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EFFECTIVENESS OF VIDEO-VISITS IN PALLIATIVE HOME CARE: PRELIMINARY FINDINGS OF AN RCT IN THE COMMUNITY

机译：姑息家庭护理中视频访问的效果：社区RCT的初步调查结果

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Background Studies have demonstrated effectiveness of home telehealth technology to deliver health care services, however challenges remain in understanding integration of the technology into routine care. Evidence of clinical effectiveness and cost-effectiveness on a population level, as well as the readiness of both clients and health care professionals is still required. Method A 36-month multi-method study (2003-2006) is currently underway in 4 health regions and 11 home care offices serving rural communities in the province of Alberta, Canada. Two study questions address the need for evidence on the effectiveness of home telehealth in terms of quality of life and symptom management, as well as on cost effectiveness. The third question addresses clients' and nurses' readiness to use the technology. Two hundred clients are being recruited and randomly assigned to routine home care or routine care plus video-visits. Preliminary Results As of March 2005, 30 clients have completed an average of 5.6 weeks of the proposed 8-week study period. Client recruitment has proven more challenging than expected due to factors such as regional variability in the definition of palliative, difficulty meeting eligibility criteria and factors in the work environment. Clients with high care requirements have not been represented in the sample, which may reflect a disease severity not suitable for video care. Nurses determined approximately 30% of their visits could have been conducted via videophone, with most clients very positive about the experience. Conclusion Implementing home telehealth technology on a population level introduces new challenges. Economic benefits may not be evident; however, a demonstrated improvement in quality of life may provide the incentive to proceed.
机译：背景研究已经证明了家用远程医疗技术在提供医疗保健服务方面的有效性，但是在理解将技术集成到常规医疗保健方面仍然存在挑战。仍然需要在人群水平上有临床效果和成本效益的证据，以及客户和医疗保健专业人员的准备程度。方法目前正在进行为期36个月的多方法研究（2003年至2006年），该研究在加拿大艾伯塔省的4个健康地区和11个家庭护理办公室为农村社区提供服务。有两个研究问题解决了在生活质量和症状管理以及成本效益方面需要有关家庭远程医疗有效性的证据的需求。第三个问题是服务对象和护士准备使用该技术的问题。正在招募200位客户，并将他们随机分配到例行家庭护理或例行护理以及视频访问。初步结果截至2005年3月，有30位客户平均完成了建议的8周学习期的5.6周。由于诸如姑息治疗定义的地区差异，难以满足资格标准和工作环境中的因素等因素，事实证明，招募客户比预期更具挑战性。样本中没有代表具有较高护理要求的客户，这可能反映出不适用于视频护理的疾病严重程度。护士们确定大约30％的探视可以通过可视电话进行，而大多数客户对该体验非常满意。结论在人口水平上实施家庭远程医疗技术带来了新的挑战。经济利益可能并不明显;但是，生活质量的明显改善可能会为继续前进提供动力。

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