ABSTRACT
INTRODUCTION: This article is part of the Focus Theme of Methods of Information in Medicine on "Biosignal Interpretation: Advanced Methods for Neural Signals and Images". OBJECTIVES: This paper presents the main concepts of a decision making approach for the remote management of COPD patients based on the early detection of disease exacerbation episodes. METHODS: An e-diary card is defined to evaluate a number of physiological variables and clinical parameters acquired remotely by means of wearable and environmental sensors deployed in patients' long-stay settings. The automatic evaluation of the card results in a so-called Chronic Status Index (CSI) whose computation is tailored to patients' specific manifestation of the disease (i.e., patient's phenotype). The decision support method relies on a parameterized analysis of CSI variations so as to early detect worsening changes, identify exacerbation severity and track the patterns of recovery. RESULTS: A preliminary study, carried out in real settings with 30 COPD patients monitored at home, has shown the validity and sensitivity of the method proposed, which was effectively able to timely and correctly identify patients' critical situation. CONCLUSION: The preliminary results showed that the proposed e-diary card, which presents several novel features with respect to other solutions presented in the literature, can be practically used to remotely monitor COPD patients.
Subject(s)
Decision Support Systems, Clinical , Health Status , Monitoring, Ambulatory , Pulmonary Disease, Chronic Obstructive/physiopathology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/diagnosis , TelemedicineABSTRACT
To improve, managers need information on the process of care and patient satisfaction. The study described in this article validates a survey for assessing the process of care and satisfaction with ambulatory care visits and illustrates how this information can be used to estimate the impact of different visit processes on patient satisfaction.
Subject(s)
Health Maintenance Organizations/standards , Outcome and Process Assessment, Health Care/organization & administration , Patient Satisfaction/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Appointments and Schedules , Data Collection , Female , Health Maintenance Organizations/organization & administration , Health Services Accessibility , Health Services Research/methods , Humans , Male , Middle Aged , Models, Organizational , New England , Physician-Patient Relations , Surveys and QuestionnairesABSTRACT
The psychosocial issues of homosexual men with AIDS and their significant others pose a profound nursing care challenge. The nurse's knowledge and sensitivity to these issues is necessary to meet the challenge of this patient group. Unique aspects of AIDS such as youth, stigma, contagiousness and sexual transmission, combined with neurologic complications, resultant anxiety and depression, and drug and alcohol use present a complicated array of needs to be addressed by the nurse. Crisis and existential theory frameworks are useful to apply to the nursing process when caring for patients facing a life-threatening illness. Goals such as maintenance of psychological well-being and the promotion of psychological growth can occur as the nurse assists the patient and his significant others to confront existential concerns. These concerns include death, meaning, freedom, and isolation. Providing nursing care for this patient population also has an impact on the nurse as he or she confronts mortality and sexuality. This calls for the nurse to examine his/her values and attitudes in order to provide optimal nursing care. In caring for homosexual men with AIDS and their significant others, the nurse is likely to experience personal growth. As the nurse assists the patient and his loved ones to live as they confront potential death, the nurse often gains an added appreciation of life.
