Tesi sul tema "Tele-homecare"

This thesis addresses the hypothesis that a single, waist-mounted triaxial accelerometer (TA) can be used to monitor human movement patterns in unsupervised, freeliving subjects over extended periods, and that it can be used to quantitatively measure parameters that can provide clinical insight into the health status of the subject. A rigorous theoretical and experimental understanding of the signals obtained from a TA is developed. The effect of the placement of the TA device on the waist is explored and a model relating device position to TA signal is developed for a range of postures and activities. A classification framework for movement identification using the signals from a waist-mounted TA is presented. This framework is based on a hierarchical binary processing tree and is designed for real time use. An implementation of this framework for monitoring housebound patients is presented. Algorithms for detecting falls, distinguishing between activity and rest, classifiying transitions between different postural orientations, and for identifying periods of standing, sitting, lying and walking are developed. In evaluation studies performed in controlled laboratory conditions, every algorithm performed with better than 90% accuracy. Once movements are identified, movement-specific parameters sensitive to changes in functional status are extracted from the signal. A two stage methodology for employing the accelerometry system in monitoring free-living subjects is introduced. The first stage involved monitoring specific movements through a directed routine. The second stage involved monitoring of free movement. Signals obtained from the directed routine are used to extract clinically relevant, movement-specific parameters. Signals obtained from the period of free movement are monitored for falls and other abnormal events. General parameters of movement, including energy expenditure, are also measured. The system was evaluated in a series of field studies in laboratory and home environments, in supervised and unsupervised settings, using cohorts of healthy subjects. A pilot trial was conducted in which six healthy elderly subjects wore the TA device for a period of up to three months. The technical performance and useability of the system were evaluated. Clinically significant parameters were measured and the effects of age and health status on the measured parameters were evaluated.

碩士
美和技術學院
健康照護研究所
98
Home-care is the major community-care practice in Taiwan, serving more than twenty thousand people now. A high demand of labor in home-care is expected. An efficient management of labor is one of the major issues in Tele Home-care (THC). Quite a few home-care organizations have been working hard on this field for more than ten years, long before the term THC came in the spotlight. As they offer valuable experiences, they are also challenged by the rise of this new industry. However, THC is still at a clinical stage of trial and error, which means an unripe THC market. High investment is still absent. Yet, capital and up-to-date hardware is not the core of the problem. In urgent demand is a new form of operation. In fact, both the government and private units are now putting most of their effort into working out a sensible new operation system. Local people’s financial background and medical habits have been taken into consideration. At present, an atypical system that features the sharing of resources among small-sized organizations might be more practical at the initial development of a THC market. What THC can add to the present home-care operation is to improve service delivery. New enterprises will surely be eager to cooperate with home-care organizations that have practiced THC. But these small organizations must first undergo change management to cope with commercialism, form a professional system, as well as maintain their traditional missions. A high risk of administration has been caused by their over-dependence on the government. It is also no easy task to resettle the professional labor and meanwhile fulfill the social workers’ expertise. It is essential that the government should establish and supervise a common platform for THC, sharing research results and related resources. With the long-term care insurance taking effect, home-care is to form a quasi-market, though THC still has to wait for insurance. Facing the quasi-market of home-care, both the government and private units will have to deal with their respective challenges.

碩士
國立交通大學
科技管理研究所
99
In recent years, the world’s population structure is facing to the continuous decline of birth rate, birth decrease and aging population. These major changes derives the need of telehomecare (THC). Telehomecare is a care model that combines services, communications, and medical equipment, and it uses remote monitoring technology to enable the elderly to enjoy a more convenient, comfortable and safe medical service at home or in community. Now the world countries develops telehomecare actively, Taiwan's ICT industry develops very well, and there is a solid foundation in overall information and communications environment, so there is sufficient potential to develop telehomecare system. It will be important how companies can successfully operate and solve management problems in this emerging field. TRIZ differs from Brainstorming within the systematic thinking process. When facing problems, brainstorming is the most common method to seek for solutions. Neverthless, this thinking process is restricted to the experiences and backgrounds of participants and it takes a lot of time. TRIZ is a systematic problem solution method and is applies to engineering and non-engineering field recently. In this study, we applies TRIZ and review related literature to construct a contradiction matrix for telehomecare, managers could use this matrix and the 40 inventive principles to seek for appropriate solutions for telehomecare.

碩士
明志科技大學
電機工程系碩士班
105
Home-based long-term care is an important policy of the government and the development of "tele-home care (tele-home care, THC)" becomes the main planning directions. The benefit of THC is to assist family caregivers to know seniors physiology and life information through their mobile phones and internet device. THC becomes the important part of preventive medicine because it can reduce the cost of national health insurance and help people stay at home and live as independently as possible. However, the current monitoring systems in Hospital are based on cable connections before. The size of system and power consumption are big and not portable. Hospital monitor systems are unsuitable for the real-time, continuous, long-term monitoring of important parameters in patients at home. This study presents a system which provides the blood pressure monitors, temperature detection and Electrocardiography(ECG) on the Arduino. The measurement data can be delivered to mobile phones through Bluetooth. After the estimation in expert system, phone will immediately send a newsletter to user or user’s family. Clinical trials reveals that the propose system can achieve the 99% accuracy to identify and detect unusual event. This system can provide the convenient, low-cost, real-time interpretation and reduce the resources advantages of medical staff.

碩士
中原大學
生物醫學工程研究所
101
Shortage of medical resource has been a major issue to many developed countries. This issue is largely worsened due to the huge increase in the aging population. A thought of integrating computers, networks, and medical examination technologies is often suggested as the solution. The theme of the thought is to monitor vital physiology signals such as electrocardiograph (ECG), blood pressure (BP), saturated pulse oxygen (SPO2), and body temperature (BT) from distance by medical experts. A term for this thought is tele-home health care. In this work, a tele-home care test-bed system has been developed to aim on the medical resource shortage issue. It includes a signal acquisition (SA) subsystem, communication subsystem and a management subsystem. The SA subsystem mainly includes a hand-held physiology signal device and a personal computer (PC). The device can simultaneously acquire waveform signals from one ECG channel and two PPG channels. In addition, a body temperature data can be obtained as well. The signals and data are then formatted to become files which are compliant with DICOM (Digital Imaging Communications on Medicine) protocol in the PC. The formatted files are then transferred to the manager subsystem. The subsystem contains several PC’s which function as section guards, section managers, viewers and database managers. A 100-Mbps Ethernet links these computers as a functional unit. All software modules developed are written in C++ language. The formatted DICOM files including ECG wave signals were successfully parsed, opened, and viewed with existing ECG applications and the viewer developed in this work. The test-bed system has been validated for seven days continuously without any system malfunctions.

碩士
國立台北護理學院
資訊管理研究所
97
Along with the population ageing in our society, the demand for long-term care for elderly people increases. Tele-care, which can be achieved using today’s information technology, is an alternative of long-term care. It is expected to lessen the burden of the families and the caregivers, and to improve the quality of care. LTTCS (Long-Term Tele-Care System) is an information platform for video tele-care established by early researchers in our group. The platform is a web-based system, which provides various services to assist home care for the elderly. The CMS (content management system) of LTTCS contains discussion board, searching engine, RSS (Really Simple Syndication), calendar, photo album, video album, and video blog. Online video care (v-care) system and personal health management system were also developed and integrated into LTTCS to offer advanced services. This study aims at improving the functions of LTTCS to fit elders’ needs better. The automatic mechanisms for uploading data of blood sugar and graphs of ECG (electrocardiography) were implemented. Text messages can be sent out spontaneously via SMS (short message service) for alerting purposes. The concise version of the home page was enhenced for the elderly. Finally, these added functions and video quality of LTTCS were evaluated. The results showed that the elderly were quite satisfied with the newly provided services and the video quality using wireless connection is acceptable.

碩士
國立清華大學
工業工程與工程管理學系
103
The population of solitary elders is increasing because of the aging society. The number of patients who are living alone and those with chronic diseases is increasing because of stressful life. Thus, tele-homecare service for solitary elders or chronic patients is an important issue because no one can provide timely help to subjects who live alone once they fall seriously ill or encounter an accident. Therefore, developing a tele-homecare system for this population group can assist paramedics in real-time evaluation. This study proposes a personalized evaluation and support care system to provide in-time care for solitary elders and home care patients. There are three roles played in this system, namely, the emergency response center (ERC), the care support agent, and the subject in need. One database and two analytical sub-models are included in the system. (1) Personal Database: Recorded by a tele-homecare device from the subject in need. The data of each subject and the professional knowledge of doctors will be integrated to establish an individual physical record, which will be stored at the ERC. (2) Evaluation Model: Fuzzy Logic is applied to derive a real-time individual health status to provide the ERC with indicators on whether the subjects are at risk. (3) Supporting Care Model: A decision-making model based on a dispatching optimization program is established to suggest the available and most efficient ERC agent to reach the subjects and provide timely assistance. A case study in Hsinchu is conducted to illustrate the proposed system. The result of the case study shows that this system can provide the accurate health status of a subject in need and support the ERC and available agent to provide assistance efficiently.

碩士
國立勤益科技大學
電子工程系
102
This work is an Internet of Things (IoT) implementation made by embedded system platform, Zedboard, becomes a concentration station for Tele-homecare application The purpose of this work is to find solutions in staging areas. One of the IoT applications is health monitoring and emergency notification system. A Zedboard is playing the role as a concentration station, managing Bluetooth Electrocardiogram Sensor and interfacing Ethernet. Also, this work achieved by a Qt-based and a HTML5-based graphical user interface, providing cross-platform availability for users who are accessing the Zedboard. For SoC-FPGA structure, flexibility is the major benefit. Even before year 2013, the development environment and tools on Zedboard were not so completed as we expected. However, vender improved in 2014, the concentration station was brought up to internet and worked as planned. The first node of our staging area is now on-line.

碩士
東海大學
電機工程學系
104
Nowadays, structure of Taiwan population has been aging slowly, but the corresponding medical caring resource has not yet become better. It is resulting in heavy burden on caregivers. In addition, the medical resource arrangement is not assigned equal between city and countryside. It leads to take people from countryside more time in order to trace the health condition regularly. Moreover, this situation has made those people unwilling to go to hospital due to the long travel, resulting in illness getting worse or undiagnosed in time. Most of the caring systems are built in Microsoft platform. If a place has different operating environment, it must be rebuilt the data base and redesigned since disparate platforms could not communicate with each other. Thus, this study tends to use JavaFX to build a cross─platform wireless far─end residential caring system in order to improve the unequal resource arrangement and various operating environment. With the Bluetooth technology, this system is able to receive the physical condition of patients and transfer data to different platform for analysis, then, manager can determine if the patients need physical assistance. This system provides the actual online receiving and transmitting in series, it makes care givers able to communicate with system immediately and observe patients’ condition to solve the less medical resource problem in countryside.

碩士
崑山科技大學
電子工程研究所
94
No matter tele-medicine or tele-homecare, which based on research of science and technology. It is important subject to acquire, examine and convey the individual physiological information immediately. The informations are such as: breath rate, heart rate (heart tone), body temperature, blood pressure, blood glucose and urine analysing, bone mass density, etc. This thesis regarded examining the heartrate in quantity as the example and apply low-priced “the metal plate” to pick the micro electric potential difference from the surface skin which due to the heart cell stimulates. Above detected will send to the IC module and dealt with by the square wave pulse outputs. The heartbeat cycle which the processor processing showed instant and physiological state by LED or LCD in real time instead of sending the information to PC. Or applying the simple, fast and reliably serial wired UART hardware or wireless bluetooth links to PC Server and stores a historical parameter as the database by high level language program. The Client terminal can browse through individual's instant or historical image, physiological information etc. in identity number, password that must sign-in privacy through the internet network web page.

碩士
東海大學
工業工程與經營資訊學系
99
Nowadays aging population is a global phenomenon, increasing costs of healthcare and shortage of healthcare providers will soon become a crucial issue all over the world. Past patterns of care by using family members who give up their current job position to provide non-professional care. This situation not only causes a mismatch of human resources, but also cannot guarantee quality care service. In recent years, tele-homecare is an emerging trend. The proportion of tele-homecare, the elderly problem is serious in Taiwan. The Executive Yuan Department of Health proposed “Telecare Service Development Project” including Wang Fang Hospital, Changhua Christian Hospital, Kaohsiung Medical University Hospital and Mennonite Christian Hospital four care teams. Each team member will develop local condition of service type with innovation technology application project. Current tele-homecare industry is not yet mature. Therefore, the main objective of this research is to survey all processes based on user’s perspectives. First, the research use service blueprint depicts the tele-homecare service delivery process, and then through the literature and practitioners ’ interviews to construct PZB service quality gap model, and then combined TRIZ theory, analysis of an innovative program available to planning as a reference. Finally, the research found that the current practice of the tele-homecare service needs to be modified. This research suggests and provides a tele-homecare industry an innovative thinking, continuous improvement as a reference for policy.

碩士
明道大學
資訊工程學系碩士班
97
The reality makes the pulse and blood oxygen sensing, transmits to the far-end web-based, and construction of the elderly Tele-homecare system. Use Soc embedded system chip, Integration of the pulse and blood oxygen through the Programmable control devices implementation of heterogeneous integration, transform into several communication forms, in the signal transmission Soc embedded system chip control panel after opening the solution, the transformation, the interpretation and the additional information, passes along to the transmitting end (Zigbee), the utilization wireless communication form transmits to the far-end receiving end (Zigbee), transfers again by the socket control stores in the web-based homepage type information bank, and unifies the general physiology to look after neglects prolonged illness person, moves about with difficulty caused the urine eczema's shortcoming, the research and development paper diaper soaks sensing method. And quotes other research elaboration to take the comparison the vertical basic point, makes the change on the construction, changes its research construction, substitutes for the blue bud take Zigbee to do as transmits the tool, reduces the system overall price, and compares between two research the difference. This research discovery transmits the tool using the Zigbee achievement under the small power consumption and the transmission capacity, may achieve with the blue bud transmission same effect, also reduced, because the equipment creates the unit price rise's question, also uses the experiment in transmission delay's part to confirm that the delay time less than 10 seconds, transmission material wrapped gift losing also from each minute 1/3 change for less than 1/60, from this we may determine the Zigbee conformity several processing systems and the homepage type information bank feasibility truly, and is adding on this research design the urine wet sensory element, may urinate the wet information to transmit immediately for the far-end monitoring knew.

碩士
元智大學
機械工程學系
94
In this study, a monitoring system for long-term monitoring of activities of daily living (ADL) in the user’s home is constructed. This system integrates the distributed data server (DDS), ADL sensors, and wireless RF transmitters. The user can login the DDS to retrieve data and observe the trend of ADL variations. Analysis methods for ADL data are also developed to find whether the daily ADL data matches the pattern of historical data. For ADL data with time-pattern, the Pearson’s correlation factor of the daily ADL curve and the historical average curve is used as the index. For ADL data without time pattern, the data is displayed by ADL energy rank. The energy ratio and time ratio of the daily ADL and historical ADL data are used as indices.

碩士
國立成功大學
電機工程學系專班
94
Tele-homecare helps hospitals monitor the changes of the condition or health of patients who are suffering from the chronic disease or just discharged from the hospital after an operation. Through some newly communicated transmission equipments, patients may have medical treatment at home or some convenient locations other than hospitals. In this study, we designed a tele-homecare system by using the LabVIEW software, tele-conference software, and PC interfaces. The system can automatically capture data (such as heart sound, pulse, blood pressure, body temperature, etc.) from the electronic medical equipments, meanwhile, can also save data by manual input. Through the system, patients’ examination data can be automatically provided to the doctor at the remote place for diagnosing need. The purpose of this study is to develop a tele-homecare system with low cost, easy operation, simple maintenance, and widespread utilization so that the system can provide the services for the remote village which may be short of doctors, the homecare of chronic diseases, and the medical treatment. Therefore the system can benefit the residents living in remote area and reduce the medical cost due to the aging problem of the society.

碩士
國立臺北護理健康大學
護理研究所
100
Due to the degeneration of bodily functions and stroke, the elderly with physical limitations may require additional home care. These patients may also require long-term care, creating difficulties and burdens for their primary caregivers. Therefore, the corresponding establishment and integration of long-term care resources that enhance services availability, convenience, accessibility, and adequacy are highly critical. Care receivers opinions about technology-driven home care are essential for the development of distance homecare services. Understanding the perspectives of care receivers’ can identify the value of services. Therefore, the purpose of this study is to examine the needs of distance homecare and its associated factors for primary caregivers of older stroke patients. This study adopts a cross-sectional design that uses a descriptive correlational method. Purposive sampling was conducted to recruit 120 primary caregivers of older stroke patients from three teaching hospitals in northern Taiwan. Study instruments include the activities of daily living (ADL) scale, burden scale, SF-36 health scale, and a distance homecare services need scale. A survey using structured questionnaires was conducted between September, 2012 and November, 2012. A total of 120 valid questionnaires were collected for statistical analysis. The study results show that: (1) the mean score of general needs of distance homecare services among primary caregivers of older stroke patients was 61.63 (SD=27.44), suggesting a moderate level of services is required. Emergency consultation and management is the most required service; (2) The mean score for care burden among primary caregivers of elderly stroke patients was 31.40 (SD=15.02), which was below the median value; (3) The mean scores for health status in the physical component summary (PCS) and mental component summary (MCS) among primary caregivers of older stroke patients were 49.90 (SD=8.84) and 49.98 (SD=10.88), respectively, indicating a comparable health status with the general population; (4) Factors influencing the general needs of distance homecare services include the relationship between caregivers and patients, availability of families or friends to alternate caring for patients, care fees, and daily expenditures. Greater needs of distance homecare services emerges when the patient’s children, families, or friends are available to alternate caring for patients, or when the care fees and daily expenses of the patient are shared among families; and (5) According to the predicting model for the needs of distance homecare services for primary caregivers of older stroke patients, care fees and daily expenditures explains 18% of variance for the need of caring knowledge and information, and 16% of variance for the need of caring skills. Furthermore, education level was a predictor of societal resources demands (OR = 0.11, 95% CI = 0.02-0.48). The predictors for the care costs and living expenses, and consider to adopt long-distance care services that are the major influences on the requirement of primary caregivers who take care of elderly stroke patients on the long-distance home care services. Deeply realize the influence of care costs and living expenses on developing the elderly stroke patients on the long-distance home care services in the future. To recommend that the policy of development on long-distance home care services in the future, the free of charge is the inducement of adopting this service. Key words: Distance homecare, elderly stroke patients, primary caregivers, need

碩士
國立台北護理學院
護理研究所
98
Background Because of high relapse and mortality rates of coronary artery disease(CAD) elderly patients, especially incharged in 1-year, the combination of technology and care services in home care and prevention strategies is an important issue. For truly reflecting the value of the services, this study was to investigate the needs of Tele-homecare in the elderly with CAD, who have been discharged in 1 year. Methods This study is a descriptive study designed for 120 patients with CAD, over 65 years, who were discharged from three medical institutions within a year. We investigated the basic characteristics, disease characteristics, uncertainly, social support, and tele-homecare needs of the study population by various questionnaires. All questionnaires were certified and have good sensitivity and specificity. Results The tele-homecare needs of these subjects was low, scored 30, with a standard deviation 20.7 and right skew distribution (Skewness=0.83). Processing requirements in emergency situations in which had the highest score. Subjects within the highest qualities of tele-homecare needs were married, well educated, had co-morbidities, no functional limitations, and high social support. By using logistical regression analysis, co-morbidities and social support were predictors of high Tele-homecare needs. Conclusion We failed to show that those high-risk group, like living alone, low education, high functional limitations , and low social support subjects had high tele-homecare needs . More research on them is needed. Therefore, in clinical work, for those who had co-morbidities, have been admitted within 1 year, are warranted to explore their Tele-homecare needs for clinical implications.

博士
國立中正大學
資訊管理學系暨研究所
102
Background: Applying web-based information and communication technology to care for patients has been implemented in various countries for many years. Most Telecare research focuses on information engineering, such as hardware development, information platform design, and system construction. Purposes: There is much less research into the use of information technology to support dementia care and the effects on caregiver mental health and quality of life. To address this gap, the objectives of this research are: (1) To evaluate the quantitative effectiveness of technology adaptability between disease severity and a Tele-Homecare Support System; (2) To explore Mediators and Moderators which affect the effectiveness of technology adaptability between disease severity and a Tele-Homecare Support System; (3) To evaluate the subjective perception of system usage by caregivers (system users). Method: A Tele-Homecare Support System specific to dementia caregivers is first proposed in this research, and then a Structure-Process-Outcome (SPO) framework is applied to conduct a field experiment to objectively test the quantitative effectiveness of the adaptability on a Tele-Homecare Support System (THSS). In addition, the qualitative effectiveness of the prototype system is explored by interviewing the users to collect their perceptions of Ease of Use and Usefulness. Results and Discussions: The results of THSS usage show that the property exit sensor (averaging at 81.17 times per household) triggered more frequently than the bed occupation sensor (59.13 times) and the fall detector (4.67 times). The problem of the patient getting lost outside is currently the major burden for caregivers. The possibility of having someone or some organization to take over or share the burden of care were at the top of their wish list. The Tele-homecare Support System is a web-based interactive platform/interface that provides a 24/7 platform to support patients by monitoring their safety, caregivers by offering them helpful instructions' and medical staff by giving them access to information crucial to making related care decisions. This research found the different adaptability between disease severity and care-aided tool would significantly improve the caregiver’s depression and quality of life overall, and in the domains of satisfaction with overall health, physical health, psychological health, social relations and environment. The difference in effectiveness showed that the fit group predictably experienced a greater increase in quality than the unfit group. The mean depression score for the fit group was also lower than that of the unfit group. Furthermore, there was a moderating effect so that the adaptability of the system would significantly affect the care support effectiveness when the age of caregiver is 65 years or under. Applying the Structure-Process-Outcome (SPO) theory, it can be concluded that the mediating effect little occur in the relationship between the technology adaptability and care support effectiveness. That is, the adaptability of THSS would directly affect the caregiver's medical utilization and mental health. Conclusions: In summary, this research is an empirical study looking at the concrete benefits of a technological intervention in dementia care. Data from the caregivers’ quantitative assessment and qualitative perspective for Tele-Homecare Support Systems were collected and analyzed. The findings of this research make a meaningful contribution to dementia care and could make a real difference in the lives of primary caregivers by alleviating their mental pressure.