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Nurse and patient reactions to a developmental home telecare system

JOURNAL OF TELEMEDICINE AND TELECARE 1998年第3期4卷 152-160页

作者： Whitten, P Collins, B Mair, F Univ Kansas Med Ctr Kansas City KS 66160 USA Univ Louisville Louisville KY 40292 USA Univ Liverpool Liverpool L69 3BX Merseyside England

Pilot studies have suggested that telemedicine is a satisfactory means of delivering nursing services into the home. A home telecare programme in Kansas provided nursing services to homes in four towns in Kansas. The present study examined patients' and nurses' perceptions of a variety of issues related to home telecare. Data-collection methods included in-depth interviews, observation and analyses of archival data from patient records. Patients suffered an average of 4.6 concurrent illnesses. On the whole, patients perceived the system as a valuable resource that offered great potential, although many saw no immediate health benefits for themselves. Nurses were enthusiastic about the prospect of practising in this way, although they did have strong opinions about what types of nurses, patients and illnesses were suited to telemedicine.

关键词：医务工作者的态度社区保健护理/组织和管理家庭医疗保健服务/组织和管理堪萨斯病人接受卫生保健的程度远程会诊/组织和管理成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Importance of experience for older home care workers in facing up to the constraints of work

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EXPERIMENTAL AGING RESEARCH 1999年第4期25卷 405-410页

作者： Cloutier, E David, H Prévost, J Teiger, C IRSST Montreal PQ H3A 3C2 Canada Univ Montreal GRASP Montreal PQ Canada CNRS Lab G Friedmann Paris France CNAM Lab Ergon Paris France

Home care workers (HCWs) are at risk from injury. A case study was undertaken in a local community health center in order (1) to identify the constraints that introduce risk into the work of HCWs, and (2) to study the strategies they apply, depending on their age, to reduce the effects of those constraints. Observation and semistructured interviews were the main soul ces of data. Analysis shows that HCWs aged 45 or over sometimes adopt different postures from those used by their younger colleagues. During physical care, the HCWs also carry out screening and social support tasks that are not recognized in the organization of their work. Older workers develop strategies that help them save time, refine their. screening and support methods, protect themselves against accidents, and react properly in emergencies or dangerous situations. Because the changes that can be made in patients' homes are limited, the expertise of experienced HCWs is essential. The organization of work must maintain a certain flexibility to allow the workers to use their strategies.

关键词：事故衰老用力卫生人员家庭医疗保健服务/组织和管理疼痛/流行病学患病率社会支持工作动物人类中年人

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Using cable television networks for interactive home telemedicine services

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JOURNAL OF TELEMEDICINE AND TELECARE 1999年第Sup1期5卷 91-92页

作者： Valero, MA Arredondo, MT del Nogal, F Rodríguez, JM Torres, D UPM ETSI Telecomunicac GBT Madrid 28040 Spain INSALUD Hosp Severo Ochoa Leganes Spain

Most recent cable television network infrastructures can be used to deliver broadband interactive telemedicine services to the home. These facilities allow the provision of social and health services like medical televisiting for elderly, disabled and chronically ill patients;health tele-education;and teleconsultation on demand. Large numbers of patients could benefit from these services. There is also the increasing European tendency to offer customized home-care services. These applications are being developed and validated by a pilot project in Madrid as part of the ATTRACT project of the European Commission. The long-term aim is to develop broadband applications on a large scale to support low-cost interactive home telemedicine services for both patients and institutions.

关键词：虚弱老人德国希腊家庭医疗保健服务/组织和管理卧病在家者意大利北爱尔兰试点项目西班牙远程医学/方法电视老年人人类

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Home telecare in the United States

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JOURNAL OF TELEMEDICINE AND TELECARE 1998年第4期4卷 195-199页

作者： Kinsella, A Catholic Univ Amer Dept Biomed Engn Telehome Care Program Washington DC 20064 USA

Telecare has the potential to extend home-care services normally delivered by conventional means. In the USA, government reductions in health-care financing have been matched by a growing interest, on the part of commercial health-care insurers, in cost reductions and cost-effective care planning. This review identifies emerging trends in home care. Several telecare demonstration projects have been undertaken with patients with coronary heart disease and HIV/AIDS. These projects have attempted to develop new methods of providing cost-effective care for a growing patient population with chronic disease.

关键词：获得性免疫缺陷综合征/治疗慢性病冠心病/治疗费用效益分析家庭医疗保健服务/经济学家庭医疗保健服务/组织和管理家庭医疗保健服务/发展趋势远程医学/经济学远程医学/发展趋势远程医学/利用遥测术/经济学遥测术/发展趋势遥测术/利用老年人人类

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A questionnaire for the assessment of patients' impressions of the risks and benefits of home telecare

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JOURNAL OF TELEMEDICINE AND TELECARE 2000年第5期6卷 278-284页

作者： Demiris, G Speedie, S Finkelstein, S Univ Minnesota Dept Lab Med & Pathol Minneapolis MN 55455 USA

Home telecare is a promising method of improving access to care for rural and urban populations. It requires, however, that patients accept the installation and use of equipment in their home. How patients perceive home telecare may influence its acceptability and diffusion. We developed a questionnaire to assess patients' impressions of the risks and benefits of home telecare. A preliminary 20-item questionnaire was developed and tested on 32 subjects. It proved to be of acceptable reliability (Cronbach's alpha of 0.8) and validity, but three items appeared to be redundant. The final 17-item version was tested twice on 10 more subjects and was found to have high test-retest reliability. Most subjects showed an overall positive attitude towards home telecare and agreed it could improve their health. Many were concerned about being able to trust the equipment. The questionnaire can be used to investigate the acceptance of telemedicine and to improve the design of applications.

关键词：健康态度机密卫生服务易得程度/组织和管理家庭医疗保健服务/组织和管理家庭医疗保健服务/标准病人接受卫生保健的程度问卷调查可重复性结果危险因素远程医学人类

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An analysis of the suitability of home health visits for telemedicine

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JOURNAL OF TELEMEDICINE AND TELECARE 1999年第2期5卷 90-96页

作者： Allen, A Doolittle, GC Boysen, CD Komoroski, K Wolf, M Collins, B Patterson, JD Univ Kansas Med Ctr Kansas City KS 66103 USA Univ Louisville Dept Commun Louisville KY 40292 USA Univ Kansas Dept Commun Studies Lawrence KS 66045 USA

To determine what percentage of traditional home health nursing visits could be done by telemedicine, we carried out a retrospective review of nursing charts (clinical records). Data of two types were recorded. The objective data, which were, abstracted from the records, included demographic information, patient assessments, teaching activities and interventions. The subjective data were the opinions of four observers as to whether the visit could have been done using currently available telemedicine technology. Records were sampled randomly for patients who had received home nursing care from three home health agencies in rural and urban areas during the winter and summer of 1996. A 54-item coding instrument was applied to 906 different charted home nursing visits. For 412 9(46%)of these, the on-site nursing could reasonably have been replaced by telenursing. Significant factors determining the possible use of telenursing included primary diagnosis, number of interventions and patient age. Among the 10 most common primary diagnoses, the most amenable to telenursing care were chronic airway obstruction and joint disorders;the least amenable were coagulation disorders and anaemia. Telenursing visits could substitute for a substantial fraction of on-site home nursing visits. This has important implications in terms of reducing the cost of home nursing care.

关键词：可行性研究家庭医疗保健服务/组织和管理回顾性研究远程医学人类

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A feasibility study of video-based home telecare for clients with spinal cord injuries

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JOURNAL OF TELEMEDICINE AND TELECARE 1998年第4期4卷 219-223页

作者： Phillips, VL Temkin, AJ Vesmarovich, SH Burns, R Emory Univ Rollins Sch Publ Hlth Dept Hlth Policy & Management Atlanta GA 30322 USA

We carried out a feasibility study of the use of a home telecare intervention to promote skin and other self-care activities for clients with spinal cord injuries (SCIs) following their discharge from a rehabilitation facility. Eleven clients (mean age 38 years) participated in at least three video-sessions over a minimum of six weeks. The equipment used was a video-phone which could transmit both audio and still images over an ordinary telephone line. Video-sessions were followed by, or interspersed with, telephone calls. There was an average of 10 video-calls (range 3-25) and an average of six telephone calls (range 0-22) per client. The average length of the consultations was 23 min (range 15-34 min). The overall impressions of the 11 clients were very positive. Weekly telecare sessions for four to six weeks, followed by telephone counselling alone every other week for another four weeks, appears to be the appropriate sequence for most SCI clients.

关键词：可行性研究家庭医疗保健服务/组织和管理病人满意度自我护理脊髓损伤/治疗远程医学/方法电话青少年成年人女(雌)性人类男(雄)性中年人

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'Smart' homes and telecare for independent living

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JOURNAL OF TELEMEDICINE AND TELECARE 2000年第1期6卷 8-14页

作者： Tang, P Venables, T Univ Sussex Sci Policy Res Unit Brighton BN1 9RF E Sussex England

Telecare services and 'smart' homes share a common technological base in information technology and telecommunications. There is growing interest in both telecare services and smart homes, although they have been studied in isolation. Telecare has been driven largely by perceived cost savings and improved service delivery to the home, leading to improved quality of life and independent living. Smart homes are also expected to provide better and safer living conditions. The integration of the two should produce more secure and autonomous living. There are different forms of telecare services, as there are different types of smart homes, each ranging from basic systems involving the use of alarms and the ordinary telephone to intelligent monitoring with sensors and interactive communication. The introduction of these systems has policy implications, such as the need for coordination between health, social services and housing policy makers, which will reduce duplication and inefficient allocation of resources. Successful delivery of telecare to the home is as much dependent on the construction and condition of the housing stock as it is on the ability of the care provider to meet users' needs. if the UK National Health Service (NHS) could replace a significant proportion of domiciliary nursing visits by telephone calls, then savings of up to pound 200 million per annum would be possible.

关键词：卫生保健提供/经济学卫生保健提供/组织和管理卫生保健提供/发展趋势卫生政策/立法和法学家庭医疗保健服务/经济学家庭医疗保健服务/组织和管理家庭医疗保健服务/发展趋势试点项目电信/经济学电信/组织和管理电信/发展趋势远程医学/经济学远程医学/组织和管理远程医学/发展趋势人类

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The potential for telemedicine in home nursing

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JOURNAL OF TELEMEDICINE AND TELECARE 1998年第4期4卷 214-218页

作者： Wootton, R Loane, M Mair, F Moutray, M Harrisson, S Sivananthan, S Allen, A Doolittle, G McLernan, A Queens Univ Inst Telemed & Telecare Belfast Antrim North Ireland Univ Liverpool Dept Primary Care Liverpool Merseyside England Queens Univ Sch Nursing Belfast Antrim North Ireland Univ Kansas Med Ctr Kansas City KS USA N & W Belfast Community Trust Belfast Antrim North Ireland

We assessed the proportion of home nursing visits that could be replaced by home telenursing in the UK. A retrospective review of nursing notes in the UK was undertaken using an abstraction instrument developed and tested in the US. A total of 1951 episodes of patient care at home were reviewed: 1450 from Liverpool and 501 from Belfast. A total of 1626 (83%) of the episodes involved 'hands-on' interventions. In Belfast two observers estimated that 14% of home nursing visits could be done via telemedicine while in Liverpool two more observers gave an estimate of 16%. Inter-rater agreement was high (kappa = 0.93 for the Belfast observers and 0.79 for the Liverpool observers). Pilot trials of an analogue video-phone in Belfast suggested that even relatively low-quality compressed video might be useful for home nursing. These findings suggest that telemedicine may have a significant role in the delivery of home health care in the UK.

关键词：数据收集英格兰家庭医疗保健服务/组织和管理北爱尔兰试点项目回顾性研究远程医学/方法遥测术/方法电话成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Preparing for a Joint Commission survey: A pharmacist's perspective

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 2000年第3期57卷 275-277页

作者： Chamallas, SN Joint Commiss Accreditat Healthcare Org Oakbrook Terrace IL USA

The Home Care Exchange section is intended to give home care practitioners an opportunity to obtain advice from their peers about tissues in the home care setting. Home care practitioners are encouraged to submit topics for this section. Suggestions for topics should be submitted to Julie L. Webb, Director, ASHP Section of Home Care Practitioners, 7272 Wisconsin Avenue, Bethesda, MD 20814.

关键词：家庭医疗保健服务/组织和管理家庭医疗保健服务/标准卫生保健组织鉴定联合委员会药剂师人类

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