互联网与面对面的慢性阻塞性肺疾病患者呼吸困难自我管理方案的随机对照试验:初步研究%A Nguyen,Huong Q %A Donesky-Cuenco,DorAnne %A Wolpin,Seth %A Reinke,Lynn F %A Benditt,Joshua O %A Paul,Steven M %A carririe - kohlman，弗吉尼亚%+华盛顿大学，西雅图，WA 98199， +1 206 543 8651，HQN@u.washington.edu %K呼吸困难%K肺部疾病%K慢性疾病%K自我护理%K自我效能%K健康行为%K健康教育%K运动%K监测%K互联网%K手机%K远程医疗%K随机对照试验%K个人数字助理(PDA) %D 2008 %7 16.4.2008 %9原创论文%J J医学互联网研究%G英语%X背景:尽管有最佳的医疗管理，慢性阻塞性肺疾病(COPD)患者仍持续经历日常生活活动(ADL)呼吸困难。信息和通信技术可以促进协同症状管理，并有可能增加这些干预措施对那些无法参加面对面肺部康复或自我管理项目的人的影响。目的:本随机研究的目的是检验基于互联网(eDSMP)和面对面(fDSMP)两种6个月呼吸困难自我管理方案对慢性阻塞性肺疾病(COPD)患者伴ADL呼吸困难的疗效。方法:我们将50名患有中度至重度COPD的参与者随机分配到eDSMP组(n = 26)或fDSMP组(n = 24)。两个项目的内容相似，都侧重于教育、技能培训和持续支持呼吸困难自我管理，包括独立锻炼。唯一的不同是模式(互联网/个人数字助理[PDA]或面对面)的教育会议，加强联系，和同伴互动发生。参与者在3个月和6个月时返回两个学术临床地点之一进行评估。 The primary outcome of dyspnea with ADL was measured with the Chronic Respiratory Questionnaire. Secondary outcomes of exercise behavior, exercise performance, COPD exacerbations, and mediators, such as self-efficacy and social support, were also measured. A satisfaction survey was administered and a semistructured exit interview was conducted at the final visit. Results: The study was stopped early due to multiple technical challenges with the eDSMP, but follow-up was completed on all enrolled participants. Data were available for 39 participants who completed the study (female: 44%; age: 69.5 ± 8.5 years; percent predicted forced expiratory volume in 1 s: 49.6 ± 17.0%). The fDSMP and eDSMP showed similar clinically meaningful changes in dyspnea with ADL from baseline to 3 months (fDSMP: + 3.3 points; eDSMP: + 3.5 points) and sustained these improvements at 6 months (fDSMP: + 4.0 points; eDSMP: + 2.5 points; time effects P < .001; group by time P = .51). Self-reported endurance exercise time (P = .001), physical functioning (P = .04), and self-efficacy for managing dyspnea (P = .02) also showed positive improvements over time in both groups with no significant differences with respect to program modality. Participants who completed the study reported favorable satisfaction with the programs. Conclusions: Although there were numerous technical challenges with the eDSMP, both dyspnea self-management programs were effective in reducing dyspnea with ADL in the short term. Our findings will need to be confirmed in a larger randomized trial with more mature Web and personal digital assistant tools, use of a control group, and longer follow-up. Trial registration: clinicaltrials.gov NCT00102401, http://www.webcitation.org/5X8CX4gLC %M 18417444 %R 10.2196/jmir.990 %U //www.mybigtv.com/2008/2/e9/ %U https://doi.org/10.2196/jmir.990 %U http://www.ncbi.nlm.nih.gov/pubmed/18417444

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