Feasibility of In-Home Telehealth for Conducting Nursing Research

Abstract

The purpose of this study was to determine the feasibility of using home audio/ video telehealth equipment for administering nursing interventions to families, observing the client response, and collecting research data over specific intervals of time. The study design was a descriptive comparison with observational data collection. The subjects were adult patients (n = 5) using nighttime mechanical ventilators for obstructive sleep apnea and their home caregivers (n = 7). Skin color vital signs, spirometry, and pulse oximetry data collected simultaneously through telehealth equipment and through nurse observation in the home were the same. Care and the caregiver's use of the patient equipment were also observed. When nursing interventions, equipment demonstrations, visual illustrations, and audiotaped educational directions were used to facilitate patient care, they were transmitted across telehealth with a few exceptions. Costs of telehealth visits were less than traditional home visits, and client evaluations of telehealth were positive.

Economic Evaluation of Manitoba Health Lines in the Management of Congestive Heart Failure

“…For telephone support versus usual care, eight RCTs 52,69,70,72,73,75,79,81 and two observational studies 77,82 evaluated the number of patients who were rehospitalized (all-cause). The pooled outcomes of the RCTs 52,69,70,72,73,75,79,81 showed a fewer number of patients who were using telephone support were rehospitalized (RR=0.91; 95% CI 0.83 to 0.99) (Table 3a, Figure 5).…”

“…Heart failure Twenty studies [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67] compared home telemonitoring with usual care, and 18 studies 52,56,57,[68][69][70][71][72][73][74][75][76][77][78][79][80][81][82] compared telephone support with usual care. Three studies 52,56,57 had three comparative arms: home telemonitoring, telephone support, and usual care.…”

“…Of the 20 studies in the home telemonitoring versus usual care comparison, 11 were RCTs, 48,49,51,52,[54][55][56][57][58]64,67 and nine were observational studies. 50,53,[59][60][61][62][63]65,66 Thirteen RCTs 52,56,57,[69][70][71][72][73]75,76,78,79,81 and five observational studies 68,74,77,80,82 compared telephone support with usual care. Appendix 4b includes a description of the intervention and comparator of each study.…”

“…Twenty-seven studies were from the US; [48][49][50]53,[55][56][57][59][60][61][63][64][65][66][68][69][70][71][72][74][75][76][77][78][79][80]82 two studies were from Canada; 67,81 one study was from the UK; 58 two studies were from Italy; 51,54 one study was from the Netherlands, UK, and Germany; 52 one study was from Argentina; 73 and one study was from Israel. 62 Six studies received funding from industry alone, 55,58,67,70,78,81 14 studies were funded by government alone, 48,49,51,54,56,[63][64]…”

“…In the quality assessment of the 21 RCTs, 10 were rated A, 49,52,54,64,69,70,73,76,79,81 six were rated B, 51,55,56,67,71,75 three were rated C, 48,72,78 and two were rated D. 57,58 Of the 14 observational studies, two were rated B, 50,63 three were rated C, 53,61,62 eight were rated D, 59,60,66,68,74,77,80,82 and one was rated E. 65 …”