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    Using OASIS Data to Assess Moderator Effects of Patient Characteristics on Telemonitoring Outcomes in Heart Failure Patients

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    Author
    Vallina, Helen
    Issue Date
    2009
    Keywords
    Heart Failure
    Home Health Care
    Moderator
    Telemonitoring
    Advisor
    Effken, Judith
    Committee Chair
    Effken, Judith
    
    Metadata
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    Publisher
    The University of Arizona.
    Rights
    Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
    Abstract
    This study had two purposes: 1) to compare the difference between home health care only and home health care plus telemonitoring on heart failure patients' symptom burden, self-care of heart failure and re-hospitalization; and 2) to explore which patient characteristics might moderate telemonitoring's impact.Heart failure has emerged as a major public health burden. Like other chronic conditions, heart failure patients have an important role to play in the day-to-day management of their condition. One of the principal reasons for introducing telemonitoring in home health care was to increase heart failure patients' capacity to self-manage their conditions at home.This study used a prospective, non-experimental, comparative, descriptive design. A total of 68 participants were recruited with 34 in each group. Symptom burden and self-care of heart failure were measured on enrollment and 40 days later. Hospitalization was measured as an event that either occurred or did not occur.Although no between-group differences in symptom burden were found, both groups showed significant decreased symptom burden over the 40-day period. Of the three self-care measures, only self-care maintenance differed significantly between the two groups at the 40-day follow-up (p<.05). Only the participant's functional status had significant moderator effect on the relation between type of service received and self-care maintenance (p<.05).The addition of telemonitoring produced similar outcomes to regular home health care, except for self-care maintenance. Like most prior study, this study focused on evaluating the overall relationship between telemonitoring and outcomes without concern for the transformation process. Although these evaluation were able to provide an overall assessment of whether or not the telemonitoring program worked, they cannnot identify the underlying mechanisms that generate the effects. Without knowing what make the program work or not work, it is difficult to pinpoint what needs to be done for future improvement. A theory-oriented evaluation will be needed in future research. Theory-oriented evaluation not only allow reseachers to clarify the connection between a program's operation and its effect, but also to specify intermediate effects of a program that might become evident and measurable.
    Type
    text
    Electronic Dissertation
    Degree Name
    Ph.D.
    Degree Level
    doctoral
    Degree Program
    Nursing
    Graduate College
    Degree Grantor
    University of Arizona
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