近年來醫療衛生不斷的成長進歩，人類的平均壽命延長，在老年人口急遽增加的同時，台灣地區的疾病型態已逐漸轉為慢性疾病，因此希望藉由資訊科技的導入，藉此降低失能發生率或延緩老化，並完成醫療照護機構的資訊系統及照護設備的連接，讓老年人在熟悉的居家環境，透過遠距監測系統的裝置，以及連結醫療系統資源，當個案量測發生異常狀況時，遠距照護服務中心人員在第一時間獲得資訊並針對個案異常狀況做警示及追蹤。本研究目的為探索居家式遠距健康照護服務模式之發展歷程、探討居家式遠距健康照護服務模式介入後對於中高齡慢性病患血壓量測行為之影響、探討居家式遠距健康照護服務模式介入後對於居家血壓自我控制之成效。
本研究為立意抽樣方式，鎖定南部某醫學中心之居家中高齡患者群體，作為研究對象，樣本追蹤期間自2010年1月到2012年6月，共計30個月，有效研究樣本個數共計152人，採單盲試驗設計，透過南部某醫學中心資訊系統的建置，連結個案家中配有的健康照護裝置，每天早、晚完成血壓量測後，裝置會自動收集並後傳至該院服務中心，研究將以30個月追蹤期間之血壓量測數據，進行評估使用遠距照護模式介入後的成效分析。
研究結果為居家中高齡患者使用遠距健康管理模式介入後，血壓量測行為資料分析結果加入1~10月均呈現顯著差異，顯示血壓量測情形是有提升的。透過GEE分析，血壓變化資料分析結加入6~20月呈現統計顯著下降，顯示加入6~20月後期血壓控制較為穩定。
研究結論為居家慢性病患提供以延伸臨床照護為基礎的居家自主健康管理環境，希望藉由資訊科技電腦與網路設備來提供更完善及良好的健康照護服務給居家慢性病患者，使居家慢性病患得到良好的血壓控制。透過本研究結果，期望能提供日後發展遠距健康照護服務設計之參考。 With the progresses of healthcare services and public health system, human life expectancy remains extended into the aged status and reveals a mainly chronic disease based health problem. Through the implementation of ICT, it makes the existed healthcare systems being integrated into patients’ living environment. Patients can get a seamless healthcare support and services. The purpose of this study is to explore the development of home-based telehealthcare model and the effectiveness of blood pressure control through the model on middle-elders with chronic disease.The study population is set by its research purpose as middle-elders used the employed in Kaohsiung and using the purposive sampling. With a totally thirty months of observation period from 2010/01 to 2012/06, 152 participants were enrolled in the trial. With the development of IS and remote health status monitoring devices connecting between the medical center and the home , the middle-elders can use health care with daily monitoring and evening with self-monitored blood and start a real time monitoring task by the call center. The remote health status monitoring devices can delivery real time health status and can be advanced used as health monitoring mechanism.Results for home use in elderly patients after remote health management intervention, blood pressure measuring behavioral data analysis results by adding 1 to October showed a significant difference in blood pressure measurement display case is elevated. Through GEE analysis, blood pressure data analysis results add 6 to 20 months showing statistically significant decline in display adding six to 20 months post-blood pressure control more stable.This study developed clinical care provided to extend the home-based self-health management environment for the chronically ill at home, hoping by information technology and computer networking equipment to provide better and good home health care services to patients with chronic diseases, chronic illnesses get to make home good blood pressure control. Through this study, hoping to provide a reference for future development of telehealth service design.
