Background
Methods
Instrument development
Data sample
Applied measures
Data analyses
Results
Sample characteristics
Characteristics* | Patients with heart failure | Patients with depression | ||
---|---|---|---|---|
Standard care | Telemedical care | Standard care | Telemedical care | |
Age group | ||||
< 35 years | – | – | 22 (48.0%) | 7 (13.7%) |
36—50 years | 1 (1.8%) | 1 (2.0%) | 12 (26.7%) | 11 (21.6%) |
51—65 years | 20 (36.4%) | 9 (18.4%) | 9 (20.0%) | 29 (56.9%) |
66—80 years | 23 (41.8%) | 26 (53.1%) | 2 (4.4%) | 4 (7.8%) |
> 80 years | 8 (14.5%) | 9 (18.4%) | – | – |
Gender | ||||
Female | 18 (32.7%) | 16 (32.7%) | 27 (60.0%) | 35 (68.6%) |
Male | 37 (67.3%) | 33 (67.3%) | 17 (37.8%) | 16 (31.4%) |
Non-binary / gender nonconforming | – | – | 1 (2.2%) | – |
Education (Highest Degree) | ||||
Primary school (8th/9th class) | 3 (5.5%) | 10 (20.4%) | 3 (6.7%) | 2 (3.9%) |
Secondary School (10th class) | 27 (49.1%) | 25 (51.0%) | 14 (31.1%) | 29 (56.9%) |
High School (12th/13th class) | 15 (27.3%) | 9 (18.4%) | 26 (57.8%) | 15 (29.4%) |
Other Degree | 7 (12.7%) | 2 (4.1%) | 2 (4.4%) | 2 (3.9%) |
No Formal Degree | 2 (3.6%) | 1 (2.0%) | – | – |
Data
Tele-QoL instruments | Number of items | Tel-QoL outcome scales | Tel-QoL impact scales | Tele-QoL index | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Multidimensional Tele-QoL measure | Needs Orientation & Trust | Patient Relief & Autonomy | Information & Education | Cooperation & Communication | Perceived Control & Monitoring | Perceived Safety & Well-Being | Data Processing & Surveillance | Patient Burden & Limitation | Total score | |
Needs Orientation & Trust | 4 | – | 0.44 | 0.50 | 0.40 | 0.52 | 0.51 | −0.24 | −0.25 | 0.59 |
Patient Relief & Autonomy | 4 | 0.44 | – | 0.69 | 0.63 | 0.47 | 0.39 | -0.07 | −0.07 | 0.63 |
Information & Education | 4 | 0.50 | 0.69 | – | 0.80 | 0.63 | 0.49 | −0.12 | −0.13 | 0.76 |
Cooperation & Communication | 4 | 0.40 | 0.63 | 0.80 | – | 0.60 | 0.53 | −0.06 | −0.14 | 0.73 |
Perceived Control & Monitoring | 4 | 0.52 | 0.47 | 0.63 | 0.60 | – | 0.81 | −0.12 | −0.28 | 0.83 |
Perceived Safety & Well-Being | 4 | 0.51 | 0.39 | 0.49 | 0.53 | 0.81 | – | −0.20 | −0.26 | 0.74 |
Data Processing & Surveillance | 4 | −0.24 | −0.07 | −0.12 | −0.06 | −0.12 | −0.20 | – | 0.44 | −0.12 |
Patient Burden & Limitation | 4 | −0.25 | −0.07 | −0.13 | −0.14 | −0.28 | −0.26 | 0.44 | – | −0.16 |
Tele-QoL index | 6 | 0.59 | 0.63 | 0.76 | 0.73 | 0.83 | 0.74 | −0.12 | −0.16 | – |
Tele-QoL instruments | Number of items | Range of item locations | Range of threshold parameters | Non-ordered thresholds | Item fit (Q index) | Internal consistency | Spilt-half reliability | Test–retest reliability ICC (CI) p-value (t-test) | |
---|---|---|---|---|---|---|---|---|---|
Multidimensional Tele-QoL measure | (nmin–max = 178–185) | (nmin–max = 178–185) | (nmin–max = 178–185) | (nmin–max = 178–185) | (nmin–max = 178–185) | (nmin–max = 178–185) | (nmin–max = 75–78) | (nmin–max = 75–78) | |
Needs Orientation & Trust | 4 | −0.84 to 0.75 | −3.90 to 3.10 | – | 0.025 to 0.048 | 0.90 | 0.89 | 0.64 (0.48-0.76) | 0.18 |
Patient Relief & Autonomy | 4 | −0.13 to 0.23 | −2.39 to 2.92 | – | 0.034 to 0.069 | 0.87 | 0.83 | 0.74 (0.62-0.83) | 0.23 |
Information & Education | 4 | −0.43 to 0.03 | −2.34 to 2.47 | – | 0.030 to 0.092 | 0.83 | 0.83 | 0.73 (0.61-0.82) | 0.48 |
Cooperation & Communication | 4 | −1.16 to 0.69 | −4.35 to 3.49 | – | 0.028 to 0.082 | 0.90 | 0.84 | 0.66 (0.51-0.77) | 0.36 |
Perceived Control & Monitoring | 4 | −0.82 to 0.80 | −2.28 to 2.24 | – | 0.038 to 0.071 | 0.84 | 0.91 | 0.72 (0.59-0.81) | 0.46 |
Perceived Safety & Well-Being | 4 | −1.17 to 0.96 | −6.27 to 4.46 | – | 0.87 | 0.84 | 0.70 (0.57-0.80) | 0.07 | |
Data Processing & Surveillance | 4 | −0.95 to 0.88 | −3.20 to 3.00 | – | 0.019 to 0.050 | 0.93 | 0.81 | 72 (0.59-0.81) | 0.13 |
Patient Burden & Limitation | 4 | −0.84 to 0.84 | −2.60 to 5.63 | – | 0.021 to 0.038 | 0.95 | 0.91 | 0.72 (0.59-0.81) | 0.01* |
Tele-QoL index | 6 | −0.26 to 0.74 | −2.71 to 3.05 | – | 0.046 to 0.075 | 0.90 | 0.84 | 0.69 (0.55-0.79) | 0.26 |
Tele-QoL instruments | Patients with heart failure (NYHA = 1 vs. NYHA > 1) | Patients with depression (PHQ < 15 vs. PHQ > 14) | ||
---|---|---|---|---|
Multidimensional Tele-QoL measure | Mean difference* | Effect size Cohen’s d | Mean difference* | Effect size Cohen’s d |
Needs Orientation & Trust | 0.93 | 0.28 | 0.42 | 0.16 |
Patient Relief & Autonomy | 0.33 | 0.12 | 1.09 | 0.41 |
Information & Education | 0.52 | 0.17 | 1.09 | 0.38 |
Cooperation & Communication | 1.21 | 0.33 | 1.29 | 0.41 |
Perceived Control & Monitoring | 1.51 | 0.44 | 0.02 | 0.01 |
Perceived Safety & Well-Being | 0.63 | 0.19 | 0.78 | 0.33 |
Data Processing & Surveillance | -0.79 | −0.27 | −0.46 | −0.18 |
Patient Burden & Limitation | -0.93 | −0.37 | −0.80 | −0.34 |
Tele-QoL index | 0.84 | 0.17 | 0.94 | 0.40 |
Tele-QoL module | (subscales) | Needs Orientation & Trust | Patient Relief & Autonomy | Information & Education | Cooperation & Communication | Perceived Control & Monitoring | Perceived Safety & Well-Being | Data Processing & Surveillance | Patient Burden & Limitation | Tele-QoL index |
---|---|---|---|---|---|---|---|---|---|---|
Items | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 6 | |
WHOQOL-BREF | Physical domain | 0.10 | 0.18 | 0.21 | 0.27 | 0.10 | 0.05 | −0.14 | −0.17 | 0.10 |
Mental domain | 0.15 | 0.40 | 0.36 | 0.28 | 0.17 | 0.09 | −0.18 | −0.07 | 0.27 | |
Social domain | 0.17 | 0.34 | 0.27 | 0.21 | 0.23 | 0.19 | −0.16 | −0.04 | 0.30 | |
Environmental domain | 0.17 | 0.29 | 0.27 | 0.25 | 0.26 | 0.13 | −0.25 | −0.22 | 0.29 | |
EQ-5D | Health-related QoL | 0.04 | 0.06 | 0.09 | 0.19 | 0.01 | 0.04 | −0.21 | −0.11 | 0.01 |
VR-12 | Physical health status | 0.04 | −0.01 | 0.01 | 0.12 | −0.01 | 0.05 | −0.13 | −0.11 | −0.02 |
Mental health status | 0.18 | 0.43 | 0.37 | 0.31 | 0.20 | 0.10 | −0.15 | −0.12 | 0.26 | |
MLHFQ * | Disease-specific QoL (Heart failure) | 0.20 | 0.26 | 0.33 | 0.34 | 0.34 | 0.27 | −0.14 | −0.15 | 0.30 |
WHO-5** | Disease-specific QoL (depression) | 0.14 | 0.37 | 0.29 | 0.36 | 0.17 | 0.15 | 0.02 | −0.04 | 0.24 |
YHC-SUN-1 | Satisfaction with healthcare | 0.39 | 0.41 | 0.46 | 0.47 | 0.47 | 0.48 | −0.10 | −0.12 | 0.52 |
ZUF-8 | Patient satisfaction | 0.46 | 0.48 | 0.56 | 0.58 | 0.59 | 0.56 | −0.19 | −0.17 | 0.61 |
PAM-13-D | Patient activation | 0.22 | 0.28 | 0.33 | 0.34 | 0.27 | 0.22 | −0.14 | −0.01 | 0.33 |
HLS-EU-Q6 | Health literacy | 0.16 | 0.07 | 0.07 | 0.21 | 0.17 | 0.28 | −0.19 | −0.19 | 0.15 |
D-HLS-EU-Q6 | Digital health literacy | 0.13 | 0.05 | 0.04 | 0.18 | 0.10 | 0.21 | −0.18 | −0.12 | 0.08 |
KSA | Private body-related self-monitoring | 0.10 | −0.03 | −0.01 | −0.01 | −0.05 | 0.03 | 0.11 | 0.10 | 0.05 |
KLC | Health-related locus of control (internal) | 0.17 | 0.01 | 0.05 | 0.02 | 0.06 | 0.10 | 0.01 | −0.05 | 0.04 |
KLC | Health-related locus of control (external) | −0.08 | 0.01 | 0.05 | −0.03 | −0.01 | −0.09 | 0.03 | −0.02 | −0.05 |
TBS | Technology acceptance | 0.12 | 0.12 | 0.13 | 0.16 | −0.03 | −0.00 | −0.12 | −0.05 | 0.07 |
Technology competence | 0.12 | −0.09 | −0.11 | 0.01 | −0.02 | 0.06 | −0.19 | −0.18 | −0.04 | |
Technology control | 0.02 | −0.05 | 0.04 | 0.15 | 0.02 | 0.02 | −0.08 | −0.09 | −0.00 | |
SeCu*** | Technology anxiety | −0.06 | −0.02 | −0.04 | 0.05 | 0.04 | 0.07 | 0.31 | 0.20 | 0.07 |
Perceived security | 0.58 | 0.57 | 0.81 | 0.74 | 0.80 | 0.80 | −0.22 | −0.30 | 0.84 | |
Perceived autonomy | 0.38 | 0.63 | 0.78 | 0.90 | 0.62 | 0.66 | −0.08 | −0.08 | 0.82 | |
Physician–patient-relationship | 0.36 | 0.59 | 0.70 | 0.66 | 0.72 | 0.71 | −0.08 | −0.17 | 0.81 |