To develop measures of change in homebound elderly peoples’ functioning and identify characteristics of individuals whose functioning improves with videophone (VP) nursing care
Evaluation of a home telehealth program using eight different assessment scales
71 elderly with mean age of 72, 70% living alone and 76% receiving formal care
Psychosocial support and educational interventions
Loneliness Scale Geriatric Depression Scale SF-15 Social Network Scale Activities of daily living Instrumental activities of daily living Medical Outcome Study SF-36 Geriatric Center Moral Scale
The VP nursing care reduced social loneliness and melancholia and improved social activity and memory. No improvement in ADL was reported. Frequency of VT calls showed a significant and positive association with change in general health functioning in individuals with small social networks and reduced family support. Time watching television, poor social network, and age >75 years were significantly associated with improved self-perception
To uncover challenges involved in implementing remote monitoring and interactive video technology for elderly patients with chronic obstructive pulmonary disease (COPD)
Feasibility study applying a descriptive and evaluative design
Three nurses 34–58 years of age. Three patients 56–83 years of age with COPD as their primary diagnosis
Daily virtual visits from a telehealth nurse to explore patients’ need of nursing interventions following hospital discharge
n.a.*
Reported challenges in running the home telehealth (HTH) were related to team performance, nurse training, patient recruitment, and technical issues with installation and use of HTH. The nurses received an average of 11.5 hours of HTH training prior to the implementation of HTH. The patients experienced difficulties in troubleshooting technological issues and handling medical devices
To compare a home telehealth (HTH) intervention for elderly patients following hospital discharge for heart failure to usual skilled home care
Randomized controlled trial
Two hundred and eighteen heart failure patients: 102 in intervention group and 116 in control group. Six-month follow-up of study participants
The intervention group received a combination of in-person and HTH daily monitoring and intermitted video visits. Control group received usual care. The protocol defined a minimum of four video visits, daily use of home device, and 5 in-person home visits
Patient satisfaction (questionnairea) Health care utilization (home care agency records, and health system database), access to care (home care agency records)
Of the 101 patients in the HTH intervention, 36 did not receive or wanted to receive any HTH. Younger patients were more likely to accept the technology. Access to care, more in-person contact, and satisfaction were significantly higher for HTH patients. No significant differences between intervention and control group in time to readmissions or death nor in emergency visits were found
To examine technical problems that affect the interaction between nurse and patient during virtual visits (VV) and to assess the verbal interaction
Randomized controlled trial
Ten patients with mean age of 78; six patients had congestive heart failure, three had COPD, and one had diabetes-related wounds. 10 nurses from one urban and three rural home care agencies
VV were used for assessing the patient’s clinical status, promoting medication and treatment compliance, psychosocial issues, and patient information and education
Technical quality (10-item questionnairea)
One hundred and twenty-two VV were reviewed. Mean duration 21 min. Patients received on average two sessions with 30-minute training. No technical problem in 78 visits. Besides technical issues the VV comprised the following themes: general information, clinical status, psychosocial issues, education, promoting compliance, patient satisfaction, administrative issues, and accessibility. The nurses reported the VV as very useful or useful for patient care and that the majority of the VV would not have been performed better in person
To demonstrate quality, clinical usefulness, and patients’ satisfaction with home telehealth (HTH) and virtual visits (VV)
Randomized controlled trial
Fifty-three patients with heart failure, COPD, and chronic wounds, mean age 74 and randomized to three groups: () standard care + videoconference, () standard care, videoconference, and monitoring, or () control group receiving standard home care only
VV consisted of two-way audio and video interaction between nurses and patients at home, a web-messaging system, and physiological monitoring system
Telemedicine Perception Questionnaire Home Care Client Satisfaction Instrument
A total of 567 VV were conducted, with 276 by video. Nurses report few technical problems and reported VV useful and time saving for the nurses, but not for the patients. The video/monitoring-group was significantly more positive to HTH after testing for several weeks. Satisfaction with homecare increased for virtual visit subjects. These patients felt safe and that the nurses paid attention to their concerns and met their needs. The VV were found to be time flexible and easy to schedule
To compare conventional methods on wound home care with a virtual concept for patients with leg wounds
Quasi-experimental study with a test group and a comparison group. Surveys, field notes, digital photos, and videotaped observations
Ten patients with wounds on lower leg/foot and their responsible nurse. Eight patients and nurses in the control group. Same inclusion criteria, but no broadband access in the control group
The virtual information and consulting concept, Everyday Learning—Leg Wounds and Their Treatment consisted of a web application containing advice on nutrition, exercise and wound treatment, and a videophone
Interaction between patient and nurse (22- item questionnairea)
Patients in both groups reported seeing staff caring for them and receiving information and a rapid reply as beneficial. Patients in the test group reported a need of more time to familiarize themselves with the technology. Nurses in the test group found the technology useful for them more than for the patients; it was humane and economical, with the web material as an educational resource. The nurses in the test group had more frequent and longer travel times due to the patients’ being in poorer condition than patients in the control group
To establish the effects of a video communication system (CareTV) on loneliness and safety in elderly patients. To evaluate the use of video communication (actual use and expectations) and user satisfaction with CareTV
Longitudinal study with baseline data collection at moment of inclusion, and a follow-up measurement 1 year after inclusion
One hundred and thirty frail elderly clients of home care organizations, mean age of 73 years
The videophone (VP) service of the CareTV was called “Good morning, Good Evening” and included medication service used on a daily basis and an alarm function used less than once per month
The Loneliness Questionnaire Clients feelings of safety (nine-item questionnairea)
Eighty-eight percent of the clients were satisfied with the use of the VP. Technical problems were reported by 12% of the participants. For 63% of the participants, feelings of loneliness decreased significantly (). CareTV had no effect on feelings of safety, explained by technical problems and patients experiencing deteriorating health conditions through the study
To compare the perspectives of patients and providers on telecare encounters via virtual visits used to reduce hospital readmission
Descriptive, evaluation study by the use of log reports and a questionnaire
Twenty-two nurses and 22 patients with COPD. Mean age of 71 years
Videophone intervention to support management of acute exacerbations in COPD patients living at home
Patient and provider perspectives on home telecare (10-item questionnairea)
Nurses completed 150 logs, and patients 145 logs. The patients consistently reported significantly more positive views of the telehealth encounters than their health care providers. Care providers were concerned about the negative effects of telehealth on communication and their ability to assess the patient’s medical problems accurately, and they were less comfortable when using the telehealth system
To evaluate the “Assisting Carers using Telematic Interventions to meet Older peoples’ Needs” (ACTION) system
Semistructured interviews and data logging
Eight family users (caregivers and elderly persons), with mean age 73 years. Four professional caregivers
The ACTION-project using information and communication technology to enhance quality of life and independence and reduce social isolation in frail elderly and family at home
n.a.
Average call time was 40 min/month/user; average initiated calls were six per user. Patients reported videophone (VP) reduced loneliness and isolation, assisted with making new social contacts, and increased social activities and safety. Barriers were having enough people to call and technical start-up problems. Caregivers reported the VP created trustful communication; the camera was useful in demonstrating procedures and making assessments. Privacy issues, technical problems, and need for a learning period for the family were a concern
To assess technical success, medication self- administration, neuropsychiatric symptoms, and mood burden following use of interactive video technology to monitor medication compliance in persons with mild dementia
Quasi-experimental study with quantitative outcome data from patients. Assessments of medication accuracy and neuropsychiatric conditions. Semistructured interviews with patients and caregivers
Fourteen elderly (aged 80–85) with mild dementia living alone. Eight persons received a video monitoring or a telephone service. Six persons received telephone service or standard unmonitored medication compliance service and acted as control group
Televideo technology to monitor medication compliance
Geriatric Depression Scale Neuropsychiatric Inventory Medication accuracy records
Participants with video and phone monitoring were contacted 4,000 times by nursing assistance services according to their medication schedule. End medication compliance was 81% in the video-monitored group compared to 80% in the phone-group, and 66% in the control. Comparison of compliance from initial to end ratings shows stable compliance in monitored participants, were reduced in unmonitored participants. Rate of change between video and no-monitoring was significantly different (). The qualitative interviews revealed that the caregivers experienced less worry and that the technology improved the patients’ medication compliance. Other perceived benefits from the technology were prevented relocation to a nursing home and increased social contact
To assess the practicality, suitability, safety, and costs of delivering daily home medication management by virtual visits (VV)
Pilot study Semistructured interviews
Nine clients (aged 61–85 years), six of them with dementia and one with memory loss. Four call center nurses
Two participants received Directly Observed Therapy for tuberculosis, 7 receiving general medication management
n.a.
Average length of the VV was nine minutes compared to 19 minutes for an equivalent field visit. One virtual visit was 60% of the cost of a field visit. All clients reported the VV easy to use, and six would continue use. One mentioned flexibility of service as a positive. Nurses reported personal contact, continuity of care, flexibility, and early intervention as advantages
n.a.: not applicable, ascale developed for application in the particular study.
