During outpatient chemotherapy, adverse events occurring at home must be carefully monitored. We have developed a tele-nursing system that can store physical information such as blood pressure and pulse measured by ca...During outpatient chemotherapy, adverse events occurring at home must be carefully monitored. We have developed a tele-nursing system that can store physical information such as blood pressure and pulse measured by cancer patients in the cloud by using Bluetooth, which is wireless communication technology, and collect information from remote locations. The tele-nursing system name is T-SCOT. The purpose of this study is to conduct a randomized controlled trial to investigate the efficacy of T-SCOT intervention. Participants are those who receive T-SCOT intervention plus Care as usual as the intervention group, and those who receive only Care as usual as the control group. T-SCOT includes the following five steps: 1) Answer questions related to side effects of chemotherapy [10 items];2) Measure blood pressure, pulse, body temperature, and SPO2. The measured data is automatically saved in the cloud via Bluetooth;3) Watch a video of coping behavior for side effects;4) The data entered by the patient is visualized as a line graph;5) Utilize the videophone function with researchers if you have any problems or troubles. Utilization of ICT in telenursing makes it possible to visualize patient’s physical information and contributes to the reduction of medical expenses.展开更多
Background: This crossover trial aimed to examine the efficacy of the Tele-nursing Symptom Management System for Chemotherapy in Outpatient Treatment (T-SCOT) in reducing the side effects in patients undergoing out-pa...Background: This crossover trial aimed to examine the efficacy of the Tele-nursing Symptom Management System for Chemotherapy in Outpatient Treatment (T-SCOT) in reducing the side effects in patients undergoing out-patient chemotherapy. Methods: Using a tablet computer, participants were asked to provide information on various items, including fever, nausea, hair loss, fatigue, and vital signs. Both the participants and researchers automati-cally monitored time-dependent changes in symptoms, and the researchers proposed concrete measures to reduce patients’ complications. The primary endpoint was the M. D. Anderson Symptom Inventory (MDASI-J) score. The secondary endpoint, Quality of Life (QOL) was evaluated using the Quality of Life Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL- ACD). Results: This study included 20 patients who met all the inclusion cri-teria, 14 of whom agreed to participate in the study. There was no significant difference between the MDASI-J and QOL-ACD pre- and post-comparison of the primary and secondary evaluations in the intervention group. The control group had significantly higher scores 3 months after the intervention for symptom intensity (p = 0.04) and symptom-induced disruption to life (p = 0.03), and the symptoms worsened. The QOL-ACD had significantly lower scores for activity (p = 0.03), overall QOL (p = 0.04), and total QOL score (p = 0.02), resulting in a lower quality of life. Conclusions: Participants used the Internet to obtain information on treatments and side effects and changed their behavior in daily life. It is speculated that the Information and Commu-nications Technology (ICT) literacy in older adults has improved, and they are benefiting from digital utilization.展开更多
Aims and objectives: To test an automated telephone service as a follow-up and support strategy for self-care in a population of adult Mexican patients with type 2 diabetes. Methods: The design was a two-group compara...Aims and objectives: To test an automated telephone service as a follow-up and support strategy for self-care in a population of adult Mexican patients with type 2 diabetes. Methods: The design was a two-group comparative design, with pre and post-intervention measurements. Patients were assigned into intervention (n = 31), or comparison (n = 33) groups. Over 12 weeks, each participant in the intervention group received automated phone calls with instructions to facilitate accomplishment of the treatment, and self-care activities. Two focus groups helped to appreciate patients’ follow-up experience. Randomized grouping was performed by selecting numbers from an urn;the final sample comprised 31 (48%) patients in the intervention group, and 33 (52%) in the comparison group;these procedures were performed by the case nurse management. The study was approved by the Ethics Committee of the Autonomous University of Nuevo Leon and the University of Michigan;all of the participants signed informed consent. Results: Of the 372 programmed phone calls made to the participants, 234 were completed, representing a 62.9% response rate. Phone calls may be associated to a 0.82% decrease in the HbA1c values and to lower depression scores. HbA1c measurements decreased 0.82% (M = 7.41 - 6.69;t = 25;4.11;p = ?0.001) from the baseline values over the 12-week study in the intervention group and 0.49% (M = 7.24 - 6.75;t = 26;2.11;p = 0.044) in the comparison group. Variables related to medication intake did not exhibit differences between the baseline and second measurements, except with respect to the scale of depression.展开更多
In order to train nurses to perform disease management and telenursing, we developed an e-learning education program, and assessed the efficacy. A single-group pre-test and post-test design was used. Nurses who worked...In order to train nurses to perform disease management and telenursing, we developed an e-learning education program, and assessed the efficacy. A single-group pre-test and post-test design was used. Nurses who worked at a medical institution or a disease management company were included, and the duration of the program was set 2 months. We developed the program so that it could grow attitude and improve knowledge and skills in disease management and patient education. Of 55 subjects, 48 who completed the program were analyzed. After the program, subjects increased knowledge and interests in disease management and patient education. Almost of the subjects answered that e-learning was a good learning method. Our program was effective at enhancing subject’s interests in disease management and patient education, and considered to improve their skills in the future.展开更多
Background: With the rapid aging of society, the number of patients with heart failure has also increased. Implantable devices for heart failure have become standardized. Remote monitoring using cardiac devices has gr...Background: With the rapid aging of society, the number of patients with heart failure has also increased. Implantable devices for heart failure have become standardized. Remote monitoring using cardiac devices has grown in popularity for medical efficiency and the early detection of abnormalities. Our first aim was to develop a tablet-PC-based nursing intervention program for patients requiring remote monitoring of implantable cardiac devices. The second purpose was to evaluate the efficacy of the program by using mixed-methods research. Methods: The study consisted of two phases. In phase 1, we designed a tablet-PC-based nursing intervention program, on the basis of a literature review and qualitative data collected via semi-structured interviews. In phase 2, we conducted a randomized controlled trial that served as a preliminary investigation of the program. The outcome measures were readmission, unexpected visits to the clinic for heart problems, quality of life, self-care behavior, and self-efficacy. After the study, we interviewed each participant about his or her experiences with the program. Interviews were audio recorded, coded, and thematically analyzed. Results: The 33 patients with heart failure were randomized into two groups as follows: 17 patients in the telenursing group and 16 in the control group. During 6 months of follow-up, the readmission for heart failure occurred in 11% of the intervention group and 18% of the control group. There were no statistically significant differences between the groups at any outcome measures. Three themes were extracted via qualitative analysis: “getting a sense of safety,” “triggering a health behavior change,” and “feeling like a burden.” Conclusion: No improvements in rates of rehospitalization or unexpected clinic visits were seen in the quantitative study. However, signs of behavior modification were seen in the qualitative study. This program has the possibility of improving patient outcomes.展开更多
The purpose of this systematic review is to identify evidence of the appropriate dose of telehealth intervention services provided to community dwelling adults experiencing chronic illness or disability related to eff...The purpose of this systematic review is to identify evidence of the appropriate dose of telehealth intervention services provided to community dwelling adults experiencing chronic illness or disability related to effectiveness, quality, safety, and cost. Academic Search Complete, CINAHL, MEDLINE, Cochrane, and JBI were searched using combinations of “telehealth or telemedicine or telemonitoring or telepractice or telenursing or telecare AND chronic illness or chronic disease”. Of the identified 449 articles, 47 articles met the inclusion criteria. Most study designs were quasi-experimental one group pre-test post-test (N = 16) with few Randomized Controlled Trials (N = 12). Twenty-three published articles studied the effect of telehealth for one chronic condition (49.9%) while 24 (51.1%) examined the effectiveness of telehealth for multiple chronic conditions. Measurement of telehealth outcomes varied and included efficacy, healthcare utilization, quality, adherence, cost, and safety. No standard measure of dose could be extrapolated. Length of intervention was measured and reported differently in each study. The dose of telehealth services that improve care effectiveness, quality, safety, and cost is still unknown for community dwelling adults experiencing chronic illness. The findings from this systematic review do indicate that longer duration of telehealth services (51 weeks), regardless of modality, produced positive outcomes as opposed to those with shorter durations (37 - 38 weeks) that produced neutral or mixed results. Collecting and reporting data related to clinical workflow such as dose of intervention specific to disease and type of modality is recommended. Rigorous study design including standard measurement at the RCT and Comparative Effectiveness level is still needed.展开更多
Purpose: This randomized controlled trial (RCT) protocol was designed to evaluate the effectiveness of the Cancer Pain Monitoring System (CAPAMOS), a telenursing system designed to alleviate pain in ambulatory patient...Purpose: This randomized controlled trial (RCT) protocol was designed to evaluate the effectiveness of the Cancer Pain Monitoring System (CAPAMOS), a telenursing system designed to alleviate pain in ambulatory patients with advanced cancer. Methods: The study design involved a randomized controlled trial consisting of an intervention group using CAPAMOS and a control group that received usual care. At the time of enrollment, both groups will be given a questionnaire regarding issues, such as concerns related to cancer pain and self-management of opioid medication. Patients will then receive pain relief education based on the results of the questionnaire. Subjects in the control group will receive a pain diary and pain-relief pamphlet that acts as an educational tool. They could also call the outpatient clinic if they wanted to ask for a nursing consultation. The intervention group will be able to use CAPAMOS to manage their pain and receive video consultation with a telenurse, who is an oncology nursing specialist. Educational tools will be built into CAPAMOS. The study will be conducted for one month. The primary endpoint of this study was to calculate the Japanese Brief Pain Inventory score. The secondary endpoints were to assess the opioid medication self-management, Barriers Questionnaire, Japanese EuroQol 5-dimensions 5-level, and economic evaluation. Assessment items will be evaluated at registration and 2 and 4 weeks after registration. Conclusions: A RCT based on this protocol is expected to validate the efficacy of telenursing using CAPAMOS in patients with advanced cancer and pain.展开更多
文摘During outpatient chemotherapy, adverse events occurring at home must be carefully monitored. We have developed a tele-nursing system that can store physical information such as blood pressure and pulse measured by cancer patients in the cloud by using Bluetooth, which is wireless communication technology, and collect information from remote locations. The tele-nursing system name is T-SCOT. The purpose of this study is to conduct a randomized controlled trial to investigate the efficacy of T-SCOT intervention. Participants are those who receive T-SCOT intervention plus Care as usual as the intervention group, and those who receive only Care as usual as the control group. T-SCOT includes the following five steps: 1) Answer questions related to side effects of chemotherapy [10 items];2) Measure blood pressure, pulse, body temperature, and SPO2. The measured data is automatically saved in the cloud via Bluetooth;3) Watch a video of coping behavior for side effects;4) The data entered by the patient is visualized as a line graph;5) Utilize the videophone function with researchers if you have any problems or troubles. Utilization of ICT in telenursing makes it possible to visualize patient’s physical information and contributes to the reduction of medical expenses.
文摘Background: This crossover trial aimed to examine the efficacy of the Tele-nursing Symptom Management System for Chemotherapy in Outpatient Treatment (T-SCOT) in reducing the side effects in patients undergoing out-patient chemotherapy. Methods: Using a tablet computer, participants were asked to provide information on various items, including fever, nausea, hair loss, fatigue, and vital signs. Both the participants and researchers automati-cally monitored time-dependent changes in symptoms, and the researchers proposed concrete measures to reduce patients’ complications. The primary endpoint was the M. D. Anderson Symptom Inventory (MDASI-J) score. The secondary endpoint, Quality of Life (QOL) was evaluated using the Quality of Life Questionnaire for Cancer Patients Treated with Anticancer Drugs (QOL- ACD). Results: This study included 20 patients who met all the inclusion cri-teria, 14 of whom agreed to participate in the study. There was no significant difference between the MDASI-J and QOL-ACD pre- and post-comparison of the primary and secondary evaluations in the intervention group. The control group had significantly higher scores 3 months after the intervention for symptom intensity (p = 0.04) and symptom-induced disruption to life (p = 0.03), and the symptoms worsened. The QOL-ACD had significantly lower scores for activity (p = 0.03), overall QOL (p = 0.04), and total QOL score (p = 0.02), resulting in a lower quality of life. Conclusions: Participants used the Internet to obtain information on treatments and side effects and changed their behavior in daily life. It is speculated that the Information and Commu-nications Technology (ICT) literacy in older adults has improved, and they are benefiting from digital utilization.
文摘Aims and objectives: To test an automated telephone service as a follow-up and support strategy for self-care in a population of adult Mexican patients with type 2 diabetes. Methods: The design was a two-group comparative design, with pre and post-intervention measurements. Patients were assigned into intervention (n = 31), or comparison (n = 33) groups. Over 12 weeks, each participant in the intervention group received automated phone calls with instructions to facilitate accomplishment of the treatment, and self-care activities. Two focus groups helped to appreciate patients’ follow-up experience. Randomized grouping was performed by selecting numbers from an urn;the final sample comprised 31 (48%) patients in the intervention group, and 33 (52%) in the comparison group;these procedures were performed by the case nurse management. The study was approved by the Ethics Committee of the Autonomous University of Nuevo Leon and the University of Michigan;all of the participants signed informed consent. Results: Of the 372 programmed phone calls made to the participants, 234 were completed, representing a 62.9% response rate. Phone calls may be associated to a 0.82% decrease in the HbA1c values and to lower depression scores. HbA1c measurements decreased 0.82% (M = 7.41 - 6.69;t = 25;4.11;p = ?0.001) from the baseline values over the 12-week study in the intervention group and 0.49% (M = 7.24 - 6.75;t = 26;2.11;p = 0.044) in the comparison group. Variables related to medication intake did not exhibit differences between the baseline and second measurements, except with respect to the scale of depression.
文摘In order to train nurses to perform disease management and telenursing, we developed an e-learning education program, and assessed the efficacy. A single-group pre-test and post-test design was used. Nurses who worked at a medical institution or a disease management company were included, and the duration of the program was set 2 months. We developed the program so that it could grow attitude and improve knowledge and skills in disease management and patient education. Of 55 subjects, 48 who completed the program were analyzed. After the program, subjects increased knowledge and interests in disease management and patient education. Almost of the subjects answered that e-learning was a good learning method. Our program was effective at enhancing subject’s interests in disease management and patient education, and considered to improve their skills in the future.
文摘Background: With the rapid aging of society, the number of patients with heart failure has also increased. Implantable devices for heart failure have become standardized. Remote monitoring using cardiac devices has grown in popularity for medical efficiency and the early detection of abnormalities. Our first aim was to develop a tablet-PC-based nursing intervention program for patients requiring remote monitoring of implantable cardiac devices. The second purpose was to evaluate the efficacy of the program by using mixed-methods research. Methods: The study consisted of two phases. In phase 1, we designed a tablet-PC-based nursing intervention program, on the basis of a literature review and qualitative data collected via semi-structured interviews. In phase 2, we conducted a randomized controlled trial that served as a preliminary investigation of the program. The outcome measures were readmission, unexpected visits to the clinic for heart problems, quality of life, self-care behavior, and self-efficacy. After the study, we interviewed each participant about his or her experiences with the program. Interviews were audio recorded, coded, and thematically analyzed. Results: The 33 patients with heart failure were randomized into two groups as follows: 17 patients in the telenursing group and 16 in the control group. During 6 months of follow-up, the readmission for heart failure occurred in 11% of the intervention group and 18% of the control group. There were no statistically significant differences between the groups at any outcome measures. Three themes were extracted via qualitative analysis: “getting a sense of safety,” “triggering a health behavior change,” and “feeling like a burden.” Conclusion: No improvements in rates of rehospitalization or unexpected clinic visits were seen in the quantitative study. However, signs of behavior modification were seen in the qualitative study. This program has the possibility of improving patient outcomes.
文摘The purpose of this systematic review is to identify evidence of the appropriate dose of telehealth intervention services provided to community dwelling adults experiencing chronic illness or disability related to effectiveness, quality, safety, and cost. Academic Search Complete, CINAHL, MEDLINE, Cochrane, and JBI were searched using combinations of “telehealth or telemedicine or telemonitoring or telepractice or telenursing or telecare AND chronic illness or chronic disease”. Of the identified 449 articles, 47 articles met the inclusion criteria. Most study designs were quasi-experimental one group pre-test post-test (N = 16) with few Randomized Controlled Trials (N = 12). Twenty-three published articles studied the effect of telehealth for one chronic condition (49.9%) while 24 (51.1%) examined the effectiveness of telehealth for multiple chronic conditions. Measurement of telehealth outcomes varied and included efficacy, healthcare utilization, quality, adherence, cost, and safety. No standard measure of dose could be extrapolated. Length of intervention was measured and reported differently in each study. The dose of telehealth services that improve care effectiveness, quality, safety, and cost is still unknown for community dwelling adults experiencing chronic illness. The findings from this systematic review do indicate that longer duration of telehealth services (51 weeks), regardless of modality, produced positive outcomes as opposed to those with shorter durations (37 - 38 weeks) that produced neutral or mixed results. Collecting and reporting data related to clinical workflow such as dose of intervention specific to disease and type of modality is recommended. Rigorous study design including standard measurement at the RCT and Comparative Effectiveness level is still needed.
文摘Purpose: This randomized controlled trial (RCT) protocol was designed to evaluate the effectiveness of the Cancer Pain Monitoring System (CAPAMOS), a telenursing system designed to alleviate pain in ambulatory patients with advanced cancer. Methods: The study design involved a randomized controlled trial consisting of an intervention group using CAPAMOS and a control group that received usual care. At the time of enrollment, both groups will be given a questionnaire regarding issues, such as concerns related to cancer pain and self-management of opioid medication. Patients will then receive pain relief education based on the results of the questionnaire. Subjects in the control group will receive a pain diary and pain-relief pamphlet that acts as an educational tool. They could also call the outpatient clinic if they wanted to ask for a nursing consultation. The intervention group will be able to use CAPAMOS to manage their pain and receive video consultation with a telenurse, who is an oncology nursing specialist. Educational tools will be built into CAPAMOS. The study will be conducted for one month. The primary endpoint of this study was to calculate the Japanese Brief Pain Inventory score. The secondary endpoints were to assess the opioid medication self-management, Barriers Questionnaire, Japanese EuroQol 5-dimensions 5-level, and economic evaluation. Assessment items will be evaluated at registration and 2 and 4 weeks after registration. Conclusions: A RCT based on this protocol is expected to validate the efficacy of telenursing using CAPAMOS in patients with advanced cancer and pain.
