2.50
Hdl Handle:
http://hdl.handle.net/10755/157383
Type:
Presentation
Title:
TELEMONITORING AND HEART FAILURE OUTCOMES
Abstract:
TELEMONITORING AND HEART FAILURE OUTCOMES
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Vallina, Helen Y., MS
P.I. Institution Name:The University of Arizona
Title:Doctoral Student
Contact Address:1305 N Martin, Tucson, AZ, 60446, USA
Co-Authors:Judith Effken
PURPOSE/AIMS: The purpose of this study is to compare the differences between home health care only and home health care plus telemonitoring on heart failure patients' symptom burden, self-care of heart failure and hospital admission.
RATIONALE/CONCEPTUAL BASIS/BACKGROUND: Heart failure has emerged as a major public health burden. Although only 14% of Medicare beneficiaries have heart failure, they account for 43% of Medicare expenditures. Like other chronic conditions, heart failure patients have an important role to play in the day-to-day management of their condition. One of the principal reasons for introducing telemonitoring in home health care was to increase heart failure patients' capacity to self-manage their conditions at home.
METHODS: This study used a prospective, non-experimental, comparative, descriptive design. Participants in the home health care plus telemonitoring (HHC plus TM) group were recruited from a telemonitoring program in the recruitment site. Participants in the home health care only (HHC only) group were recruited from patients who met the inclusion criteria but did not enroll in the telemonitoring program. A total of 68 participants were recruited with 34 in each group. The Memorial Symptom Assessment Scale - Heart Failure was used to assess symptom burden and the Self-Care of Heart Failure Index was used to measure 3 dimensions of heart failure self-care (self-care maintenance, heart failure management and self-confidence) on enrollment and 40 days later. Hospitalization was measured as an event that either occurred or did not, as opposed to the number of hospitalization.
RESULTS: Although no between-group differences in symptom burden were found, both groups showed significant decreased symptom burden (19% in the HHC only group and 14% in the HHC plus TM group) over the 40-day period. Of the three self-care measures, only self-care maintenance differed significantly between the two groups at the 40-day follow-up (p < .05). The HHC only groupÆs score dropped 5.5% while the HHC plus TM group remained stable. The HHC plus TM group had 17.7% more hospital admissions than the HHC only group over the 40-day period.
IMPLICATIONS: The addition of telemonitoring produced similar outcomes to regular home health care, except for self-care maintenance. Like most prior studies, this study focused on evaluating the overall relationship between telemonitoring and outcomes without concern for the transformation process. Although these evaluations were able to provide an overall assessment of whether or not the telemontiroing program worked, they cannot identify the underlying mechanisms that generate the effects. Without knowing what made the program work or not work, it is difficult to pinpoint what needs to be done for future improvement. A theory-oriented evaluation will be needed in future research. Theory-oriented evaluations not only allow researchers to clarify the connection between a program's operation and its effect, but also to specify intermediate effects of a program that might become evident and measurable.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleTELEMONITORING AND HEART FAILURE OUTCOMESen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157383-
dc.description.abstract<table><tr><td colspan="2" class="item-title">TELEMONITORING AND HEART FAILURE OUTCOMES</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Vallina, Helen Y., MS</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The University of Arizona</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Doctoral Student</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1305 N Martin, Tucson, AZ, 60446, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">hvallina@nursing.arizona.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Judith Effken</td></tr><tr><td colspan="2" class="item-abstract">PURPOSE/AIMS: The purpose of this study is to compare the differences between home health care only and home health care plus telemonitoring on heart failure patients' symptom burden, self-care of heart failure and hospital admission.<br/>RATIONALE/CONCEPTUAL BASIS/BACKGROUND: Heart failure has emerged as a major public health burden. Although only 14% of Medicare beneficiaries have heart failure, they account for 43% of Medicare expenditures. Like other chronic conditions, heart failure patients have an important role to play in the day-to-day management of their condition. One of the principal reasons for introducing telemonitoring in home health care was to increase heart failure patients' capacity to self-manage their conditions at home.<br/>METHODS: This study used a prospective, non-experimental, comparative, descriptive design. Participants in the home health care plus telemonitoring (HHC plus TM) group were recruited from a telemonitoring program in the recruitment site. Participants in the home health care only (HHC only) group were recruited from patients who met the inclusion criteria but did not enroll in the telemonitoring program. A total of 68 participants were recruited with 34 in each group. The Memorial Symptom Assessment Scale - Heart Failure was used to assess symptom burden and the Self-Care of Heart Failure Index was used to measure 3 dimensions of heart failure self-care (self-care maintenance, heart failure management and self-confidence) on enrollment and 40 days later. Hospitalization was measured as an event that either occurred or did not, as opposed to the number of hospitalization.<br/>RESULTS: Although no between-group differences in symptom burden were found, both groups showed significant decreased symptom burden (19% in the HHC only group and 14% in the HHC plus TM group) over the 40-day period. Of the three self-care measures, only self-care maintenance differed significantly between the two groups at the 40-day follow-up (p &lt; .05). The HHC only group&AElig;s score dropped 5.5% while the HHC plus TM group remained stable. The HHC plus TM group had 17.7% more hospital admissions than the HHC only group over the 40-day period.<br/>IMPLICATIONS: The addition of telemonitoring produced similar outcomes to regular home health care, except for self-care maintenance. Like most prior studies, this study focused on evaluating the overall relationship between telemonitoring and outcomes without concern for the transformation process. Although these evaluations were able to provide an overall assessment of whether or not the telemontiroing program worked, they cannot identify the underlying mechanisms that generate the effects. Without knowing what made the program work or not work, it is difficult to pinpoint what needs to be done for future improvement. A theory-oriented evaluation will be needed in future research. Theory-oriented evaluations not only allow researchers to clarify the connection between a program's operation and its effect, but also to specify intermediate effects of a program that might become evident and measurable.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:49:23Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:49:23Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.