on the usability of ITEC-CHF was collected via survey from study participants following 6 months of receiving telemonitoring care for their body weight. Survey responses were provided on a 5-point Likert scale and through open-ended questions to determine participants' perceived benefits and barriers to using ITEC-CHF.ResultsA total of 67 participants (49/67, 73% male), with a mean age of 69.8 (SD 12.4) years completed the survey. The majority of participants agreed or strongly agreed that the ITEC-CHF program was easy to use (61/67, 91%), easy to navigate (51/65, 78%), useful (59/65, 91%), and made them feel more confident in managing their weight (57/67, 85%). Themes related to participants' perceptions of telemonitoring included increased support for early intervention of clinical deterioration, improved compliance to daily weighing, a sense of reassurance, and improved self-care and accountability, among others.ConclusionsITEC-CHF was rated highly on usability and was well accepted by users as part of their routine self-management activities. Participants were willing to use telemonitoring because they perceived a broad spectrum of benefits for CHF management.Trial registrationAustralian New Zealand Clinical Trial Registry ID ACTRN 12614000916640; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366691.
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