Patient satisfaction and anxiety status
To evaluate the patients’ acceptance and satisfaction with the RM program, two nurses administered (within a month since the first transmission) the Home Monitoring Acceptance and Satisfaction Questionnaire (HoMASQ) to all new patients who received the RM system (12). HoMASQ includes 12 items aimed at investigating five different aspects: 1- relationship with their healthcare provider, 2- ease of use of home monitoring technology, 3- related psychological aspects, 4- implications on general health and 5- overall satisfaction. Each item was rated on a five-point scale: from 0, strongly unfavourable, to 4, strongly favourable; an answer was considered favourable with a score ≥ 2.
Furthermore, the Generalized Anxiety Disorder 7-item (GAD-7) scale was administered by the same nurses to all new patients in RM. GAD-7 was administered to assess the level of safety or anxiety associated with RM and the psychological discomfort related to the home-delivery and office-delivery services. The questionnaire consists of seven items: 1- feeling nervous, anxious, or on edge; 2- being able to stop or control worrying; 3- worrying too much about different things; 4- trouble relaxing; 5- being restless; 6- becoming easily annoyed or irritable; 7- feeling afraid as if something awful might happen (13). Response options are “not at all” (scores as 0), “several days” (scores as 1), “more than half the days” (scores as 2) and “nearly every day” (scores as 3). The total score ranges from 0 to 21, with scores of 5, 10, and 15 representing the cut-off points for mild, moderate, and severe anxiety, respectively.