Tools to Support Self-Care Monitoring at Home: Perspectives of Patients with Heart Failure

Aamodt, Ina Thon; Strömberg, Anna; Hellesø, Ragnhild; Jaarsma, Tiny; Lie, Irene

doi:10.3390/ijerph17238916

Cited by 12 publications

(12 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Deficiencies in communication and its sub-categories (Issues with technology inhibits contact, Lacking personal contact, Unexpressed aims and expectations) clarify which factors inhibited meaningful use and challenged PCC implementation. These findings confirm previous reports on limited access as the main obstacle to digital platform usage [ 30 ] and the lack of face-to-face contact in remote interventions [ 31 , 32 ]. Our qualitative findings on communication barriers were congruent with our quantitative findings, showing a lower adoption of digital platform use than telephone support.…”

Section: Discussionsupporting

confidence: 91%

Meaningful use of a digital platform and structured telephone support to facilitate remote person-centred care – a mixed-method study on patient perspectives

Barenfeld

Fuller

Wallström

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

Background Process evaluations are useful in clarifying results obtained from randomised controlled trials (RCTs). Traditionally, the degree of intervention usage in process evaluations is monitored by measuring dose or evaluating implementation fidelity. From a person-centred perspective, such evaluations should be supplemented with patients’ experiences of meaningful use, given that intervention use should be agreed upon between interested parties and tailored to each patient. This study aimed to elucidate patients’ experiences of a remote person-centred care (PCC) intervention by deepening the understanding of, if, how and for whom the intervention contributed to meaningful use. Methods Patients (n = 86) were recruited from the RCT PROTECT intervention group. A convergent mixed-method approach was implemented. Data were collected in parallel with the ongoing RCT via a survey, including ratings and written comments on meaningful or non-meaningful use. Also, interviews were performed with twelve purposefully selected participants. Descriptive statistics, logistic regression and content analysis were employed. Data sources were integrated in the results. Results Most participants rated the overall intervention as meaningful to use, with the telephone support rated as most meaningful. Interviews and written comments showed that patient ratings on meaningful use were explained by four categories: Not in need, Communication deficiency, Benefits in everyday life and A personal boost. Meaningful use of rating symptoms on the digital platform was predicted by living alone (adjusted odds ratio [aOR] = 2.8 P = .044). A diagnosis of chronic obstructive pulmonary disease (COPD) predicted meaningful use of digital platform direct messaging (aOR = 3.5, P = .045). Moreover, having access to direct-dial telephone contact explained meaningful use among participants with low ratings of technical competence (aOR = 3.6, P = .014). Conclusions The combined digital platform and structured telephone support could be helpful in identifying preventive actions to maintain health for people diagnosed with COPD and chronic heart failure but tends to be more meaningful for those diagnosed with COPD. Overall, lower adoption of the digital platform was seen compared to telephone support. Shortcomings were noted in the digital platform’s implementation that negatively influences experiences of meaningful use. When used, the intervention proved to be an easily applicable and valued tool to support preventive actions in a person-centred manner.

show abstract

Section: Discussionsupporting

confidence: 91%

Meaningful use of a digital platform and structured telephone support to facilitate remote person-centred care – a mixed-method study on patient perspectives

Barenfeld

Fuller

Wallström

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…An important finding for HCPs is that when using self-care tools for home monitoring, our patients with CHF emphasized that they did not want to read or be reminded of CHF. This may be a way for people with CHF to cope with everyday life [8]. It also highlights the need for HCPs to listen to their patients' concerns and individualize care accordingly.…”

Section: Principal Findingsmentioning

confidence: 99%

“…Therefore, self-management strategies that enhance self-efficacy are crucial to optimize [4] and strengthen preventive approaches in primary care [5]. Digital solutions have been suggested as a safe option for addressing health care challenges and promoting self-management of chronic conditions such as COPD and CHF [6][7][8]. However, most digital solutions lack user involvement in the development of the platform [9].…”

Section: Introductionmentioning

confidence: 99%

Effects of Person-Centered Care Using a Digital Platform and Structured Telephone Support for People With Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Randomized Controlled Trial

Ali¹,

Wallström²,

Fors³

et al. 2021

J Med Internet Res

View full text Add to dashboard Cite

Background Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) are characterized by severe symptom burden and common acute worsening episodes that often require hospitalization and affect prognosis. Although many studies have shown that person-centered care (PCC) increases self-efficacy in patients with chronic conditions, studies on patients with COPD and CHF treated in primary care and the effects of PCC on the risk of hospitalization in these patients are scarce. Objective The aim of this study is to evaluate the effects of PCC through a combined digital platform and telephone support for people with COPD and CHF. Methods A multicenter randomized trial was conducted from 2018 to 2020. A total of 222 patients were recruited from 9 primary care centers. Patients diagnosed with COPD, CHF, or both and with internet access were eligible. Participants were randomized into either usual care (112/222, 50.5%) or PCC combined with usual care (110/222, 49.5%). The intervention’s main component was a personal health plan cocreated by the participants and assigned health care professionals. The health care professionals called the participants in the intervention group and encouraged narration to establish a partnership using PCC communication skills. A digital platform was used as a communication tool. The primary end point, divided into 2 categories (improved and deteriorated or unchanged), was a composite score of change in general self-efficacy and hospitalization or death 6 months after randomization. Data from the intention-to-treat group at 3- and 6-month follow-ups were analyzed. In addition, a per-protocol analysis was conducted on the participants who used the intervention. Results No significant differences were found in composite scores between the groups at the 3- and 6-month follow-ups. However, the per-protocol analysis of the 3-month follow-up revealed a significant difference in composite scores between the study groups (P=.047), although it was not maintained until the end of the 6-month follow-up (P=.24). This effect was driven by a change in general self-efficacy from baseline. Conclusions PCC using a combined digital platform and structured telephone support seems to be an option to increase the short-term self-efficacy of people with COPD and CHF. This study adds to the knowledge of conceptual innovations in primary care to support patients with COPD and CHF. Trial Registration ClinicalTrials.gov NCT03183817; http://clinicaltrials.gov/ct2/show/NCT03183817

show abstract

“…Informal caregivers, such as spouses or family members, are important for supporting self-care in persons with heart failure [ 3 ] for monitoring changes of physical symptoms at home [ 4 ], or for managing these symptoms [ 5 , 6 ]. A caregiver’s burden may impact their ability and willingness to contribute as much as expected from the specialized and community health care services [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Informal caregivers of persons with chronic conditions using remote monitoring of vital signs at home expressed a feeling of empowerment and improved care [ 15 ]. A study of the active involvement of the informal caregiver performing non-invasive measurements at home using telemonitoring reports findings of improved self-care behavior for HF patients in NYHA class III-IV [ 4 ]. Other studies using non-invasive home telemonitoring in HF care present neutral findings on all-cause hospitalizations and all-cause death [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Informal Caregivers’ Experiences with Performing Telemonitoring in Heart Failure Care at Home—A Qualitative Study

et al. 2022

Self Cite

View full text Add to dashboard Cite

Informal caregivers have an important role in caring for family members at home. Supporting persons with a chronic illness such as heart failure (HF) in managing their self-care is reported to be a challenge and telemonitoring has been suggested to be of support. Aim: to explore informal caregivers’ experiences with performing non-invasive telemonitoring to support persons with HF at home for 30 days following hospital discharge in Norway and Lithuania. Methods: A qualitative explorative study of informal caregivers performing non-invasive telemonitoring using lung-impedance measurements and short message service (SMS). Data was collected using semi-structured interviews with informal caregivers of persons with HF in NYHA class III-IV in Norway and Lithuania. Results: Nine interviews were conducted with informal caregivers of persons with HF who performed non-invasive telemonitoring at home. A sequential process of three categories emerged from the data: access to support, towards routinizing, and mastering non-invasive telemonitoring. Conclusion: Informal caregivers performed non-invasive telemonitoring for the first time in this study. Their experiences were of a sequential process that included access to support from health care professionals, establishing a routine together, and access to nurses or physicians in HF care as part of mastering. This study highlights involving informal caregivers and persons with HF together in the implementation and future research of telemonitoring in HF care.

show abstract

Tools to Support Self-Care Monitoring at Home: Perspectives of Patients with Heart Failure

Cited by 12 publications

References 43 publications

Meaningful use of a digital platform and structured telephone support to facilitate remote person-centred care – a mixed-method study on patient perspectives

Meaningful use of a digital platform and structured telephone support to facilitate remote person-centred care – a mixed-method study on patient perspectives

Effects of Person-Centered Care Using a Digital Platform and Structured Telephone Support for People With Chronic Obstructive Pulmonary Disease and Chronic Heart Failure: Randomized Controlled Trial

Informal Caregivers’ Experiences with Performing Telemonitoring in Heart Failure Care at Home—A Qualitative Study

Contact Info

Product

Resources

About