TY - JOUR AU - Lefler, Leanne L AU - Rhoads, Sarah J AU - Harris, Melodee AU - Funderburg, Ashley E AU - Lubin, Sandra A AU - Martel, Isis D AU - Faulkner, Jennifer L AU - Rooker, Janet L AU - Bell, Deborah K AU - Marshall, Heather AU - Beverly, Claudia J PY - 2018 DA - 2018/12/04 TI -评估老年心力衰竭患者移动医疗技术的使用:混合方法研究JO - JMIR Aging SP - e12178 VL - 1 IS - 2 KW -心力衰竭KW -远程监测KW - mHealth KW -老年人KW -可行性KW -自我管理AB -背景:心力衰竭(HF)与高住院率、发病率、死亡率和成本相关。远程患者监测(移动医疗、移动医疗)有望改善自我保健和心衰管理，从而提高护理质量，同时减少住院和成本;然而，关于老年心衰患者对移动医疗使用的看法的信息有限。目的:本研究旨在比较老年HF患者的观点，他们被随机分配到(1)连接24小时呼叫中心的移动医疗设备，(2)数字家庭设备，或(3)标准护理，涉及设备的易用性和满意度，提供者沟通和参与，以及自我监测和管理疾病的能力。方法:我们采用混合方法描述性设计进行了一项初步研究，对参与者进行了为期12周的前后调查。我们通过半结构化的定性访谈来增强这些数据，以了解更多关于可行性、满意度、沟通和自我管理的信息。结果:我们纳入了28例55岁及以上的HF患者，其中57%(16/28)为男性，79%(22/28)为非西班牙裔白人，并伴有多种合并症。在基线时，50%(14/28)的人认为自己的健康状况一般或较差，36%(10/28)和25%(7/28)的人经常/总是对自己的健康感到沮丧和沮丧。在基线时，46%(13/28)没有监测体重，29%(8/28)没有监测血压，68%(19/28)没有监测症状。 Post intervention, 100% of the equipment groups home monitored daily. For technology anxiety, 36% (10/28) indicated technology made them nervous, and 32% (9/28) reported fear of technology, without significant changes post intervention. Technology usability post intervention scored high (91/100), reflecting ease of use. A majority indicated that a health care provider should be managing their health, and 71% reported that one should trust and not question the provider. Moreover, 57% (16/28) believed it was better to seek professional help than caring for oneself. Post intervention, mHealth users relied more on themselves, which was not mirrored in the home equipment or standard care groups. Participants were satisfied with communication and engagement with providers, yet many described access problems. Distressing symptoms were unpredictable and prevailed over the 12 weeks with 79 provider visits and 7 visits to emergency departments. The nurse call center received 872 readings, and we completed 289 telephone calls with participants. Narrative data revealed the following main themes: (1) traditional communication and engagement with providers prevailed, delaying access to care; (2) home monitoring with technology was described as useful, and mHealth users felt secure knowing that someone was observing them; (3) equipment groups felt more confident in self-monitoring and managing; and finally, (4) uncertainty and frustration with persistent health problems. Conclusions: mHealth equipment is feasible with potential to improve patient-centered outcomes and increase self-management in older adults with HF. SN - 2561-7605 UR - http://aging.www.mybigtv.com/2018/2/e12178/ UR - https://doi.org/10.2196/12178 DO - 10.2196/12178 ID - info:doi/10.2196/12178 ER -