杂志文章@ 2291-5222 I JMIR出版物%V 6% N 7%卡塔尔世界杯8强波胆分析 P e10768 %T评估基于移动电话的远程监控程序的实施:以实施研究统一框架为指导的纵向研究%A Ware,Patrick %A Ross,Heather J %A Cafazzo,Joseph A %A Laporte,Audrey %A Gordon,Kayleigh %A Seto,Emily +卫生政策、管理和评估研究所，达拉拉纳公共卫生学院，多伦多大学，学院街155号，ON, M5T 3M6，加拿大，1 647 227 6015，patrick.ware@mail.utoronto.ca %K实施研究统一框架%K eHealth %K心力衰竭%K实施%K远程监测%D 2018 %7 31.07.2018 %9原始论文%J JMIR Mhealth Uhealth %G英文%X背景:远程监测已显示出减轻个人和卫生系统心力衰竭负担的前景。然而，在现实世界中实施持续的项目是罕见的。目的:本研究的目的是通过回答两个研究问题来评估一个基于手机的远程监测项目的实施情况，该项目已作为专业心功能诊所标准护理的一部分实施:(1)远程监测项目成功实施的程度如何?(2)实施远程监测项目的障碍和促进因素是什么?方法:我们进行了纵向单例研究。使用以下四个实现结果来评估实现成功:采用、渗透、可行性和保真度。基于实施研究综合框架(CFIR)，在0、4和12个月对12名项目工作人员进行了半结构化访谈，以确定实施的障碍和促进因素。结果:实施一年后，共有98名患者和8名临床医生加入该项目。 Despite minor technical issues, the intervention was used as intended. We obtained qualitative data from clinicians (n=8) and implementation staff members (n=4) for 24 CFIR constructs. A total of 12 constructs were facilitators clustered in the CFIR domains of inner setting (culture, tension for change, compatibility, relative priority, learning climate, leadership engagement, and available resources), characteristics of individuals (knowledge and beliefs about the intervention and self-efficacy), and process (engaging and reflecting and evaluating). In addition, we identified other notable facilitators from the characteristics of the intervention domain (relative advantage and adaptability) and the outer setting (patient needs and resources). Four constructs were perceived as minor barriers— the complexity of the intervention, cost, inadequate communication among high-level stakeholders, and the absence of a formal implementation plan. The remaining CFIR constructs had a neutral impact on the overall implementation. Conclusions: This is the first comprehensive evaluation of the implementation of a mobile phone–based telemonitoring program. Although the acceptability of the telemonitoring system was high, the strongest facilitators to the implementation success were related to the implementation context. By identifying what works and what does not in a real-world clinical context using a framework-guided approach, this work will inform the design of telemonitoring services and implementation strategies of similar telemonitoring interventions. %M 30064970 %R 10.2196/10768 %U http://mhealth.www.mybigtv.com/2018/7/e10768/ %U https://doi.org/10.2196/10768 %U http://www.ncbi.nlm.nih.gov/pubmed/30064970