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Bakgrunn: Bakgrunn for studien er Barsel hjemme, et prosjekt som har sett på en helhetlig modell for svangerskap, fødsel og barselomsorg. Det har vært et samarbeid mellom Ullevål universitetssykehus og Bydelene Sagene/St.Hanshugen. Kvinnene som har deltatt har gått til jordmødre fra prosjektet som er/har vært ansatt på sykehuset i svangerskapet, født på Ullevål og reist tidlig hjem i barsel med besøk fra samme gruppe jordmødre. Hensikt: Evaluere Barsel hjemme ved å se på pasienterfaringer med prosjektet og undersøke kvinnenes opplevelse og ønsker når det gjelder kontinuitet og helhet i svangerskap, fødsel og barselomsorg. Metode: En triangulering av metoder er brukt: Dette inkluderer en pasienterfaringsundersøkelse, en anonym spørreundersøkelse som er sammenliknet med en liknende undersøkelse fra en barselavdeling, og fokusgruppediskusjon med kvinner fra prosjektet som er analysert med inneholdsanalyse. Funn: Kvinnene som har deltatt i Barsel hjemme er svært fornøyd med prosjektet, gjennomgående mer fornøyd enn kvinner som har hatt vanlig barselopphold ved sykehuset. De hadde deltatt igjen om det hadde vært mulig. De er ikke opptatt av kontinuitet i den forstand at samme person trenger å følge de i hele forløpet. Her spiller forventninger en viktig rolle. Personalets evne til å skape en god relasjon, en følelse av trygghet og se individuelle behov er mer viktig. De ønsker mer kontinuitet i informasjonen de får under svangerskap, fødsel og barseltid. Konklusjoner: Barsel hjemme er et prosjekt som kvinnene anbefaler, og som de skulle ønske fortsatte. Når det gjelder kontinuitet og helhet er dette avhengig av forventinger. Det at personalet kan skape personlige relasjoner og møte kvinnene på deres individuelle behov er det viktigste. / Background: This study is based on a project known as “Barsel hjemme” (“postnatal careat home”), whose main goal has been to develop a model for prenatal, birth, and postnatalcare, focusing particularly on continuity. Participants had prenatal check-ups with projectmidwives, delivered their babies at Ullevål University Hospital, and were discharged fromthe hospital early in the postnatal period. Project midwives visited all participants at home. Aim: This study aimed to evaluate Barsel hjemme by examining patient satisfaction andassessing their experiences and desires through the prism of continuity. Methods: A triangulation of methods was used. This included a patient satisfaction survey;an anonymous survey that was then compared with a similar survey from a standardpostnatal department; and content analysis of focus group discussions. Findings: Women who participated in Barsel hjemme were very satisfied, generally moresatisfied than women from a standard postnatal department. They would participate again ifpossible. They did not define continuity of care as being cared for by the same person.Expectations played an important role in how they experienced the project. Midwives’ability to create a personal connection and treat participants as individuals were paramount.Participants wanted greater continuity in the information given during pregnancy, birth, andthe postnatal period. Conclusions: Women recommend the Barsel hjemme project and want it to continue.Continuity of care hinges on individual expectations. Personal relationships and recognitionof individuality are of primary importance. / <p>ISBN 978-91-85721-94-8</p>

Bakgrund: Barnmorskor har en viktig roll i att informera, stötta och vägleda kvinnan genom graviditet, förlossning och eftervården. Det vanligaste är att kvinnorna föder sitt barn på sjukhuset och därefter vårdas på BB för att bland annat få hjälp med amning och eftervård. Vårdtiden har idag förkortats och eftervården sker ofta via vårdformen ”tidig hemgång”, vilket upplevs olika av kvinnorna. Upplevelser av tidig hemgång efter förlossningen är av intresse för barnmorskor för att öka kännedomen av fenomenet. Syfte: Att beskriva förstagångsmammors upplevelser av stöd från BB relaterat till tidig hemgång efter barnets födelse. Metod: En kvalitativ metod användes med induktiv ansats och kvalitativ innehållsanalys. 15 förstagångsmammor fick svara på öppna frågor i en enkät. Resultat: Resultatet presenteras i löpande text utifrån ett tema och tre kategorier som framkommit. Resultatet visa att förstagångsmammorna önskar tydlig information och behöver olika mycket och olika typer av stöd som i sig genererar i trygghet. Förstagångsmammor upplever olika känslor vid tidig hemgång så som oro, stress, lugn och nervositet. Konklusion: Det är viktigt med tydlig information om vad tidig hemgång innebär. Informationen ges med fördel redan tidigt under graviditeten. Barnmorskornas stöd och tillgänglighet på BB är av stor vikt för förstagångsmammorna. Individanpassad vård är viktig. / Background: Midwives have an important role informing, supporting and guiding the woman through pregnancy, childbirth and postnatal care. Most common is that the woman is giving birth to her child at the hospital and go for continue care at the maternity hospital for help with breastfeeding and postnatal care. Maternity hospital time is shortened and the postnatal care are often given thru the form of care “early discharge”. Mothers´ feelings in relation to early hospital discharge differs. There is a lack of knowledge about mother’s feelings in relation to early hospital discharge. Therefore, more research is needed experience of womens feelings of early discharge after childbirth is important for the midwives for the knowledge of the phenomenon. Purpose: The aim of this study was to investigate first-time mothers´ experiences of support from maternity ward related to early hospital discharge after childbirth. Method: A qualitative method with inductive approach and qualitative content analysis was used. 15 first-time mothers answered a questionnaire after birth and hospital discharge. Result: The result is presented in continuous text based on a theme and three categories that have emerged. The results shows that first-time mothers´ want clear information and that they have different need of support for the feeling of safety. Feelings related to early discharge that first-time mothers´ experience are worry, stress, calm and nervousness. Conclusion: It is important to give clear information about what early hostpital discharge means. The information is advantageously given early during pregnancy. The availability of support from midwives is important for first-time mothers. Individualized care is therefore of importance.

Indlæggelsestiden i forbindelse med kirurgi er blevet kortere. Der er meget lidt viden om, hvordan den umiddelbare postoperative periode forløber. Formålet med undersøgelsen har været at vurdere om korte hospitalsforløb hos patienter, der er opereret for forstørret prostata, bevirker at de pårørende overtager en del af plejen, at undersøge om der kommer en øget belastning på andre dele af sundhedsvæsenet, samt at få en viden om hvordan patienterne har det i de første uger efter operationen. Der er foretaget kvalitative interviews med ti hustruer. Til analyse af interviewene er brugt den fænomenologiske metode, beskrevet af Giorgi og Karlsson. På baggrund af disse interviews er der udarbejdet et spørgeskema, som er udsendt til alle hustruer, hvis ægtefælle i perioden november 2004 til maj 2005 er blevet prostataopereret. Resultaterne fra spørgeskemaundersøgelsen blev sat ind i en access database. Resultatet viser at den første postoperative periode er præget af mange vandladningsgener så som inkontinens, hyppige vandladninger, blødning og urinstop. Gener som også belaster hustruerne. Hustruerne følte sig usikre på om efterforløbet var normalt, og de manglede viden om, hvor de kunne henvende sig med problemer. / The length of stay at hospital after surgery has shortened. Little is known about the immediate post-surgery period. The aim of this study is to assess whether spouses have to take active care of their husbands and to assess if the burden of other part of the health service increases as a result of early discharge after prostatic surgery. Furthermore, the study intends to increase the knowledge about how patients experience the first postoperative weeks. Initially qualitative interviews were conducted with ten spouses. The Phenomological method described by Giorgi and Karlsson was used for analysing the interviews. Based on the experience of this, a questionnaire was prepared and sent to all spouses of patients who had undergone prostatic surgery between November 2004 and May 2005. The results of the questionnaires were put into an access database. The principal finding is that many patients during the first postoperative period experience various urinary problems such as incontinence, frequency, haematuria, and urinary retention. Problems which negatively impacted on the spouses. Furthermore, the spouses were uncertain whether it was common to experience these problems, and they did not know whom to contact when in need of support / <p>ISBN 91-7997-152-0</p>

Having a newborn can be a big change for families, especially for first-time parents. At hospital discharge, parents are often provided with a lot of information, which can be difficult to retain. Due to shortened postnatal lengths of stay, nurses typically have less time to educate parents, which often results in families feeling overwhelmed. After hospital discharge, it is recommended for families to see a health care provider (i.e., physician, nurse practitioner, or registered midwife) within 72 hours for a follow-up appointment. This follow-up appointment is meant to assess both the mother and newborn to ensure they are both in good health and to provide any needed support. Unfortunately, completing the appointment within this timeframe may not be possible for every family or they may not be aware of its importance. Depending on the family’s model of care, completing the follow-up appointment within 72 hours after hospital discharge can be challenging. Families that have a physician as their health care provider may experience delays in scheduling the follow-up appointment. This can be due to the physician’s lack of availability, as there is a physician shortage in most communities. Furthermore, some families do not have access to a health care provider and, therefore, do not see a care provider after hospital discharge. Completing the follow-up appointment later than when it is recommended, or not at all, can result in negative health consequences for the mother and newborn and can also increase re-admission hospital rates and related costs (Cargill et al., 2007). At the moment, postnatal lengths of stay are shortening but the service delivery has not changed to accommodate this trend (Lemyre et al., 2018). This means that the services typically provided to families in the hospital now need to be provided in the community. The follow-up appointment after hospital discharge is an opportunity to provide these services; however, timely access to a health care provider, specifically a physician, can be challenging. Thus, this thesis explores the development of a general design methodology for a postpartum nurse practitioner-led clinic. The aim of the clinic is to provide timely access to any family that needs to complete the necessary postpartum services after hospital discharge within a community. An analytical model was developed to explore the characteristics of a postpartum nurse practitioner-led clinic and how it would operate (i.e., what services would be offered, the amount of time needed for these services, what is needed to offer these services, etc.). The model conducts a simulation of the appointment scheduling process based on the input values entered into it and evaluates a number of performance metrics (e.g., number of diversions, patient wait times, resource idle time, clinic overtime, number of appointments provided within 72 hours and number of appointments provided beyond 72 hours). The findings from the model can support the potential implementation of a postpartum nurse practitioner-led clinic in any community. Implementing such clinics could increase awareness, further educate parents and increase access to postpartum services.

Aujourd’hui, la satisfaction des utilisateurs des services de santé est reconnue comme une mesure de la qualité des soins. Au Québec, le congé précoce en obstétrique constitue la norme pour les mères ayant donné naissance à un bébé en santé. Selon la littérature, cette pratique n’entraîne pas de répercussions négatives pour la santé des mères et de leur nouveau-né à condition qu’un suivi adéquat soit assuré. D’autre part, bien qu’il semble que la diminution de la durée du séjour hospitalier soit appréciée par les mères, peu de données sont disponibles relativement aux caractéristiques menant à l’appréciation du suivi postnatal. Objectifs : Cette étude s’intéresse principalement à la première visite à domicile effectuée par une infirmière suite au congé précoce en obstétrique. Dans un premier temps, elle vise à tracer un portrait des mères en fonction du délai de la première visite à domicile et, dans un second temps, à connaître les facteurs associés à l’appréciation, par les mères, du délai de cette visite. Méthode : Les données de cette étude ont été recueillies au Québec, entre janvier 2002 et janvier 2003, lors d’une enquête téléphonique effectuée auprès de mères de bébés nés en santé, un mois suivant leur accouchement vaginal sans complication (n=1548). Pour nos analyses, nous avons retranché les mères ayant eu une durée de séjour de plus de 60 heures, une grossesse de moins de 37semaines et un bébé pesant moins de 2500 g à la naissance. Notre échantillon se compose donc de 1351 mères. Résultats : 86,2 % des mères ont reçu une offre de visite à domicile. La majorité (80.2 %) des mères ont reçu la visite dans les trois premiers jours suivant leur retour à la maison, dont près du tiers (28,1 %), dans les 24 premières heures. Comparativement aux mères visitées au deuxième ou troisième jour suivant le congé, celles visitées dans les 24 premières heures ont jugé la durée de séjour hospitalier trop courte (p=0,018) et reçu un appel de l’infirmière qui a duré plus longtemps (p=0, 009). De plus, au moment du congé, elles perçoivent leur bébé en moins bonne santé (p=0,029). Elles ont aussi accouché d’un bébé plus petit (p=0,052) qui a tendance à avoir présenté des signes d’ictères pendant le séjour hospitalier (p=0,100). D’autre part, la majorité des mères (86,4 %) disent que le délai de la première visite à domicile est adéquat alors que 11,6 % le jugent trop court et 2,3 % trop long. Pour les mères visitées au premier jour, l’analyse multivariée révèle que certaines caractéristiques et certains besoins sont associés à la perception que le délai de la visite est trop court : une seule visite postnatale, un revenu familial de plus de 40 000 $, la perception que la durée de séjour est trop longue et le fait de ne pas allaiter. Pour les mères qui reçoivent la visite au deuxième et troisième jour, ce sont, seulement, le fait d’avoir été au rendez-vous médical et le fait d’avoir reçu une seule visite qui sont associés à la perception que le délai de la visite est trop court. Pour conclure, au Québec, le programme de suivi postnatal universel semble en mesure d’offrir une visite à domicile dans les délais prescrits à une majorité de mères. Les résultats de cette étude suggèrent que le délai de la première visite à domicile n’est pas optimal pour toutes les mères et permettent d’envisager que certaines mères auraient souhaité recevoir une seconde visite plus tardivement au cours de la période postnatale. D’autres recherches devront être effectuées afin de parfaire nos connaissances relativement au moment idéal pour réaliser les interventions postnatales.Mots clefs : Satisfaction, appréciation des utilisateurs, qualité des soins, programme universel, suivi postnatal, congé précoce en obstétrique, visite à domicile, délai de la visite, provision des services. / Patient satisfaction is now recognized as part of a measure of quality of care. In Québec, early discharge following normal delivery is common practice. Early discharge was proven to have no impact on the mother’s and baby’s health status when adequate follow-up is ensure. Women’s seems to appreciate early discharge but few studies have explored the factors contributing to the expression of satisfaction regarding home visits in the context of postnatal early discharge. Objectives: This study as two main objectives. First, we want to identify which characteristics are associated with the delay of the first postnatal visit. Second, we want to determine which factors are contributing to the appreciation of the visit’s delay. Methods : Data were obtained through a telephone survey conducted in the province of Quebec between January 2002 and January 2003. Mothers that had a normal vaginal delivery and a healthy baby were reached one month after giving birth (n=1548). For analysis purposes, mothers with length of stay above 60 hours, less than 37 week of pregnancy and a newborn weighing less than 2500 g at birth were cut off leaving a sample of 1351 mothers. Results: 86.2% of the mothers have been offered a postnatal visit. Most women (80.2%) received a home visit within three days and almost a third (28.1%) within the first 24 hours after hospital discharge. When compared to the mothers who received the visit within 2 or 3 days, mothers that received a visit within the first 24 hours found the hospital stay too short (p=0.018) but received a longer telephone call by the nurse (p=0.009). These mothers gave birth to smaller babies (p=0.052) whom also presented jaundiced while being in the hospital (p=0.100). Finally, at discharge, these mothers perceive their baby to be less healthy (p=0.029). On the other end, 86.4 % of all mothers are satisfied with the delay of the first postnatal visit, while 11.6% of them found it too short and 2.3% too long. For the mothers visited the first day, logistic regression analysis reveals that some characteristics as: having only one postnatal visit, a family income of more than 40 000$, perceived hospital stay as too long and not breastfeeding, are significantly associated with the perception of having a visit too soon after hospital discharge. For mothers visited on the second or third day after discharge, the perception that the delay was too short is only significantly associated with having a baby’s medical appointment within the first two weeks and one postnatal visit. Conclusion: Quebec’s postnatal visit program seems to offer a visit within an adequate length of time for the majority of mothers. Results of this study suggest that the time after the hospital discharge for the first visit might not be optimal for all mothers. This allows us to consider that some mothers would have appreciated a second postnatal visit. Further studies are needed to pursue analysis of the delays between discharge and the first visit in order to better meet the needs of mothers. Keywords :Satisfaction, user evaluation, quality of care, universal program, postnatal care, postpartum early discharge, home visit, timing, service provision

Aujourd’hui, la satisfaction des utilisateurs des services de santé est reconnue comme une mesure de la qualité des soins. Au Québec, le congé précoce en obstétrique constitue la norme pour les mères ayant donné naissance à un bébé en santé. Selon la littérature, cette pratique n’entraîne pas de répercussions négatives pour la santé des mères et de leur nouveau-né à condition qu’un suivi adéquat soit assuré. D’autre part, bien qu’il semble que la diminution de la durée du séjour hospitalier soit appréciée par les mères, peu de données sont disponibles relativement aux caractéristiques menant à l’appréciation du suivi postnatal. Objectifs : Cette étude s’intéresse principalement à la première visite à domicile effectuée par une infirmière suite au congé précoce en obstétrique. Dans un premier temps, elle vise à tracer un portrait des mères en fonction du délai de la première visite à domicile et, dans un second temps, à connaître les facteurs associés à l’appréciation, par les mères, du délai de cette visite. Méthode : Les données de cette étude ont été recueillies au Québec, entre janvier 2002 et janvier 2003, lors d’une enquête téléphonique effectuée auprès de mères de bébés nés en santé, un mois suivant leur accouchement vaginal sans complication (n=1548). Pour nos analyses, nous avons retranché les mères ayant eu une durée de séjour de plus de 60 heures, une grossesse de moins de 37semaines et un bébé pesant moins de 2500 g à la naissance. Notre échantillon se compose donc de 1351 mères. Résultats : 86,2 % des mères ont reçu une offre de visite à domicile. La majorité (80.2 %) des mères ont reçu la visite dans les trois premiers jours suivant leur retour à la maison, dont près du tiers (28,1 %), dans les 24 premières heures. Comparativement aux mères visitées au deuxième ou troisième jour suivant le congé, celles visitées dans les 24 premières heures ont jugé la durée de séjour hospitalier trop courte (p=0,018) et reçu un appel de l’infirmière qui a duré plus longtemps (p=0, 009). De plus, au moment du congé, elles perçoivent leur bébé en moins bonne santé (p=0,029). Elles ont aussi accouché d’un bébé plus petit (p=0,052) qui a tendance à avoir présenté des signes d’ictères pendant le séjour hospitalier (p=0,100). D’autre part, la majorité des mères (86,4 %) disent que le délai de la première visite à domicile est adéquat alors que 11,6 % le jugent trop court et 2,3 % trop long. Pour les mères visitées au premier jour, l’analyse multivariée révèle que certaines caractéristiques et certains besoins sont associés à la perception que le délai de la visite est trop court : une seule visite postnatale, un revenu familial de plus de 40 000 $, la perception que la durée de séjour est trop longue et le fait de ne pas allaiter. Pour les mères qui reçoivent la visite au deuxième et troisième jour, ce sont, seulement, le fait d’avoir été au rendez-vous médical et le fait d’avoir reçu une seule visite qui sont associés à la perception que le délai de la visite est trop court. Pour conclure, au Québec, le programme de suivi postnatal universel semble en mesure d’offrir une visite à domicile dans les délais prescrits à une majorité de mères. Les résultats de cette étude suggèrent que le délai de la première visite à domicile n’est pas optimal pour toutes les mères et permettent d’envisager que certaines mères auraient souhaité recevoir une seconde visite plus tardivement au cours de la période postnatale. D’autres recherches devront être effectuées afin de parfaire nos connaissances relativement au moment idéal pour réaliser les interventions postnatales.Mots clefs : Satisfaction, appréciation des utilisateurs, qualité des soins, programme universel, suivi postnatal, congé précoce en obstétrique, visite à domicile, délai de la visite, provision des services. / Patient satisfaction is now recognized as part of a measure of quality of care. In Québec, early discharge following normal delivery is common practice. Early discharge was proven to have no impact on the mother’s and baby’s health status when adequate follow-up is ensure. Women’s seems to appreciate early discharge but few studies have explored the factors contributing to the expression of satisfaction regarding home visits in the context of postnatal early discharge. Objectives: This study as two main objectives. First, we want to identify which characteristics are associated with the delay of the first postnatal visit. Second, we want to determine which factors are contributing to the appreciation of the visit’s delay. Methods : Data were obtained through a telephone survey conducted in the province of Quebec between January 2002 and January 2003. Mothers that had a normal vaginal delivery and a healthy baby were reached one month after giving birth (n=1548). For analysis purposes, mothers with length of stay above 60 hours, less than 37 week of pregnancy and a newborn weighing less than 2500 g at birth were cut off leaving a sample of 1351 mothers. Results: 86.2% of the mothers have been offered a postnatal visit. Most women (80.2%) received a home visit within three days and almost a third (28.1%) within the first 24 hours after hospital discharge. When compared to the mothers who received the visit within 2 or 3 days, mothers that received a visit within the first 24 hours found the hospital stay too short (p=0.018) but received a longer telephone call by the nurse (p=0.009). These mothers gave birth to smaller babies (p=0.052) whom also presented jaundiced while being in the hospital (p=0.100). Finally, at discharge, these mothers perceive their baby to be less healthy (p=0.029). On the other end, 86.4 % of all mothers are satisfied with the delay of the first postnatal visit, while 11.6% of them found it too short and 2.3% too long. For the mothers visited the first day, logistic regression analysis reveals that some characteristics as: having only one postnatal visit, a family income of more than 40 000$, perceived hospital stay as too long and not breastfeeding, are significantly associated with the perception of having a visit too soon after hospital discharge. For mothers visited on the second or third day after discharge, the perception that the delay was too short is only significantly associated with having a baby’s medical appointment within the first two weeks and one postnatal visit. Conclusion: Quebec’s postnatal visit program seems to offer a visit within an adequate length of time for the majority of mothers. Results of this study suggest that the time after the hospital discharge for the first visit might not be optimal for all mothers. This allows us to consider that some mothers would have appreciated a second postnatal visit. Further studies are needed to pursue analysis of the delays between discharge and the first visit in order to better meet the needs of mothers. Keywords :Satisfaction, user evaluation, quality of care, universal program, postnatal care, postpartum early discharge, home visit, timing, service provision

Η αντιμετώπιση των χρόνιων ασθενών αποτελεί σήμερα για τα συστήματα υγείας και κοινωνικής φροντίδας ένα από τα πιο δύσκολα προβλήματα διεθνώς, τόσο από ιατρικής όσο και από κοινωνικό-οικονομικής πλευράς. Για το λόγο αυτό, τα αντίστοιχα συστήματα στις ΗΠΑ και ΕΕ έχουν αποδυθεί τα τελευταία χρόνια σε ένα εντατικό αγώνα για την αναδόμηση (reengineering) της συνολικής αντιμετώπισής τους, με στόχο τη βελτιστοποίηση των παρεχομένων υπηρεσιών και τον εξορθολογισμό του κόστους. Στρατηγικό εργαλείο για τη παροχή των νέων υπηρεσιών αποτελούν οι νέες Τεχνολογίες Πληροφορικής και Επικοινωνιών (ΤΠΕ). Στο πλαίσιο της παρούσας ερευνητικής εργασίας εξετάζεται η αξιοποίηση σύγχρονων και ευρέως διαθέσιμων τεχνολογιών επικοινωνιών (ευρυζωνικότητα, δίκτυα κινητής τηλεφωνίας κ.ά.), σε συνδυασμό με τη χρήση καινοτόμων προϊόντων, όπως αυτά των «ηλεκτρονικών» υφασμάτων (e-Textiles) για την παροχή καινοτόμων υπηρεσιών παρακολούθησης από απόσταση. Η παρούσα διπλωματική είχε σαν στόχο την εφαρμογή και αξιολόγηση ενός προγράμματος πρώιμης εξόδου από νοσοκομείο και κατ’ οίκον νοσηλείας σε χρόνιους αναπνευστικούς ασθενείς στο Νοσοκομείο «Η Σωτηρία» και διεξήχθη στο πλαίσιο του Ευρωπαϊκού Ερευνητικού Προγράμματος ‘HealthWear’. Η μεθοδολογική προσέγγιση έγινε αφενός με την ευρεία βιβλιογραφική ανασκόπηση αναλόγων παρεμβάσεων και αφετέρου με την αξιολόγηση ενός προγράμματος κλινικής εφαρμογής του σε πραγματικές συνθήκες. Στο πρόγραμμα συμμετείχαν 48 ασθενείς με Χρόνια Αποφρακτική Πνευμονοπάθεια, διαχωρισμένοι τυχαία σε ομάδα ελέγχου (ενδονοσοκομειακή φροντίδα), και ομάδα παρέμβασης (πρώιμη έξοδος και παρακολούθηση με τη χρήση φορετών και φορητών, μη επεμβατικών συσκευών). Παρουσιάζονται αναλυτικά ο σχεδιασμός του συστήματος και της υπηρεσίας, η μεθοδολογία και ο τρόπος παρακολούθησης των ασθενών της ομάδας παρέμβασης καθώς και τα αποτελέσματα της αξιολόγησης. Η εφαρμογή του προγράμματος στην καθ’ ημέρα κλινική πράξη κατέδειξε τη χρήση φορητών και φορετών συστημάτων ως αξιόπιστη εναλλακτική μέθοδο για την πρώιμη έξοδο και συνέχεια της φροντίδας των ασθενών με Χ.Α.Π. Παράλληλα διερευνήθηκαν μελλοντικές προοπτικές εφαρμογών για την εξ αποστάσεως παρακολούθηση κατά τη διάρκεια του ύπνου ή ταυτόχρονα με εκτέλεση άσκησης σε εξωτερικούς χώρους. / Treatment of chronic patients is currently one of the most difficult international issues that health and social care systems need to address, both medically and by socio-economic terms. For this reason, the corresponding systems in the U.S. and EU have engaged the last years a lot of effort, in an intense struggle, for the restructuring (reengineering) of the total care management process, in order to optimize service and streamline costs. Strategic tool for providing new services is Information and Communication Technologies (ICTs). In the current study, the usage of modern and widely available communication technologies (broadband internet, mobile telephony, etc.), combined with innovative products, such as the 'electronic' fabrics (e-Textiles), in order to provide advanced remote monitoring services, were thoroughly examined. This thesis aimed to implement and evaluate a program of early hospital discharge, followed by a home hospitalization program, in chronic respiratory patients of ‘Sotiria’ Hospital in the region of Attica - Greece, conducted within the framework of a European Research Project named 'HealthWear'. The methodological approach followed was first to establish an in-depth background for this type of interventions, through a broad, thorough systematic literature review, and secondly to evaluate a clinical trial, in the real everyday life of a public hospital. The program involved 48 patients with Chronic Obstructive Pulmonary Disease (COPD), separated randomly into control group (traditional care) and intervention group (early discharge and follow up by using wearable, portable, non-invasive devices). A comprehensive presentation of the ICT system used, the clinical protocol of the service and the methodology for the remote monitoring the intervention group patients, are followed by the assessment results of the trial. Our experience from this trial allows the prediction that wearable and wireless systems can be proved as new era’s tools in patients’ remote follow up and personalized care, especially valuable in early discharge, as well as in home based monitoring during sleep and outdoor activities.