Telehealth for persons with severe functional disabilities and their caregivers: Facilitating self-care management in the home setting.

Abstract

Persons with severe functional disabilities are the highest users of health care services. Caring for the needs of this population represents a significant percentage of our national health care costs. A growing body of research has demonstrated the efficacy of self-management strategies and caregiver engagement for effective long-term care for individuals with chronic medical conditions. Economic forces over the past decade have led to new challenges and resulted in major changes in health care delivery resulting in shortened length of inpatient stays and greater limits on the length of outpatient treatment. Telehealth is an innovative method for health care delivery and a means of meeting this new challenge. This paper highlights the findings of three pilot studies on the use of telecommunications technologies in promoting self-care management and enhancing health care outcomes in persons with severe disabilities and their family caregivers. The importance of matching technology to the needs of this population, lessons learned from these investigations, and future directions for research are addressed.

Telerehabilitation and recovery of motor function: a systematic review and meta-analysis

“…Among these 64 papers were excluded for the following reasons: 35 because the ICTs used were not aimed to rehabilitation purposes ; eight papers were protocols of ongoing studies and results were not available [52][53][54][55][56][57][58][59] ; seven studies did not have a control group [60][61][62][63][64][65][66] ; five because the intervention setting was the same in the two groups 8,[67][68][69][70] ; five were pilot studies [71][72][73][74][75] ; two were secondary analysis of RCTs already included 76,77 ; two studies were excluded because the poor reporting precluded any possible assessment of its eligibility 78,79 . Finally, 12 RCTs for a total of 1047 participants were included in the review ( Figure 1).…”

Upper Limb Rehabilitation Following Stroke: Current Evidence and Future Perspectives

“…Both groups improved but there were no significant differences in outcomes between the groups post intervention [89] . While the potential advantages are obvious, systematic reviews are inconclusive focusing on the highly selected populations, the absence of older people with cognitive impairment in the studies and the lack of information on cost effectiveness [90,91].…”

Telehealth Nursing Effectiveness in Stroke Patients

“…Findings suggest that telestroke network usage seems to be beneficial in managing acute ischemic stroke and may decrease the need for transfer, optimizing the stroke therapy to shorten the hospital stay and to increase the discharge home, with additional financial benefit and cost-saving for the hospital [9]. The use of telehealth and telecommunications technologies helps in promoting self-care management and enhancing health care outcomes in persons with stroke and severe disabilities and is favored by family as well as caregivers [11,12]. Telestroke is aiming to increase patient access, at a lower cost while maintaining the quality of health care[ Figure 3]The importance of matching the telestroke technology to the needs of the population, lessons learned from these investigations, and future directions for research are addressed in these papers [12,13,14].…”

“…The most recent article was published in September, 2017, we can easily observe the timely relevance of the topic of telehealth, nursing and stroke. Four of the selected articles were pertaining to telehealth nursing management and education for stroke patients(10%, n=4) [24,25,27,31], two articles were about the benefits of telestroke for speedy discharge and recovery(5.4%, n=2) [29,34], seven were about telehealth nursing education and care for stroke patients as well as caregivers(18.92%, n=7) [11,12,30,32,33,34,36], two covered the topic of a stroke-specific, care coordination home telehealth (CCHT) program (5.4%,n=2) [18,19], two were related to acceptance of telestroke by caregivers in home setting(5.4%, n=2) [25,37], five articles emphasized how telehealth and such techniques help in savings and decrease stroke patient cost( 13.5%,n=5) [3,14,17,22,28], seven more papers discussed how telemedicine is considered along with other strategies to manage stroke(18.92%, n=7) [7,15,16,20,23,38,39], six papers described the methods in which acute ischemic stroke is managed in emergency medicine with telehealth and related techniques(16.27%,n=6) [2,6,8,9,13,35] and two articles covered how telehealth helps in diagnosis of stroke(5.4%, n=2) [15,29]. Findings suggest that telestroke network usage seems to be beneficial in managing acute ischemic stroke and may decrea...…”

“…The use of telehealth and telecommunications technologies helps in promoting self-care management and enhancing health care outcomes in persons with stroke and severe disabilities and is favored by family as well as caregivers [11,12]. Telestroke is aiming to increase patient access, at a lower cost while maintaining the quality of health care[ Figure 3]The importance of matching the telestroke technology to the needs of the population, lessons learned from these investigations, and future directions for research are addressed in these papers [12,13,14].…”