Telehealth for persons with severe functional disabilities and their caregivers: facilitating self-care management in the home setting.

Persons with severe functional disabilities are the highest users of health care services. Caring for the needs of this population represents a significant percentage of our national health care costs. A growing body of research has demonstrated the efficacy of self-management strategies and caregiver engagement for effective long-term care for individuals with chronic medical conditions. Economic forces over the past decade have led to new challenges and resulted in major changes in health care delivery resulting in shortened length of inpatient stays and greater limits on the length of outpatient treatment. Telehealth is an innovative method for health care delivery and a means of meeting this new challenge. This article highlights the findings of 3 pilot studies on the use of telecommunications technologies in promoting self-care management and enhancing health care outcomes in persons with severe disabilities and their family caregivers. The importance of matching technology to the needs of this population, lessons learned from these investigations, and future directions for research are addressed.

[1]  D. Swendeman,et al.  Prevention for Substance-Using HIV-Positive Young People: Telephone and In-Person Delivery , 2004, Journal of acquired immune deficiency syndromes.

[2]  Robert L. Glueckauf,et al.  Telehealth and Family Caregiving: Developments in Research, Education, Policy, and Practice , 2011 .

[3]  J. Malec,et al.  Outcome evaluation and prediction in a comprehensive-integrated post-acute outpatient brain injury rehabilitation programme. , 1993, Brain injury.

[4]  T. Miller,et al.  Prevalence of Long‐Term Disability From Traumatic Brain Injury in the Civilian Population of the United States, 2005 , 2008, The Journal of head trauma rehabilitation.

[5]  Brian T. Austin,et al.  Organizing care for patients with chronic illness. , 1996, The Milbank quarterly.

[6]  Robert L. Glueckauf,et al.  Telehealth and Constraint-Induced Movement Therapy (CIMT) , 2007 .

[7]  M. Sherer,et al.  Therapeutic alliance in post-acute brain injury rehabilitation: Predictors of strength of alliance and impact of alliance on outcome , 2007, Brain injury.

[8]  J. Mathias,et al.  Psychosocial outcomes of telephone-based counseling for adults with an acquired physical disability: A meta-analysis. , 2011, Rehabilitation psychology.

[9]  Reinier Akkermans,et al.  Web-Based Targeted Nutrition Counselling and Social Support for Patients at Increased Cardiovascular Risk in General Practice: Randomized Controlled Trial , 2004, Journal of medical Internet research.

[10]  Giovanni Pulignano,et al.  Two-year outcome of a prospective, controlled study of a disease management programme for elderly patients with heart failure , 2007, Journal of cardiovascular medicine.

[11]  L. Thompson,et al.  Impact of Psychoeducational Interventions on Distressed Family Caregivers , 2000 .

[12]  J. Sheridan,et al.  Chronic stress alters the immune response to influenza virus vaccine in older adults. , 1996, Proceedings of the National Academy of Sciences of the United States of America.

[13]  V. Burke,et al.  Effects of a general practice-based intervention on diet, body mass index and blood lipids in patients at cardiovascular risk. , 2003 .

[14]  R. Spitzer,et al.  The PHQ-9 , 2001, Journal of General Internal Medicine.

[15]  L. Burgio,et al.  Impact of two psychosocial interventions on white and African American family caregivers of individuals with dementia. , 2003, The Gerontologist.

[16]  S. Wessely,et al.  A systematic review of controlled trials of the effectiveness and cost-effectiveness of brief psychological treatments for depression. , 2002, Health technology assessment.

[17]  B. Demaerschalk,et al.  US cost burden of ischemic stroke: a systematic literature review. , 2010, The American journal of managed care.

[18]  Stacey L. Sheridan,et al.  Promoting Informed Choice: Transforming Health Care To Dispense Knowledge for Decision Making , 2005, Annals of Internal Medicine.

[19]  J. Giacino,et al.  Evidence-based cognitive rehabilitation: recommendations for clinical practice. , 2000, Archives of physical medicine and rehabilitation.

[20]  M L Jones,et al.  Using telerehabilitation to support assistive technology. , 1998, Assistive technology : the official journal of RESNA.

[21]  D. Southard,et al.  Clinical trial of an Internet-based case management system for secondary prevention of heart disease. , 2003, Journal of cardiopulmonary rehabilitation.

[22]  Klaus Abraham-Fuchs,et al.  Telerehabilitation Needs: A Survey of Persons with Acquired Brain Injury , 2002, The Journal of head trauma rehabilitation.

[23]  G. Andersson,et al.  Treatment of panic disorder: live therapy vs. self-help via the Internet. , 2005, Behaviour research and therapy.

[24]  M. Lawton,et al.  Measuring caregiving appraisal. , 1989, Journal of gerontology.

[25]  B. Resnick,et al.  Reliability and Validity Testing of the Revised 12-Item Short-Form Health Survey in Older Adults , 2001, Journal of Nursing Measurement.

[26]  A. Cameron.  Patient self-management , 1998 .

[27]  Ursula Giedion,et al.  Review of Evidence , 2019, Cybercrime Investigators Handbook.

[28]  Gerry Richardson,et al.  The effectiveness and cost effectiveness of a national lay-led self care support programme for patients with long-term conditions: a pragmatic randomised controlled trial , 2007, Journal of Epidemiology and Community Health.

[29]  R. Snow,et al.  Review of the Evidence. , 1964, Science.

[30]  R. Glueckauf,et al.  Telehealth Interventions for Individuals With Chronic Illness: Research Review and Implications for Practice. , 2004 .

[31]  T. Bodenheimer,et al.  Patient self-management of chronic disease in primary care. , 2002, JAMA.

[32]  T. Bergquist,et al.  Internet-based cognitive rehabilitation in individuals with acquired brain injury: A pilot feasibility study , 2008, Brain injury.

[33]  W. Anthony,et al.  The Nature and Dimensions of Social Support Among Individuals with Severe Mental Illnesses , 2004, Community Mental Health Journal.

[34]  C. Randolph,et al.  Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) , 2009 .

[35]  R. Glasgow,et al.  Internet-Based Diabetes Self-Management and Support: Initial Outcomes From the Diabetes Network Project , 2002 .

[36]  A. Heuser,et al.  Televideo assessment using Functional Reach Test and European Stroke Scale. , 2007, Journal of rehabilitation research and development.

[37]  S. Kolakowsky-Hayner,et al.  A Structured Approach to Family Intervention After Brain Injury , 2002, The Journal of head trauma rehabilitation.

[38]  J. Malec,et al.  Postacute brain injury rehabilitation. , 1996, Archives of physical medicine and rehabilitation.

[39]  Brett C Meyer,et al.  A Review of the Evidence for the Use of Telemedicine Within Stroke Systems of Care: A Scientific Statement From the American Heart Association/American Stroke Association , 2009, Stroke.

[40]  T. L. Williams,et al.  Systematic review of cost effectiveness studies of telemedicine interventions , 2002, BMJ : British Medical Journal.

[41]  W. Gordon,et al.  Poststroke depression: an examination of the literature. , 1997, Archives of physical medicine and rehabilitation.

[42]  P. Dieppe,et al.  Economic evaluation of a rehabilitation program integrating exercise, self-management, and active coping strategies for chronic knee pain , 2007, Arthritis and rheumatism.

[43]  A J Fyer,et al.  Treatment of Panic Disorder , 1981, Journal of clinical psychopharmacology.

[44]  M. Pinquart,et al.  Racial and ethnic differences in the relationship of caregiving stressors, resources, and sociodemographic variables to caregiver depression and perceived physical health , 2005, Aging & mental health.

[45]  R. Devol,et al.  An Unhealthy America:The Economic Burden of Chronic Disease , 2007 .

[46]  Richard Schulz,et al.  Dementia caregiver intervention research: in search of clinical significance. , 2002, The Gerontologist.

[47]  T. Bergquist,et al.  Satisfaction ratings after receiving internet-based cognitive rehabilitation in persons with memory impairments after severe acquired brain injury. , 2010, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[48]  M P Lawton,et al.  A research and service oriented multilevel assessment instrument. , 1982, Journal of gerontology.

[49]  Michelle M. Kazmer,et al.  Telephone-based, cognitive-behavioral therapy for African American dementia caregivers with depression: initial findings. , 2012, Rehabilitation psychology.

[50]  L. Frantsve,et al.  Implementation and evaluation of an integrated care program in a VA medical center. , 2011 .

[51]  R. Toseland,et al.  Telephone Groups for Older Persons and Family Caregivers , 2007 .

[52]  M. Vitiello,et al.  Sleep disturbances in caregivers of persons with dementia: contributing factors and treatment implications. , 2007, Sleep medicine reviews.

[53]  T. Schacker,et al.  Clinical and Epidemiologic Features of Primary HIV Infection , 1996, Annals of Internal Medicine.

[54]  M. Pinquart,et al.  Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a meta-analysis. , 2005, The Gerontologist.

[55]  J. Brazier,et al.  The Estimation of a Preference-Based Measure of Health From the SF-12 , 2004, Medical care.

[56]  A M Jette,et al.  Nutrition and health risks in the elderly: the nutrition screening initiative. , 1993, American journal of public health.

[57]  R. Schulz,et al.  The extent and impact of dementia care: Unique challenges experienced by family caregivers. , 2000 .

[58]  K. Emmons,et al.  Peer-delivered smoking counseling for childhood cancer survivors increases rate of cessation: the partnership for health study. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[59]  R. Spitzer,et al.  The PHQ-9: validity of a brief depression severity measure. , 2001, Journal of general internal medicine.

[60]  C. Granger,et al.  PERFORMANCE PROFILES OF THE FUNCTIONAL INDEPENDENCE MEASURE , 1993, American journal of physical medicine & rehabilitation.

[61]  Michelle S. Bourgeois,et al.  Alzheimer's Rural Care Healthline: Linking Rural Caregivers to Cognitive-Behavioral Intervention for Depression. , 2005 .

[62]  L. Radloff.  The CES-D Scale , 1977 .

[63]  A. Drewnowski,et al.  Journals of Gerontology , 2001 .

[64]  S. Katz,et al.  Progress in development of the index of ADL. , 1970, The Gerontologist.

[65]  Christopher R. Wolfe,et al.  Telehealth Interventions in Rehabilitation Psychology: Postcards From the Edge. , 2005 .

[66]  I. Altman,et al.  Productivity after neuropsychologically oriented milieu rehabilitation , 1994 .

[67]  C. Stine,et al.  Telephone-Based Cognitive-Behavioral Intervention for Distressed Rural Dementia Caregivers , 2007 .

[68]  J. Mandrekar,et al.  The effect of internet-based cognitive rehabilitation in persons with memory impairments after severe traumatic brain injury , 2009, Brain injury.

[69]  Kathleen R. Bell,et al.  Journal of Head Trauma Rehabilitation: Preface , 2009 .

[70]  PROMOTING INFORMED CHOICES ON CANCER SCREENING IN A DIVERSE COMMUNITY , 2009 .

[71]  A. Rogers,et al.  Re-thinking the relationship between long-term condition self-management education and the utilisation of health services. , 2007, Social science & medicine.

[72]  C. Mateer,et al.  Training use of compensatory memory books: a three stage behavioral approach. , 1989, Journal of clinical and experimental neuropsychology.

[73]  R. Shewchuk,et al.  Recognizing the family caregiver: integral and formal members of the rehabilitation process , 1998 .

[74]  Financial and vocational outcomes 2 years after traumatic brain injury , 2009, Disability and rehabilitation.

[75]  Peter V. Rabins,et al.  The 36-hour day : a family guide to caring for people with Alzheimer disease, other dementias, and memory loss in later life , 2006 .

[76]  Marcia J. Scherer,et al.  Assistive technology: Matching device and consumer for successful rehabilitation. , 2002 .