The Effectiveness of Technology Types in Telenursing for Home Health Care

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Abstract
Background: This systematic review aimed to evaluate the performance of various telenursing technologies in home health care and to compare whether specific telenursing modalities yield superior clinical outcomes compared with nurse-led telephone support. Methods: Following PRISMA 2020 guidelines, we searched PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest through April 12, 2024. This study was registered with PROSPERO (CRD42023396450). We included randomized controlled trials published in English since 1997 that compared advanced telenursing technologies, such as telemonitoring and videophones, with nurse-led telephone support for adult patients receiving home health care. Quality was appraised using the Cochrane Risk of Bias 2.0. Due to clinical heterogeneity, a qualitative synthesis was performed. Results: Eight studies were ultimately included. Heart failure was the most targeted condition. Telemonitoring showed the most consistent benefits across studies, including reductions in hospitalizations and length of stay, lowered 1-year mortality, and improvement in glycemic control and self-care behaviors. Videophone-based interventions demonstrated improvement trends in the quality of life and self-care behaviors, focusing predominantly on fundamental nursing and interactive approaches. Discussion: This review highlights that telenursing effectiveness varies by technology and that no single telenursing method can address the diverse, complex needs of home care patients. While telemonitoring showed superior clinical impacts, small sample sizes in several studies may limit the precision of findings. A flexible, multimodal strategy that is tailored to patient characteristics, care goals, and available resources appears most appropriate, and integrated models that combine telemonitoring with videophone or telephone support may enhance continuity, access, and personalization of care.

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