ABSTRACT
The objective of this study was to test whether a telehealth intervention could improve the compliance with continuous positive airway pressure (CPAP) by patients with sleep apnea. These patients had been nonadherent for the initial 3 months of therapy even after receiving the initial standard and then supplemental audiotaped/videotaped patient education for adhering to CPAP nightly. The materials and methods included a randomized testing of experimental and placebo interventions. Interventions were delivered by nurses to two groups in their homes by telehealth over a 12-week period. The placebo intervention was used to control for Hawthorne effect, time and attention influences and the novelty of having telehealth in the home. Results following the telehealth interventions were that significantly more patients in the experimental group 1 (n = 10) than the placebo group 2 (n = 9) were adhering nightly to CPAP (chi 2 = 4.55, p = 0.033). Group 1 patients reported greater satisfaction with their intervention. However, both groups rated telehealth delivery positively. The mean cost of each 20-minute telehealth visit was 30 dollars while the total cost of the telehealth intervention for each patient was 420 dollars. These costs included telehealth equipment, initial installation, longdistance telephone charges, nurse salary, and intervention materials. Conclusions are that telehealth interventions are a potentially cost-effective service for increasing adherence to prescribed medical treatments. Replication studies with large samples and in other clinical groups are recommended.
Subject(s)
Continuous Positive Airway Pressure/methods , Sleep Apnea, Obstructive/therapy , Telemedicine/methods , Treatment Refusal , Aged , Aged, 80 and over , Continuous Positive Airway Pressure/economics , Female , Humans , Male , Middle Aged , Sleep Apnea, Obstructive/economics , Telemedicine/economicsABSTRACT
This article describes the experiences of nurses who, as part of a large clinical trial, brought the Internet into older adults' homes by installing a computer, if needed, and connecting to a patient education Web site. Most of these patients had not previously used the Internet and were taught even basic computer skills when necessary. Because of increasing use of the Internet in patient education, assessment, and home monitoring, nurses in various roles currently connect with patients to monitor their progress, teach about medications, and answer questions about appointments and treatments. Thus, nurses find themselves playing the role of technology managers for patients with home-based Internet connections. This article provides step-by-step procedures for computer installation and training in the form of protocols, checklists, and patient user guides. By following these procedures, nurses can install computers, arrange Internet access, teach and connect to their patients, and prepare themselves to install future generations of technological devices.
Subject(s)
Aged , Community Health Nursing/organization & administration , Computer User Training/methods , Computer-Assisted Instruction , Home Care Services/organization & administration , Internet , Patient Education as Topic , Teaching/methods , Activities of Daily Living , Aged/psychology , Aged, 80 and over , Attitude to Computers , Computer Literacy , Computer-Assisted Instruction/methods , Geriatric Assessment , Humans , Internet/organization & administration , Manuals as Topic , Middle Aged , Needs Assessment , Nurse's Role , Nursing Assessment , Nursing Education Research , Patient Care Planning , Patient Education as Topic/organization & administration , Positive-Pressure Respiration , Program Evaluation , Sleep Apnea, Obstructive/prevention & control , Surveys and Questionnaires , Teaching MaterialsABSTRACT
In the future, more nurses and other healthcare professionals will be providing patient education on the Internet. Having knowledge of processes that lead to quality patient education Web site design is essential. These quality assurance processes include determining the site's purpose, selecting the user population, establishing the expected clinical and learning outcomes, providing an educational framework, incorporating specific design principles, and multiple and ongoing site evaluation. Therefore, Web site development processes designed to undergird quality patient education are presented, and an example Web site is used to illustrate them.
