Implementation and Efficacy Assessment of a Telenursing Intervention Model for Promoting Self-monitoring of Elderly Patients with Chronic Heart Failure

Abstract

Purpose: This study aims to propose a telenursing intervention model for assisting the self-monitoring of elderly patients with chronic heart failure and ascertain its efficacy in lowering the risk for hospitalization and the maintenance and improvement of patients' quality of life (QOL). Methods: Nursing intervention was provided through video calls for one year to patients aged ≥65 years with chronic heart failure who had frequently been hospitalized. The following items were compared and investigated: patients' number and duration of hospitalization before, during, and after the intervention along with their weight, blood pressure, brain natriuretic peptide (BNP) values, and QOL. Results: Video call nursing intervention was provided to 11 patients. The mean length of calls was 11.5 ± 3.6 min/session. Patients were hospitalized two to five times a year before the intervention , but nine were not hospitalized even once during the intervention period; of these, five were never hospitalized during the year following the completion of the intervention. No apparent changes were observed in parameters such as the BNP value; however, the scores for the psychological questions of the SF-36® used to assess post-intervention QOL were significantly higher. Conclusion: This study confirms the efficacy of the telenursing intervention model for giving successive sessions of rapid and intensive intervention, customized for each patient to enhance their QOL and prevent hospitalizations. The preventive impact on hospitalization continued to last after the completion of the intervention period, suggesting that it effectively contributed to strengthening the self-monitoring abilities of patients living in their homes. 要 旨 目的：慢性心不全患者への遠隔看護介入モデルが入院リスクの軽減，QOL の維持・向上に有用である かを検証する． 方法：入院を繰り返す 65 歳以上の慢性心不全患者 11 名にビデオ通話による看護介入を 1 年間実践し， 受付日：2018 年 6 月 5 日 受理日：2018 年 11 月 2 日