Grant-in-Aid for Scientific Research (B)
|Allocation Type||Single-year Grants |
Community health/Gerontological nurisng
|Research Institution||St.Luke's College of Nursing |
KAMEI Tomoko St.Luke's College of Nursing, Department of Nursing, Associate Professor, 看護学部, 助教授 (80238443)
KAJII Fumiko St.Luke's College of Nursing, Department of Nursing, Lecturer, 看護学部, 講師 (40349171)
YAMADA Tsuyako St.Luke's College of Nursing, Department of Nursing, Assistant, 看護学部, 助手 (00290057)
KAMEI Nobuaki University of Meisei, School of Engineering, Associate Professor, 理工学部, 助教授 (20233968)
久代 和加子 聖路加看護大学, 看護学部, 講師 (10286908)
|Project Period (FY)
2003 – 2006
Completed (Fiscal Year 2006)
|Budget Amount *help
¥14,600,000 (Direct Cost: ¥14,600,000)
Fiscal Year 2006: ¥1,200,000 (Direct Cost: ¥1,200,000)
Fiscal Year 2005: ¥2,500,000 (Direct Cost: ¥2,500,000)
Fiscal Year 2004: ¥6,200,000 (Direct Cost: ¥6,200,000)
Fiscal Year 2003: ¥4,700,000 (Direct Cost: ¥4,700,000)
|Keywords||Home Oxygen Therapy / Chronic Respiratory Failure / Telenursing / Telenurs / Telecare / Telementoring / Telemedicine / Telemonitoring / 遠隔看護システム / 急性増悪 / 遠隔看護 / 問診システム|
We developed the Life Management Telenursing System for Home Oxygen Therapy (LMS-HOT) for chronic respiratory failure patients to prevent acute exacerbation of respiratory failure and detect it early.
LMS-HOT consists of four systems administered by the nursing monitoring center : internet terminals in the patient's home for physical and mental self-assessment ; telemonitoring with literature-based algorithms that trigger individualized response messages; the server supporting the interactions and care system; and educational systems to guide patient compliance.
Five volunteers (a sixth withdrew at day 6 due to another disease) used this system for more than two months (total 953 days experience). Their self-monitoring data, system responses, and patient responses to the Health-Related QOL SF-36 and statements about using LMS-HOT provided data for our evaluation.
1. Patients submitted 876 reports. 701 possible exacerbation episodes were identified when one or more parameters triggered the
emergency alarm, an over-all incidence rate of 80%. Of the possible exacerbation episodes, 67.1% were judged to be emergencies ; the number of emergencies per reports per patient varied (4/55, 48/230, 301/340, 71/79, 164/172). On the day of triggering parameters were significantly lower for SpO_2, peak flow, pulse rate, systolic blood pressure, body temperature, Borg scale score, and daily total points. There were no hospital readmissions.
2. HR-QOL (SF36) was improved in function related to physical (RP), body pain (BP), vitality (VT) but changes were not statistically significant.
3 The patients reported that LMS-HOT alleviated anxieties in daily life, resolved problems at early stage, improved self-care consciousness, and provided a sense of security.
4. The cost of maintaining a patient at home using LMS-HOT was 25% of a usual readmission hospital stay.
5. We organized two telementoring seminars in 2006-2007 attended by 146 people (37.7% nurses ; 29.5% other health professionals ; 32.9% others). 87.5% gave positive evaluations. We prepared a telementoring textbook and distributed it to each participant. Less