Page 268 - Encyclopedia of Nursing Research

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mechanical system that has led to Food and of both published reviews are that there
Drug Administration’s approval for clinical is strong evidence indicating the benefits
trials conducted by nurses. Government reg- of home telecare for home chronic disease H
ulation also has called for research on the management and growth in these services.
manuals accompanying devices to determine picture phone use for hospice care has been
readability and effectiveness of instructions well received by caregivers and verified as
for laypersons. cost effective, although social workers have
In 1996, the National Academy of Science found it is underused (Glasgow, 2007).
presented a report to the congress from man- A cochrane review of seven clinical tri-
ufacturers, regulators, health professionals, als concluded that picture phones were reli-
families, and patients regarding findings from able, well accepted by patients and family,
research on safety and issues of home technol- and without detrimental effects but that clin-
ogies and family care. problems to be studied ical outcomes and cost research was lacking
included the impact of family caregiver quality (collins, Murphy, & Strecher, 2007; currell,
of life (Smith, Hunt, czaja, Juhn, & Kelly, 2002), Urquhart, Wainwright, & lewis, 2001; lytle,
the ethical decision making in use of technol- 2002). clinical trials of in-home picture phone
ogies, the costs of safety regulations for manu- visits by nurses found significant improve-
facturers, and the quality control measures for ment in treatment adherence in an older pop-
home care (Schulz, lustig, Hondler, & Martire, ulation at costs much lower than delivering
2002). problems to be studied included the traditional home nursing visits (Smith, Dauz,
impact of technologies on patients and fam- clements, cook, & Doolittle, 2006).
ily caregivers’ quality of life, ethical decision recently summarized clinical trials data
making in use of technologies, costs of safety identified several efficacious Internet-based
regulations for all technologies, and quality interventions related to chronic disease
control measures for home devises. patient education, interactive support, treat-
Major conclusions from research are that ment follow-up, and home problem man-
home care technologies enhance and extend agement guides (Glasgow, 2007). effective
quality of life for those who would otherwise informatics technology interventions such
succumb to illness, frailty, or disability. Further, as step-by-step algorithms for guiding daily
family members are very capable and desirous technology procedures, video scene illustra-
of home care for their technology-dependent tions of technologic health care equipment
loved one. Direct physical care and indirect assembly, and contacts between health pro-
costs (reduced income, innumerable expenses, fessionals and families have been successful
and transportation fees) are shifted to the fam- (Smith, 2011; Smith et al., 2005).
ily, and evidence of emotional and physical Future directions for research include
strain occurs in family caregivers. Delivery the need for continued study of informatics
of technology services in home care is costly technologies that can support safe, optimal
and uncoordinated, although cost savings and care. In addition, all informatics technolo-
quality improvements occurred when models gies themselves must be continuously tested
of comprehensive care were followed. In some for ease of use. Study of interventions for
communities and states and in some popula- technology home care in culturally diverse
tions of patients (e.g., ventilator dependent), populations is still needed (Smith, 2008). In
coordinated technology care services do exist. addition, policy, ethical, professional, and
The Agency for Healthcare research interdisciplinary areas of regulation and
and Quality commissioned two Technology safety issues should be researched to reduce
Assessment reports in 2001 and in 2006 to duplication and enhance resource availabil-
review the efficacy-based studies of telecare ity (Smith et al., 1996). predicting cost and
technology (HMr, 2007). Telecare Outcomes outcomes of care should be compared with