期刊文章%@ 2562-7600 %I JMIR Publicatio卡塔尔世界杯8强波胆分析ns %V 5 %N 1 %P在护士领导的复杂慢性患者群体的护理模式中规范化远程监测:案例研究%A Gordon,Kayleigh %A Seto,Emily %A Dainty,Katie N %A Steele Gray,Carolyn %A DeLacy,Jane %+多伦多大学健康政策、管理和评估研究所，155学院街4楼，加拿大多伦多，ON, M5T 3M6, 1 416 978 4326，kayleigh.gordon@mail.utoronto.ca % K遥控% K TM % K护士% % K模型K NP-led保健% K一体化护理% K疾病护理模式% K疾病% K护士% K护士让实现% K复杂的慢性疾病% K CCC % K临床团队手机% D % K原始论文7 28.4.2022 % 9 2022% % % G J JMIR护理英语% X背景:远程控制的实现(TM)已成功的整体可行性和采用单一疾病护理模式。然而，缺乏针对护士主导的TM实施(针对多重复杂慢性疾病(CCC)患者)的现有研究，阻碍了TM的规模和传播到这些患者群体。特别是，对门诊CCC患者实施TM的临床视角知之甚少。目的:本研究旨在更好地了解在护士主导的临床模式下，临床团队(包括一线临床医生和行政人员)对复杂患者TM实施和规范化的看法。方法:开展了一项务实的、为期6个月的实施研究，将包括心衰、高血压和糖尿病在内的多病TM嵌入到一个综合护士主导的护理模型中。在整个研究过程中，对临床团队成员进行观察，并对期间提供的护理进行图表回顾。在研究结束时，临床团队成员参加了定性访谈并完成了改编的规范化测量发展问卷。归一化过程理论指导演绎数据分析。 Results: Overall, 9 team members participated in the study as part of a larger feasibility study of the TM program, of which 26 patients were enrolled. Team members had a shared understanding of the purpose and value of TM as an intervention embedded within their practice to meet the diverse needs of their patients with CCC. TM aligned well with existing chronic care practices in several ways, yet it changed the process of care delivery (ie, interactional workability subconstruct). Effective TM normalization in nurse-led care requires rethinking of clinical workflows to incorporate TM, relationship development between the clinicians and their patients, communication with the interdisciplinary team, and frequent clinical care oversight. This was captured well through the subconstructs of skill set workability, relational integration, and contextual integration of the Normalization Process Theory. Conclusions: Clinicians successfully adopted TM into their everyday practice such that some providers felt their role would be significantly and negatively affected without TM. This study demonstrated that smartphone-based TM systems complemented the routine and challenging clinical work caring for patients with CCC in an integrated nurse-led care model. %M 35482375 %R 10.2196/36346 %U https://nursing.www.mybigtv.com/2022/1/e36346 %U https://doi.org/10.2196/36346 %U http://www.ncbi.nlm.nih.gov/pubmed/35482375