RESUMEN
AIMS: To investigate the feasibility, acceptance and potential effectiveness of delivering a telecare service on the health outcomes and hospital service utilization of community-dwelling patients with chronic obstructive pulmonary disease. METHODS: Eligible participants were older people, with moderate or severe chronic obstructive pulmonary disease, and who had been admitted to hospital at least once for exacerbation during the previous year. The participants were randomly assigned to the intervention or control group. Participants in the intervention group received a telecare device kit and they were asked to monitor their oxygen saturation, pulse rate and respiration rate using the device and to transmit the data to an online network platform. A medication and purse-lip breathing reminder with a feedback function is also provided in the device kit. A community nurse monitors changes in the physiological parameters and takes immediate action to address the patients' needs. Participants in the control group received no other extra care. Study outcomes include user satisfaction, health-related quality of life, pulmonary function, hospital re-admission and use of emergency room services. RESULTS: Twenty-two participants in the intervention group and 18 in the control group were included in the analysis. The mean age of all 40 participants was 72.93 years. Overall, the participants in the intervention group expressed satisfaction with the telecare service. Some patients reported difficulty in reading the screen of the mobile phone and manipulating the tiny key-in buttons. No significant differences were found between the two time points (baseline and post-test period) with regard to health-related quality of life. No significant differences in pulmonary function and in the number of emergency department visits and hospital re-admissions between the study groups were found. CONCLUSION: The high level of user satisfaction indicated the feasibility of conducting a large-scale randomized control trial to evaluate the effects of a telecare service on health outcomes of patients with chronic obstructive pulmonary disease.
Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica/terapia , Telemedicina , Anciano , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Readmisión del Paciente , Satisfacción del Paciente , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Calidad de Vida , Pruebas de Función RespiratoriaRESUMEN
Severe acute respiratory syndrome (SARS) is a highly infectious disease, with high potential for transmission to close contacts, particularly among healthcare workers. This is the first systematic study investigating hospital nurses' physical and psychological health status and the kinds of healthcare used-stratified by the level of contact with SARS patients-during the 2003 outbreak in Hong Kong. Nurses in moderate-risk areas appeared to have more stress symptoms than those working in high-risk areas. It is essential to design hospital support systems and occupational health policy to promote the psychological well-being of nurses during future outbreaks of emerging infections.