The proposed pilot test will explore the feasibility of identifying symptom patterns in older persons with advanced congestive heart failure by videophone rather than in-person home visits.
The aims are to: a) identify symptom patterns of frequency, severity and duration; b) determine whether remote visual and audio communication is more advantageous than audio alone for monitoring severe CHF, according to patients and nurses; c) determine the frequency with which clinical measurements are advised and/or obtained and d) identify relationships among symptom patterns and subject characteristics of health status, clinical status, functional status, quality of life and retrospective and prospective health utilization, A prospective longitudinal non-experimental design is planned with 15 outpatients who will receive 10 weekly videophone calls from an advanced practice nurse for observations and data collection regarding CHF symptoms. A subset of 20 calls will be recorded with audio and audiovisual methods, and four nurses will observe the recordings and rate them for ease of assessing patients. A comparison of communication receptivity between sound and sound-plus-image among skilled cardiac nurses will provide cutting edge knowledge on which to build telehealth care delivery models. Additional analyses will characterize the sample, identify symptom characteristics, symptom patterns and perceptions of videophone utility. The data will be used to develop analysis models of symptom patterns over time in individuals and aggregates. This work will contribute new knowledge about symptoms in a traditionally high-cost chronically ill population that has not been widely studied for symptom patterns or telenursing applications.
