Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Marinschek, S.
Netcoaching: A new and effective alternative to traditional onsite models
for supervised tube weaning in infancy
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Graz Medical University; 2015. pp.87.
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- Autor*innen der Med Uni Graz:
- Marinschek Sabine
- Betreuer*innen:
- Dunitz-Scheer Marguerite
- Hofmann-Wellenhof Rainer
- Holzinger Andreas
- Altmetrics:
- Abstract:
- Aim of the study: The „Graz model“ of tube weaning has been internationally recognised since nearly 30 years. Patients from all over the world participate in the program. Besides the in- and outpatient treatment option (onsite program), a new telemedical program (online program called Netcoaching) has been developed in 2009. This thesis offers data of a unique and large sample of patients (N=473) who participated either in the onsite program (N=228) or in the telemedical online program „Netcoaching“ (N=245) between Jan 1st, 2009 and December 31st, 2013. Biographic data (age, country of referral, gender), biometrical and medical data (diagnoses, weight development, type of tube, duration of tube feeding) as well as psychological (reaction to food, client satisfaction) aspects were collected, analysed and evaluated. Furthermore, the sustainability of the tube weaning intervention corresponding to the long-term success rate has been analysed. Method: The outcome of the tube weaning program was declared as the target variable. A four-step scale (totally weaned, partially weaned, weaning trial without success, interruption of treatment) has been used. Both treatment options were compared, statistical values were calculated. Results: Complete weaning was achieved in 220/245 (89.8%) patients opting for the online program as well as in 184/228 patients (80.7%) in the onsite program. In the online program, no child was labelled with the outcome “weaning trial without success” whereas 6/228 children (2.6%) in the onsite program have been labelled with this outcome. Both results show no significant differences between the treatment groups. Significant results are shown in the outcome groups “partially weaned” – 12(245 (4.9%) in the Netcoaching group versus 37/228 (16.2%) patients in the onsite group could be weaned partially – and “weaning trial without success”: 13/245 patients (5.3%) interrupted the Netcoaching program, and only 1/228 (0.4%) patient left the onsite program before completion. Conclusion: In this first evaluation of a large sample of children participating in the “Graz model”-concept for tube weaning, similar efficacy of the newly invented telemedical online option compared with onsite program has been demonstrated. Based on economical aspects (less hospital admission, lower risk of infections, less expensive, no travel costs, no waiting list), the Netcoaching program can be considered as an adequate and attractive alternative for the goal of effective and sustainable transition from enteral to sufficient oral intake to the traditional onsite treatment options.