TY - JOUR AU - Nguyen, Huong Q AU - Donesky-Cuenco, DorAnne AU - Wolpin, Seth AU - Reinke, Lynn F AU - Benditt, Joshua O AU - Paul, Steven M AU - Carrieri-Kohlman, Virginia PY - 2008 DA - 2008年4月16日TI -慢性阻塞性肺疾病患者基于互联网与面对面呼吸困难自我管理计划的随机对照试验:试点研究JO - J医疗互联网Res SP - e9 VL - 10 IS - 2kw -呼吸困难KW -肺部疾病KW -慢性疾病KW -自我保健KW -自我效能KW -健康行为KW -健康教育KW -锻炼KW -监测KW -互联网KW -手机KW -远程医疗KW -随机对照试验KW -个人数字助理(PDA) AB -背景:尽管有最佳的医疗管理，慢性阻塞性肺疾病(COPD)患者在日常生活活动(ADL)时仍会持续出现呼吸困难。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的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测试两项为期6个月的呼吸困难自我管理计划，即基于互联网的(eDSMP)和面对面的(fDSMP)对COPD患者伴有ADL的呼吸困难的疗效。方法:我们将50名中度至重度COPD患者随机分配到eDSMP组(n = 26)或fDSMP组(n = 24)。这两个项目的内容相似，都侧重于教育、技能培训和对呼吸困难自我管理(包括独立锻炼)的持续支持。唯一的区别是模式(互联网/个人数字助理[PDA]或面对面)，其中教育会议、强化联系和同伴互动发生。参与者在3个月和6个月时回到两个学术临床地点之一进行评估。ADL合并呼吸困难的主要结局用慢性呼吸问卷测量。 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 SN - 1438-8871 UR - //www.mybigtv.com/2008/2/e9/ UR - https://doi.org/10.2196/jmir.990 UR - http://www.ncbi.nlm.nih.gov/pubmed/18417444 DO - 10.2196/jmir.990 ID - info:doi/10.2196/jmir.990 ER -