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    Web-based health interventions for family caregivers of elderly individuals: A Scoping Review. Wasilewski Marina B,Stinson Jennifer N,Cameron Jill I International journal of medical informatics BACKGROUND:For the growing proportion of elders globally, aging-related illnesses are primary causes of morbidity causing reliance on family members for support in the community. Family caregivers experience poorer physical and mental health than their non-caregiving counterparts. Web-based interventions can provide accessible support to family caregivers to offset declines in their health and well-being. Existing reviews focused on web-based interventions for caregivers have been limited to single illness populations and have mostly focused on the efficacy of the interventions. We therefore have limited insight into how web-based interventions for family caregiver have been developed, implemented and evaluated across aging-related illness. OBJECTIVES:To describe: a) theoretical underpinnings of the literature; b) development, content and delivery of web-based interventions; c) caregiver usage of web-based interventions; d) caregiver experience with web-based interventions and e) impact of web-based interventions on caregivers' health outcomes. METHODS:We followed Arksey and O'Malley's methodological framework for conducting scoping reviews which entails setting research questions, selecting relevant studies, charting the data and synthesizing the results in a report. RESULTS:Fifty-three publications representing 32 unique web-based interventions were included. Over half of the interventions were targeted at dementia caregivers, with the rest targeting caregivers to the stroke, cancer, diabetes and general frailty populations. Studies used theory across the intervention trajectory. Interventions aimed to improve a range of health outcomes for caregivers through static and interactive delivery methods Caregivers were satisfied with the usability and accessibility of the websites but usage was generally low and declined over time. Depression and caregiver burden were the most common outcomes evaluated. The interventions ranged in their impact on health and social outcomes but reductions in perception of caregiver burden were consistently observed. CONCLUSIONS:Caregivers value interactive interventions that are tailored to their unique needs and the illness context. However, usage of the interventions was sporadic and declined over time, indicating that future interventions should address stage-specific needs across the caregiving trajectory. A systematic review has the potential to be conducted given the consistency in caregiver burden and depression as outcomes. 10.1016/j.ijmedinf.2017.04.009
    Nursing professionals' experiences of the facilitators and barriers to the use of telehealth applications: a systematic review of qualitative studies. Koivunen Marita,Saranto Kaija Scandinavian journal of caring sciences The aim of the study was to synthesise the best available research evidence on nursing professionals' experiences of the facilitators and barriers to the use of online telehealth services in nursing practice. Telehealth is used to deliver healthcare services and health-related information by means of information and communication technology (ICT). The systematic review of qualitative studies was conducted using thematic synthesis of previous studies. International electronic databases PubMed, CINAHL, Eric, Web of Science/Web of Knowledge and Scopus, and Finnish databases Medic and Ohtanen were searched in spring 2013. In addition, the search was complemented in fall 2015. Following critical appraisal, 25 studies from 1998 to fall 2015 were reviewed and the findings were synthesised. Both facilitators and barriers were grouped into five main categories which were related to nurses' skills and attitudes, nurses' work and operations, organisational factors, patients and technology. The highest number of facilitators and barriers was found in the category focusing on nurses' work and operations. Based on the findings, nurses' skills and attitudes are preventing factors in the implementation of telehealth. There is also a need to focus on patients' role in telehealth usage although the findings support positive adoption of ICT tools among patients. The findings call for further development of technological tools used in nursing practice and healthcare services. The change from traditional face-to-face nursing to the use of telehealth calls for local agreements and further discussions among professionals on how this change will be accepted and implemented into practice. In addition, organisations need to make sure that nurses have enough resources and support for telehealth use. 10.1111/scs.12445
    Web-based videoconferencing for rural palliative care consultation with elderly patients at home. Read Paul Linda,Salmon Charleen,Sinnarajah Aynharan,Spice Ron Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer PURPOSE:Providing specialized palliative care support to elderly patients in rural areas can be challenging. The purpose of this study was to gain a preliminary understanding of the experience of using mobile web-based videoconferencing (WBVC) for conducting in-home palliative care consults with elderly rural patients with life-limiting illness. METHODS:This was a descriptive, exploratory, proof-of-concept study with a convenience sample of 10 WBVC visits. A palliative care clinical nurse specialist (PC-CNS), in the home with the patient/family and home care nurse (HC-N), used a laptop computer with webcam and speakerphone to connect to a distant palliative care physician consultant (PC-MD) over a secure Internet connection. Data was collected using questionnaires, interviews, and focus groups. RESULTS:Analysis of qualitative data revealed four themes: communication, logistics, technical issues, and trust. Participants reported they were comfortable discussing concerns by WBVC and felt it was an acceptable and convenient way to address needs. Audiovisual quality was not ideal but was adequate for communication. Use of WBVC improved access and saved time and travel. Fears were expressed about lack of security of information transmitted over the Internet. CONCLUSIONS:Using WBVC for in-home palliative care consults could be an acceptable, effective, feasible, and efficient way to provide timely support to elderly rural patients and their families. Having a health care provider in the home during the WBVC is beneficial. WBVC visits have advantages over telephone calls, but limitations compared to in-person visits, suggesting they be an alternative but not replacement for in-person consultations. 10.1007/s00520-018-4580-8
    Managing Cancer Experiences: An Interpretive Description Study of Internet Information Use. Haase Kristen R,Gifford Wendy,Holtslander Lorraine,Thomas Roanne Cancer nursing BACKGROUND:People with cancer increasingly use the Internet to find information about their illness. However, little is known regarding people's use of cancer-related Internet information (CRII) to manage their patient experience, defined as patients' cumulative perceptions of interactions with the healthcare system during their illness. OBJECTIVE:The purpose of this study was to create an understanding of CRII use by people newly diagnosed with cancer and how it shapes their patient experience and informs their interactions with healthcare professionals and healthcare services. METHODS:An embedded mixed design guided this study. Nineteen people with cancer were interviewed twice and completed a survey about CRII use. Qualitative data were analyzed using thematic analysis. Descriptive statistics summarized the quantitative findings. RESULTS:Participants of all ages and educational levels reported using CRII as a pivotal resource, across the cancer trajectory. Cancer-related Internet information played a central role in how patients understood their illness and when they sought and used healthcare services. Two themes emerged based on patient interviews: (1) person in context and (2) management of information. CONCLUSION:Cancer-related Internet information plays a crucial role in how people manage their illness and take control of their patient experience. Participants used CRII to learn about their illness, support their efforts to self-manage, and complement information from professionals. IMPLICATIONS FOR PRACTICE:Individuals and institutions can promote and encourage tailored CRII use by engaging patients and suggesting websites based on their needs. Doing so may create efficiencies in service use and empower patients to be more involved in their own care. 10.1097/NCC.0000000000000619
    The effectiveness of extended care based on Internet and home care platform for orthopaedics after hip replacement surgery in China. Wang Jie,Tong Yahui,Jiang Yingqing,Zhu Hongxia,Gao Hui,Wei Rong,Que Xianfeng,Gao Luoluo Journal of clinical nursing AIMS AND OBJECTIVES:To evaluate the effect of an Internet-based home orthopaedic care platform on patients' functional joint recovery, quality of life and activities of daily living after hip replacement. BACKGROUND:Most of the functional exercises after arthroplasty are performed outside the hospital. At present, the WeChat platform is used mainly in the inland of China for continuous nursing of patients with chronic disease in the Department of Orthopedics. DESIGN:An experimental design was applied. METHODS:Four hundred patients who had undergone hip replacement from April to October 2016 were selected from 18 hospitals with nurse specialists in clinical orthopaedics. These patients were randomised into control and intervention groups (n = 200 per group). In the control group, only routine nursing care was carried out after discharge. In the intervention group, continuous intervention was performed via the Internet-based orthopaedic care platform. The patients in the two groups were compared in terms of functional recovery (Harris hip score), quality-of-life score (MOS SF-36) and activities of daily living (Barthel index) at 3 and 6 months after discharge. RESULTS:In total, 389 patients were enrolled in this study. There were no significant differences in the baseline data between the two groups. After 6 months of continuous intervention, the mean MOS SF-36 score, Barthel index and Harris hip score in the intervention group were significantly higher than those in the control group. CONCLUSION:The study gives full play to the role of clinical nurse specialists and provides professional home care services to patients in the region after hip replacement through home care orthopaedic platform. The platform guides the patients to master the correct disease knowledge and rehabilitation exercise methods, promotes the recovery of joint function, improves the activity of daily living, elevates the quality of life and meets the need of long-term management. RELEVANCE TO CLINICAL PRACTICE:Internet and home care orthopaedic platform is a nursing system designed specifically for extended care management outside of the hospital, which is helpful for patients who undergone hip replacement to obtain effective home care services after discharge, improving patients' quality of life and rehabilitation efficacy. 10.1111/jocn.14545