Effectiveness of a Telehealth Intervention on Functional Status, Anxiety, Depression, and Rehospitalization Among Older Adults Undergoing Coronary Artery Bypass Grafting: Randomized Controlled Trial
Notice bibliographique
Résumé
Abstract Background Telehealth has shown promise in enhancing care transitions and physical health outcomes in patients with cardiovascular disease. However, limited studies have explored its effect on functional status, psychological health, and rehospitalization, specifically in older patients undergoing coronary artery bypass grafting (CABG). Objective This study aimed to evaluate the effectiveness of a telehealth intervention in improving functional status, reducing anxiety and depression, and decreasing rehospitalization rates compared with usual care among older patients undergoing CABG. Methods The study was a 2-arm parallel randomized controlled trial. This was conducted in 2 phases. Phase 1 was conducted in the cardiac surgical units at a university hospital in Bangkok, Thailand. Phase 2 involved following up with the participant at home 30 and 90 days after discharge. A total of 84 older adults undergoing CABG were randomly assigned to either the control group (n=42), which received usual care (discharge planning), or the intervention group (n=42), which received a telehealth intervention based on the transitional care model in addition to usual care. The telehealth intervention included home monitoring via the “Zip Heart” app and scheduled video consultations. The primary outcome was functional status, measured using the Thai version of the Enforced Social Dependency Scale. Secondary outcomes included anxiety and depression, assessed using the Thai Hospital Anxiety and Depression Scale, and rates of rehospitalization. Data were collected at baseline, 30, and 90 days after discharge. Analyses were conducted using an intention-to-treat approach, with missing outcome data handled using multiple imputation. Two-way repeated-measures ANOVA was used to evaluate group, time, and group-by-time interaction effects. Results A total of 84 participants were randomized and included in the intention-to-treat analysis (intervention group, n=42; control group, n=42). At baseline, there were no statistically significant differences between the two groups. Significant group-by-time interactions were observed for functional status scores ( F 2,164 =32.09, ηp ²=.28; P< .001), anxiety ( F 2, 164 =20.22, ηp² =.2; P<. 001), and depression ( F 2,164 =16.81, ηp²= .17; P<. 001). The intervention group demonstrated significantly greater improvements in functional status and greater reductions in anxiety and depression at both 30 and 90 days after discharge compared to the control group (all P <.001). Additionally, rehospitalization rates were significantly lower in the intervention group at 30 days ( Z =2.77; P =.006) and between 31 and 90 days post discharge ( Z =2.31; P =.02). Conclusions The Telehealth intervention is effective in improving functional and psychological outcomes and reducing rehospitalization rates among older patients undergoing CABG. Integrating telehealth into usual care can support recovery and enhance continuity of care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,004 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».