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Supported by telecare PD-research project

Supported by telecare PD-research project. Aase Riemann Amsterdam PD-consult EDTNA/ERCA. Telecare. Content. Use of telecare Project Telediavisie Structure Design Discussion. Telecare. Growing international interest western countries growing techological developments

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Supported by telecare PD-research project

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  1. Supported by telecarePD-research project Aase Riemann Amsterdam PD-consult EDTNA/ERCA

  2. Telecare

  3. Content • Use of telecare • Project Telediavisie • Structure • Design • Discussion

  4. Telecare • Growing international interest • western countries • growing techological developments • patient selfmanagement • complex problems in care • growing numbers of elderly • shortage of nurses

  5. Use telecare • Communication and contacts • screens, video • Monitoring • devices, • bloodsugar, natrium, O2 • Information • patient files • Education • patient websites • Entertainment

  6. Effects, results research • Emotional support and better quality of life • Feelings of safety • More time and less stress also for family • Less hospital visits Tinker 2010, Peeters 2010, Axelsson, 2010

  7. Effects of telecare • A better ADL and cognitive scores in 225 elderly with diabetes, hypertension and COPD (m/R) Telemed JEHealth, 2004 • Better quality of life, lung-function and O2-content in 300 patients with asthma (m/R) Journal of Allergy and Clinical immunologie, 2005 • Better bloodsugars in 30 patients > 60 yr with diabetes (v/e/R) Telemed JEHEalth 2006

  8. Effects of telecare • Better blood sugars and LDL/Cholesterol in1665 patients with diabetes (v/m/i/e/R) Trans Am Clin Climatol Association, 2007 • Better support and education for patients with cancer – numbers pt.? (v) Int J geriatric Psychiatric, 2009 • Acceptance of applications, no difference in quality of life for 83 patients with HIV (v/p/e/R) ICMCC database 2011

  9. Effects telecare • Great satisfaction, high levels of selfmanagement, feelings of safeness in 20 mentally handicapped grown-ups Journal Cordaan, 2011 • Virtual Hospital, use of video-screens and monitoring by 175 discharged patients with COPD (v/m/R), • no results yet • cost analysis Virtual Hospital Frederiksberg/Herlev 2010

  10. Telediavisie, a PD-project • Patients with PD-treatment • Use of video-screens • connections with other applications • Project • implementation and research • specially for PD-nurses • To start in October 2011

  11. Thesis • Better care and support • Safety for patients and family • Improvement selfmanagement • Less complications • Less visits and admittances to hospital

  12. Patients • 25 patients • already doing PD or after training • 2 centers • Inclusion of patients by nurses • will ask patients

  13. Interventions • Video screens instead of telephones • Acute situations • peritonitis • exit-site infections • fluid-problems • problems with homechoice or exchanges

  14. Instructions • Video screen instead of telephone • Instructions to • exchanges • building up home-choice • antibiotics injection in bags • hygiene • washing hands

  15. Virtual house visits • Video screens instead of house visits • Prevention • hygiene • medicine • counseling • familily and district nurses • specially after discharge hospital

  16. Participants • Quality Institute Nephrology • Hans Mak Institute • interviews and data • Support • Counsellor • working in centers • presentations, implementation, data gathering, crisis management, interviews • Expert telecare • contact and implementation ICT

  17. Aim 1 and approach • Applications, list of demands ↓ • Focusgroupe • Users, patients, professionals

  18. Aim 2 and approach • Are users satisfied? ↓ • Installing screens • Education users • Interviews

  19. Aim 3 and approach • Opinion users • patients, family and professionals • satisfaction • selfmanagement ↓ • Interviews with patients and family • Interviews nurses • self- reports • Data • Quantitative • Health-records

  20. Aim 4 and approach • Looking for answers • does the programme work? • do’s and don’t’s • difference using screens instead of telephones? • which barriers and problems? ↓ • Conclusion and report

  21. Primairy outcomes • Contacts between patients and professionals • telephone contacts versus screens • virtual home visits • medical data • kt/v • hb, calc/phosphate, glucose • events, visits out patient clinic, admittance hospital

  22. Secondary outcomes • Satisfaction with application • Level of safety • Level of selfmanagement

  23. Design • Evaluation research • form of research that involves finding out how well a program, practice or procedure is working • non-experimental design • developing a methode to measure behaviour under study • -collecting qualitative and quantitative data Polit F, Hungler P, 1995

  24. Quality • Theory • Bandura’s theory about selfmanagement • Qualitative interviews • validated • self-reports professionals

  25. Quantity • During whole programme • health-care records • electronically

  26. Challenges • Complex intervention • Technical challenges • Other ways of organising work • acceptance professionals

  27. End • ‘It seems that telecare is more difficult to implement than we thought’ • ‘We have seen great telecare projects being not succesfull because somebody had forgotten to involve the nurses and doctors who must work with it’. Wootton R, Norwegian Center of telemedicin, 2011

  28. Telediavisie

  29. Discussion and questions

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