建構一個照護平台於心臟衰竭居家照護之成效評估

Effectiveness of Developing a home care Platform for Patients with Heart Failure

心臟衰竭居家照護是我國近期推動的一種創新照護模式，不論是輕症或者是重症返家後居家照護都適用此照護模式，特別適合心臟衰竭出院返家後於居家密切照護與觀察。研究旨在瞭解並建構一個照護平台於心臟衰竭病患居家照護並透過穿戴式設備，進行生理量測，包含心率監測手環、血壓器、血氧監測儀及體重儀等，另外，透過醫療人員進行24小時監測與緊急諮詢並在需要時啟動緊急醫療處置。2024年3月至2025年1月，經由立意取樣共完成20位心臟衰竭居家照護，其成效包含再住院率0％；72小時入院重返率0％；體重控制下降2.42公斤（SD：±1.9）；血壓控制下降：19.85mmHg（SD：±11.6）；血氧濃度提升：2.05％（SD：±0.24）；尋求遠距醫療諮詢次數：103.65次。各變項之間的關係資料，發現血氧與心律異常的次數呈現負相關（-0.44，p>0.05）、異常心律與體重呈現負相關（r-0.44，p<0.05），平均動脈壓與體重（r.54，p<0.05）、心律異常值提醒諮詢次數（r.78，p<0.05）、體重後測與異常值提醒諮詢次數（r.78，p<0.05）呈現正相關。本研究在建構一個照護平台於心臟衰竭居家照護之成效評估，在研究結果可看到病患對於遠距醫療的依賴及需求是有相當高的依從性及需求性的一個照護模式。

Home care for patients with heart failure is an innovative care model that has been promoted in Taiwan in recent years. It is applicable to post-discharge home care for patients with mild and severe heart failure, and it is particularly suitable for patients with heart failure who require close observation and care following discharge. In the present study, the aim was to develop and evaluate a home care platform for patients with heart failure. In this care model, physiological measurements are performed by wearable devices including a wristband heart rate monitor, a blood pressure monitor, a pulse oximeter, and a weight scale. Medical professionals provide 24-hour monitoring and emergency consultation services, and they activate emergency medical responses when necessary. Between March 2024 and January 2025, 20 patients were enrolled by purposive sampling and received home care for heart failure. The outcomes included a 0% rehospitalization rate, 0% 72-hour unplanned readmission rate, 2.42kg (standard deviation [SD]:±1.9kg) reduction in body weight, 19.85 mmHg (SD:±11.6mmHg) reduction in blood pressure, 2.05% (SD:±0.24%) improvement in oxygen saturation, and a mean of 103.65 telemedicine consultations. There were negative correlations between oxygen saturation and the number of arrhythmia events (r=-0.44, p>0.05) and between arrhythmia and body weight (r=-0.44, p<0.05). There were positive correlations between mean arterial pressure and body weight (r=0.54, p<0.05) and between post-intervention body weight and the number of abnormal heart rate-triggered telemedicine consultations (r=0.78, p<0.05). In the present study, the effectiveness of developing a care platform for home care of patients with heart failure has been demonstrated, with the outcomes indicating high patient adherence and high reliance on telemedicine. Therefore, it is evident that remote care serves as a highly acceptable and necessary model for home management of patients with heart failure.