Modelo de cuidados crónicos sustentado en la salud digital: un análisis para investigación en enfermedad cardiovascular

Contenido principal del artículo

D. Aranda-Sánchez
https://orcid.org/0000-0001-6269-5723
O. Sanhueza-Alvarado
https://orcid.org/0000-0002-0184-8957
V. Tíscar-González
J.M. Gutiérrez-Valverde
https://orcid.org/0000-0001-9506-5947

Resumen

Introducción: Las enfermedades cardiovasculares se encuentran entre las principales causas de morbimortalidad en los adultos a nivel mundial. Los últimos años evidencian los factores que obstaculizan el cuidado presencial de enfermería dirigido a estas personas, por tal motivo es necesario realizar investigaciones basadas en marcos teóricos que incluyan conceptos de enfermería y herramientas de salud digital para sustentar el cuidado en línea.


Objetivo: Analizar el modelo mejorado de cuidados crónicos de la eSalud y evaluar su efectividad en la investigación en enfermedad cardiovascular.


Metodología: Se usó el análisis de la Teoría de Walker y Avant para analizar el origen, significado, congruencia lógica, utilidad, parsimonia y transferibilidad del modelo. 


Desarrollo del análisis teórico del modelo: Dicha herramienta es descriptiva, sus componentes son de nivel de abstracción alto, adecuados para explorar contextos y patrones de cuidado de los pacientes con enfermedad cardiovascular. Su estructura teórica permite establecer proposiciones factibles de ser probadas y aplicadas a la práctica de enfermería. La eEducación, la eComunidad, el circuito de retroalimentación completa y el apoyo al automanejo sustentan significativamente la investigación de enfermería con un enfoque desde la salud digital.


Conclusión: El modelo fundamentaría el cuidado de enfermería que se brinda al paciente con enfermedad cardiovascular vía digital, ya sea como un modo único o como complemento al cuidado presencial. Esto permitirá crear e implementar diseños informáticos para la entrega del cuidado y así contribuir al desarrollo del conocimiento de enfermería. El uso del modelo en investigación en enfermería fortalecerá el liderazgo innovador-tecnológico de la disciplina.

Detalles del artículo

Dimensions citation

MÉTRICAS

 

Citas

(1) World Health Organization. WHO global coordination mechanism on the prevention and control of noncommunicable diseases. Final report: WHO GCM/NCD Working Group on the 2. Alignment of International Cooperation with National NCD Plans‎. Geneva: World Health Organization; 2018. https://bit.ly/3dVkABu

(2) Salazar M, Barochiner J, Espeche W, Ennis I. COVID-19, hipertensión y enfermedad cardiovascular. Hipertens Riesgo Vasc. 2020; 37(4): 176-80. https://doi.org/10.1016/j.hipert.2020.06.003

(3) Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020; 5(7): 811-18. https://doi.org/10.1001/jamacardio.2020.1017

(4) Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020; 17: 259-60. https://doi.org/10.1038/s41569-020-0360-5

(5) Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323(11): 1061-69. https://doi.org/10.1001/jama.2020.1585

(6)Thomas RJ, Balady G, Banka G, Beckie TM, Chiu J, Gokak S, et al. 2018 ACC/AHA Clinical performance and quality measures for cardiac rehabilitation: A report of the American College of Cardiology/American Heart Association task force on performance measures. J Am Coll Cardiol. 2018; 71(16): 1814-37. https://doi.org/10.1016/j.jacc.2018.01.004

(7) González-Salvado V, Rodríguez-Núñez A, González-Juanatey JR. From prevention to rehabilitation: Toward a comprehensive approach to tackling cardiac arrest. Rev Esp Cardiol (Engl Ed). 2019; 72(1): 3-6. https://doi.org/10.1016/j.rec.2018.04.021

(8) Ragupathi L, Stribling J, Yakunina Y, Fuster V, McLaughlin MA, Vedanthan R. Availability, use, and barriers to cardiac rehabilitation in LMIC. Glob Heart. 2017; 12(4): 323-34. https://doi.org/10.1016/j.gheart.2016.09.004

(9) Hwang R, Bruning J, Morris NR, Mandrusiak A, Russell T. Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: A randomised trial. J Physiother. 2017; 63(2): 101-7. https://doi.org/10.1016/j.jphys.2017.02.017

(10) Batalik L, Dosbaba F, Hartman M, Batalikova K, Spinar J. Benefits and effectiveness of using a wrist heart rate monitor as a telerehabilitation device in cardiac patients: A randomized controlled trial. Medicine. 2020; 99(11): e19556. https://doi.org/10.1097/MD.0000000000019556

(11) Ruano-Ravina A, Pena-Gil C, Abu-Assi E, Raposeiras S, Van't Hof A, Meindersma E, et al. Participation and adherence to cardiac rehabilitation programs. A systematic review. Int J Cardiol. 2016; 223: 436-43. https://doi.org/10.1016/j.ijcard.2016.08.120

(12) Melo-Barbosa OP. Enfermedad cardiovascular: creencias y prácticas en la adherencia al tratamiento. Rev. cienc. cuidad. 2018; 15(2): 164-76. http://dx.doi.org/10.22463/17949831.1410

(13) Leslie KH, McCowan C, Pell JP. Adherence to cardiovascular medication: A review of systematic reviews. J Public Health. 2019; 41(1): e84-e94. https://doi.org/10.1093/pubmed/fdy088

(14) Gupta S, Dhamija JP, Mohan I, Gupta R. Qualitative study of barriers to adherence to antihypertensive medication among rural women in India. Int J Hypertens. 2019; 5749648. https://doi.org/10.1155/2019/5749648(13)

(15) Fernández-Boccazzi J, Merchán-del Hierro X, Persi G, Seguí J, Aldinio V, Muniagurria S. Efectos de la pandemia por COVID-19 con relación al ACV isquémico. ¿La pandemia realmente lo cambió todo? Un estudio comparativo pre-post COVID-19 con revisión de la literatura. Neurolog. argent. 2022; 14(4): 244-50. https://doi.org/10.1016/j.neuarg.2022.08.004

(16) Wind TR, Rijkeboer M, Andersson G, Riper H. The COVID-19 pandemic: The 'black swan' for mental health care and a turning point for e-health. Internet Interv. 2020; 20: e100317. https://doi.org/10.1016/j.invent.2020.100317 (13)

(17) Kumar A, Mohammadnezhad M, May W. Patients' perception of factors influencing noncompliance with medication among cardiac patients in Fiji: A qualitative study. Patient Prefer Adherence. 2021; 15: 1843-52. https://doi.org/10.2147/PPA.S322731

(18) Organización Panamericana de la Salud. Cuidados innovadores para las condiciones crónicas: Organización y prestación de atención de alta calidad a las enfermedades crónicas no transmisibles en las Américas. Washington, D.C.: OPS; 2013. https://bit.ly/2CQ76Ty

(19) Sua YS, Jiang Y, Thompson DR, Wang W. Effectiveness of mobile phone-based self-management interventions for medication adherence and change in blood pressure in patients with coronary heart disease: A systematic review and meta-analysis. Eur J Cardiovasc Nurs. 2020; 19(3): 192-200. https://doi.org/10.1177/1474515119895678

(20) Brørs G, Pettersen TR, Hansen TB, Fridlund B, Hølvold LB, Lund H, et al. Modes of e-Health delivery in secondary prevention programmes for patients with coronary artery disease: A systematic review. BMC Health Serv Res. 2019; 19: e364. https://doi.org/10.1186/s12913-019-4106-1

(21) Tighe SA, Ball K, Kensing F, Kayser L, Rawstorn JC, Maddison R. Toward a digital platform for the self-management of noncommunicable disease: Systematic review of platform-like interventions. J Med Internet Res. 2020; 22(10): e16774. https://doi.org/10.2196/16774

(22) Laukka E, Pölkki T, Heponiemi T, Kaihlanen AM, Kanste O. Leadership in digital health services: Protocol for a concept analysis. JMIR Res Protoc. 2021; 10(2): e25495. https://doi.org/10.2196/25495

(23) Duplaga M. A cross-sectional study assessing determinants of the attitude to the introduction of eHealth services among patients suffering from chronic conditions. BMC Med Inform Decis Mak. 2015; 15(33): 1-15. https://doi.org/10.1186/s12911-015-0157-3

(24) Huygens MWJ, Vermeulen J, Swinkels ICS, Friele RD, Van Schayck OCP, De Witte LP. Expectations and needs of patients with a chronic disease toward self-management and eHealth for self-management purposes. BMC Health Serv Res. 2016; 16: e232. https://doi.org/10.1186/s12913-016-1484-5

(25) Gee PM, Greenwood DA, Paterniti DA, Ward D, Miller LMS. The eHealth enhanced chronic care model: A theory derivation approach. J Med Internet Res. 2015; 17(4): e86. https://doi.org/10.2196/jmir.4067

(26) Walker LO, Avant KC. Strategies for theory construction in nursing. 6th ed. New York: Pearson; 2019

(27) Wagner EH. Chronic disease management: What will it take to improve care for chronic illness? Eff Clin Pract. 1998; 1(1): 2-4. https://bit.ly/44n69Lr

(28) Wagner EH, Davis C, Schaefer J, Von Korff M, Austin B. A survey of leading chronic disease management programs: Are they consistent with the literature? Journ Nurs Care Qual 2002; 16(2): 67-80. https://bit.ly/43Wxnsn

(29) Matney S, Brewster PJ, Sward KA, Cloyes KG, Staggers N. Philosophical approaches to the nursing informatics data-information-knowledge-wisdom framework. ANS Adv Nurs Sci. 2011; 34(1): 6-18. https://doi.org/10.1097/ANS.0b013e3182071813

(30) Leppla L, Mielke J, Kunze M, Mauthner O, Teynor A, Valenta S, et al. Clinicians and patients perspectives on follow-up care and eHealth support after allogeneic hematopoietic stem cell transplantation: A mixed-methods contextual analysis as part of the SMILe study. Eur J Oncol Nurs. 2020; 45: 1-13. https://doi.org/10.1016/j.ejon.2020.101723

(31) Leppla L, Schmid A, Valenta S, Mielke J, Beckmann S, Ribaut J, et al. Development of an integrated model of care for allogeneic stem cell transplantation facilitated by eHealth-the SMILe study. Support Care Cancer. 2021; 29(12): 8045-57. https://doi.org/10.1007/s00520-021-06328-0

(32) Ribaut J, Leppla L, Teynor A, Valenta S, Dobbels F, Zullig LL, et al. Theory-driven development of a medication adherence intervention delivered by eHealth and transplant team in allogeneic stem cell transplantation: The SMILe implementation science project. BMC Health Serv Res. 2020; 20(827): 1-22. https://doi.org/10.1186/s12913-020-05636-1

(33) Kocher A, Simon M, Dwyer AA, Villiger PM, Künzler-Heule P, De Geest S, et al. Developing a rare disease chronic care model: Management of systemic sclerosis (MANOSS) study protocol. J Adv Nurs. 2019; 75(12): 3774-91. https://doi.org/10.1111/jan.14185

(34) Kim H, Park E, Lee S, Kim M, Park EJ, Hong S. Self-management of chronic diseases among older korean adults: An mHealth training, protocol, and feasibility study. JMIR Mhealth Uhealth. 2018; 6(6): 1-11. https://doi.org/10.2196/mhealth.9988

(35) Jiang Y, Liu F, Guo J, Sun P, Chen Z, Li J, et al. Evaluating an intervention program using WeChat for patients with chronic obstructive pulmonary disease: Randomized controlled trial. J Med Internet Res. 2020; 22(4): 1-18. https://doi.org/10.2196/17089

Artículos más leídos del mismo autor/a

Publication Facts

Metric
This article
Other articles
Peer reviewers 
2,4 promedio

Reviewer profiles  N/D

Author statements

Author statements
This article
Other articles
Data availability 
N/A
16%
External funding 
No
32% con financiadores
Competing interests 
N/D
11%
Metric
Para esta revista
Other journals
Articles accepted 
Artículos aceptados: 21%
33% aceptado
Days to publication 
617
145

Indexado: {$indexList}

Editor & editorial board
profiles
Academic society 
N/D
Editora: 
Universidad Nacional Autónoma de México