Nurse and patient communication profiles in a home-based telehealth intervention for heart failure management.
OBJECTIVE
This study compared differences in nurse and patient communication profiles between two telehealth modes: telephone and videophone, and evaluated longitudinal changes in communication, nurse perceptions, and patient satisfaction.


METHODS
Subjects were enrolled in a randomized controlled clinical trial evaluating a 90-day home-based intervention for heart failure. Telephone (n=14) and videophone (n=14) interactions were audio taped and analyzed using the Roter Interaction Analysis System.


RESULTS
Nurses were more likely to use open-ended questions, back-channel responses, friendly jokes, and checks for understanding on the telephone compared to videophone. Compliments given and partnership were more common on the videophone. Patients were more likely to give lifestyle information and approval comments on the telephone, and used more closed-ended questions on the videophone. Nurses perceptions of the interactions were not different between the telephone and videophone, nor did their perceptions change significantly over the course of the intervention. There were no significant differences in patient satisfaction between the telephone and videophone.


CONCLUSIONS
The results of this study did not support use of a videophone over the telephone.


CONCLUSIONS
It is critical to match technologies to patient needs and use the least complex technology possible. When considering use a videophone, health care providers should critically examine the trade-offs between additional complexities with the added value of the visual interaction.
Wakefield
Bonnie J
BJ
Research Service, Harry S. Truman Memorial Veterans Hospital, 800 Hospital Drive, Columbia, MO 65201, USA. bonnie.wakefield@va.gov
Bylund
Carma L
CL
Holman
John E
JE
Ray
Annette
A
Scherubel
Melody
M
Kienzle
Michael G
MG
Rosenthal
Gary E
GE
D000368:Aged; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D003142:Communication; D003625:Data Collection; D005260:Female; D006333:Heart Failure / Q000517:prevention & control / Q000523:psychology*; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009723:Nurse-Patient Relations; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D010353:Patient Education as Topic / Q000458:organization & administration; D017060:Patient Satisfaction; D017216:Telemedicine / Q000295:instrumentation* / Q000458:organization & administration; D013689:Telephone; D013997:Time Factors; D014741:Video Recording