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Hiskey O, McKeirnan K, Frazier C. Ambulatory Care Pharmacists' Perception of Telehealth Services in the Wake of the COVID-19 Pandemic: Identifying Barriers and Best Practices for the Older Patient and Beyond. Sr Care Pharm 2023; 38:193-207. [PMID: 37185142 DOI: 10.4140/tcp.n.2023.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Background Telehealth practice in the ambulatory care pharmacy setting has seen extensive expansion because of the COVID-19 pandemic. Historically, evaluations of pharmacy-driven telehealth services have shown positive patient outcomes and high patient satisfaction, but little was known about pharmacist provider satisfaction. Additionally, barriers to telehealth practice have been highlighted with the widespread expansion of telehealth. With the push to continue high rates of telehealth use postpandemic, evaluation of current ambulatory care pharmacist telehealth practices is needed. Objective This study aimed to evaluate ambulatory care pharmacists' perception of the telehealth services they provide, including barriers patients experience, solutions to address these barriers, and perceptions of the quality of care provided through telehealth. Methods Ambulatory care pharmacists in Washington State were recruited to participate in a 16-item key informant interview. The Technology Acceptance Model was the theoretical framework applied to the interview questions and used to evaluate common themes emerging from the interviews. Results Common themes from the interviews included positive and negative attributes to telehealth care, pharmacist preferences for a video telehealth platform, technology access and use barriers for patients accessing telehealth, technology support from the provider's organization as an avenue to address these barriers, and patient-specific characteristics allowing high-quality health care through telehealth. Conclusion Using these described common ideals, ambulatory care pharmacist telehealth best practices can be developed, including a personalized approach to this care. As we emerge from the COVID-19 pandemic, actively addressing common barriers as well as successfully identifying appropriate telehealth candidates will be essential in providing high-quality virtual care.
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Affiliation(s)
- Olivia Hiskey
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Department of Pharmacotherapy, Spokane, Washington
| | - Kimberly McKeirnan
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Department of Pharmacotherapy, Spokane, Washington
| | - Cheyenne Frazier
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Department of Pharmacotherapy, Spokane, Washington
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Shamsi A, Ehteshami A, Zandi H, Namnabati M. Tele Homecare in Premature Infants’ Post-Discharge Early Follow-Up: A Narrative Review. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2023; 35:129-139. [DOI: 10.1177/10848223221127437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
The study was conducted to review, categorize and organize early tele-homecare follow-up research in premature infants based on research type, the focus of tele-homecare, and measured outcomes. This narrative review was conducted in 2021 through international databases, including PubMed, Scopus, ProQuest, and Web of Science databases. Studies selected for this purpose included original articles on premature infants. We reviewed 16 out of 267 identified articles. These studies were analyzed according to general characteristics, elements, and characteristics of tele-homecare intervention. Based on the obtained data, most studies had been conducted in Nordic countries as the pioneer in tele homecare. Also, most of them were on the psychological status of premature infants’ parents. Phone calls, video consultation, and applications were considered dominant tele-homecare communication tools. Overall, the qualitative studies on parents’ and health providers’ views about tele homecare revealed its hidden aspects as a supportive tool. The tele-homecare studies were distributed across different fields and countries, resulting in positive outcomes for infants and parents. However, further studies in the long-term periods are recommended to follow up on premature infants.
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Affiliation(s)
- Atefeh Shamsi
- Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Hamed Zandi
- Isfahan University of Medical Sciences, Isfahan, Iran
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Seah JJ, Zhao J, Wang DY, Lee HP. Review on the Advancements of Stethoscope Types in Chest Auscultation. Diagnostics (Basel) 2023; 13:diagnostics13091545. [PMID: 37174938 PMCID: PMC10177339 DOI: 10.3390/diagnostics13091545] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/16/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Stethoscopes were originally designed for the auscultation of a patient's chest for the purpose of listening to lung and heart sounds. These aid medical professionals in their evaluation of the cardiovascular and respiratory systems, as well as in other applications, such as listening to bowel sounds in the gastrointestinal system or assessing for vascular bruits. Listening to internal sounds during chest auscultation aids healthcare professionals in their diagnosis of a patient's illness. We performed an extensive literature review on the currently available stethoscopes specifically for use in chest auscultation. By understanding the specificities of the different stethoscopes available, healthcare professionals can capitalize on their beneficial features, to serve both clinical and educational purposes. Additionally, the ongoing COVID-19 pandemic has also highlighted the unique application of digital stethoscopes for telemedicine. Thus, the advantages and limitations of digital stethoscopes are reviewed. Lastly, to determine the best available stethoscopes in the healthcare industry, this literature review explored various benchmarking methods that can be used to identify areas of improvement for existing stethoscopes, as well as to serve as a standard for the general comparison of stethoscope quality. The potential use of digital stethoscopes for telemedicine amidst ongoing technological advancements in wearable sensors and modern communication facilities such as 5G are also discussed. Based on the ongoing trend in advancements in wearable technology, telemedicine, and smart hospitals, understanding the benefits and limitations of the digital stethoscope is an essential consideration for potential equipment deployment, especially during the height of the current COVID-19 pandemic and, more importantly, for future healthcare crises when human and resource mobility is restricted.
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Affiliation(s)
- Jun Jie Seah
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Jiale Zhao
- Department of Mechanical Engineering, National University of Singapore, Singapore 117575, Singapore
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Infectious Diseases Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
| | - Heow Pueh Lee
- Department of Mechanical Engineering, National University of Singapore, Singapore 117575, Singapore
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Ollis L, Skene SS, Williams J, Lyon R, Taylor C. The SEE-IT Trial: emergency medical services Streaming Enabled Evaluation In Trauma: study protocol for an interventional feasibility randomised controlled trial. BMJ Open 2023; 13:e072877. [PMID: 37094896 PMCID: PMC10151834 DOI: 10.1136/bmjopen-2023-072877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
INTRODUCTION Accurate and timely dispatch of emergency medical services (EMS) is vital due to limited resources and patients' risk of mortality and morbidity increasing with time. Currently, most UK emergency operations centres (EOCs) rely on audio calls and accurate descriptions of the incident and patients' injuries from lay 999 callers. If dispatchers in the EOCs could see the scene via live video streaming from the caller's smartphone, this may enhance their decision making and enable quicker and more accurate dispatch of EMS. The main aim of this feasibility randomised controlled trial (RCT) is to assess the feasibility of conducting a definitive RCT to assess the clinical and cost effectiveness of using live streaming to improve targeting of EMS. METHODS AND ANALYSIS The SEE-IT Trial is a feasibility RCT with a nested process evaluation. The study also has two observational substudies: (1) in an EOC that routinely uses live streaming to assess the acceptability and feasibility of live streaming in a diverse inner-city population and (2) in an EOC that does not currently use live streaming to act as a comparator site regarding the psychological well-being of EOC staff using versus not using live streaming. ETHICS AND DISSEMINATION The study was approved by the Health Research Authority on 23 March 2022 (ref: 21/LO/0912), which included NHS Confidentiality Advisory Group approval received on 22 March 2022 (ref: 22/CAG/0003). This manuscript refers to V.0.8 of the protocol (7 November 2022). The trial is registered with the ISRCTN (ISRCTN11449333). The first participant was recruited on 18 June 2022.The main output of this feasibility trial will be the knowledge gained to help inform the development of a large multicentre RCT to evaluate the clinical and cost effectiveness of the use of live streaming to aid EMS dispatch for trauma incidents. TRIAL REGISTRATION NUMBER ISRCTN11449333.
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Affiliation(s)
- Lucie Ollis
- School of Health Sciences, University of Surrey, Guildford, Surrey, UK
| | - Simon S Skene
- Surrey Clinical Trials Unit, University of Surrey, Guildford, UK
| | - Julia Williams
- South East Coast Ambulance Service NHS Foundation Trust, Banstead, Surrey, UK
- University of Hertfordshire School of Health and Social Work, Hatfield, UK
| | - Richard Lyon
- School of Health Sciences, University of Surrey, Guildford, Surrey, UK
- Kent, Surrey & Sussex Air Ambulance, Redhill, UK
| | - Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, Surrey, UK
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Kiran T, Green ME, Strauss R, Wu CF, Daneshvarfard M, Kopp A, Lapointe-Shaw L, Latifovic L, Frymire E, Glazier RH. Virtual Care and Emergency Department Use During the COVID-19 Pandemic Among Patients of Family Physicians in Ontario, Canada. JAMA Netw Open 2023; 6:e239602. [PMID: 37115549 PMCID: PMC10148195 DOI: 10.1001/jamanetworkopen.2023.9602] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Importance The COVID-19 pandemic has played a role in increased use of virtual care in primary care. However, few studies have examined the association between virtual primary care visits and other health care use. Objective To evaluate the association between the percentage of virtual visits in primary care and the rate of emergency department (ED) visits. Design, Setting, and Participants This cross-sectional study used routinely collected administrative data and was conducted in Ontario, Canada. The sample comprised family physicians with at least 1 primary care visit claim between February 1 and October 31, 2021, and permanent Ontario residents who were alive as of March 31, 2021. All residents were assigned to physicians according to enrollment and billing data. Exposure Family physicians' virtual visit rate was the exposure. Physicians were stratified by the percentage of total visits that they delivered virtually (via telephone or video) during the study period (0% [100% in person], >0%-20%, >20%-40%, >40%-60%, >60%-80%, >80% to <100%, or 100%). Main Outcomes and Measures Population-level ED visit rate was calculated for each stratum of virtual care use. Multivariable regression models were used to understand the relative rate of patient ED use after adjusting for rurality of practice, patient characteristics, and 2019 ED visit rates. Results Data were analyzed for a total of 13 820 family physicians (7114 males [51.5%]; mean [SD] age, 50 [13.1] years) with 12 951 063 patients (6 714 150 females [51.8%]; mean [SD] age, 42.6 [22.9] years) who were attached to these physicians. Most physicians provided between 40% and 80% of care virtually. A higher percentage of the physicians who provided more than 80% of care virtually were 65 years or older, female individuals, and practiced in big cities. Patient comorbidity and morbidity were similar across strata of virtual care use. The mean (SD) number of ED visits was highest among patients whose physicians provided only in-person care (470.3 [1918.8] per 1000 patients) and was lowest among patients of physicians who provided more than 80% to less than 100% of care virtually (242.0 [800.3] per 1000 patients). After adjustment for patient characteristics, patients of physicians with more than 20% of visits delivered virtually had lower rates of ED visits compared with patients of physicians who provided more than 0% to 20% of care virtually (eg, >80% to <100% vs >0%-20% virtual visits in big cities: relative rate, 0.77%; 95% CI, 0.74%-0.81%). This pattern was unchanged across all rurality of practice strata and after adjustment for 2019 ED visit rates. In urban areas, there was a gradient whereby patients of physicians providing the highest level of virtual care had the lowest ED visit rates. Conclusions and Relevance Findings of this study show that patients of physicians who provided a higher percentage of virtual care did not have higher ED visit rates compared with patients of physicians who provided the lowest levels of virtual care. The findings refute the hypothesis that family physicians providing more care virtually during the pandemic resulted in higher ED use.
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Affiliation(s)
- Tara Kiran
- Department of Family and Community Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- ICES Central, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Michael E Green
- Department of Family Medicine, Queen's University, Kingston, Ontario, Canada
- Health Services and Policy Research Institute, Queen's University, Kingston, Ontario, Canada
- ICES Queen's, Kingston, Ontario, Canada
| | | | | | - Maryam Daneshvarfard
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | | | - Lauren Lapointe-Shaw
- ICES Central, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto and University Health Network, Toronto, Ontario, Canada
| | - Lidija Latifovic
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Eliot Frymire
- Health Services and Policy Research Institute, Queen's University, Kingston, Ontario, Canada
- ICES Queen's, Kingston, Ontario, Canada
| | - Richard H Glazier
- Department of Family and Community Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- ICES Central, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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106
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Shawwa L. The Use of Telemedicine in Medical Education and Patient Care. Cureus 2023; 15:e37766. [PMID: 37213963 PMCID: PMC10198592 DOI: 10.7759/cureus.37766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/23/2023] Open
Abstract
The COVID-19 pandemic has accelerated and expanded the adoption of telemedicine globally. This allowed telemedicine to engage medical students in patient care and ensured continuity of care for vulnerable patients. In this review, the history of telemedicine and some of its applications in medical education were reviewed. Furthermore, we also shed light on how to incorporate telemedicine into several curricula and the strategies used to include it. The article also explored how to evaluate telemedicine and the major facilitators and barriers any medical and educational institution must address when using telemedicine. At the end of the review, we explored the future promises telemedicine has for medical education.
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Affiliation(s)
- Lana Shawwa
- Medical Education, King Abdul Aziz University, Jeddah, SAU
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107
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Tsen C, Andreatto CADA, Aily JB, Pelicioni PHS, Neto DB, Mattiello SM, Gomes GADO, de Andrade LP. Effects of telehealth on functional capacity, mental health and quality of life among older people with dementia: LAPESI telehealth protocol for a randomized controlled trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e1981. [PMID: 36445170 DOI: 10.1002/pri.1981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 08/17/2022] [Accepted: 10/09/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Telehealth can be an alternative action at a distance that can help as a form of motor intervention, alleviating the deleterious effects arising from social distancing on functional capacity, mental health and quality of life among older people with dementia during the COVID-19 pandemic. PURPOSE We aim to analyze the effects of a telehealth program on functional capacity, mental health and quality of life among older people with dementia and their caregivers. METHODS seventy-eight individuals with mild and moderate dementia and their caregivers will answer an anamnesis and be evaluated through Clinical Dementia Assessment Score. They will also be evaluated by blinded examiners in terms of functional capacity (Activities of Daily Living Questionnaire and World Health Organization Disability Assessment Schedule 2.0), mental health (Mini-Mental State Examination, Clock Drawing Test, Verbal Fluency test and the Neuropsychiatric Inventor) and quality of life (Quality of Life in Alzheimer's Disease scale). Afterward, the volunteers will be randomized into the telehealth training group and the control group. The TR will perform systematic physical and cognitive exercises in 50-min sessions three times a week with professional monitoring, while the CG will receive non-systematized guidance, both for 12 weeks. Participants will be evaluated at baseline, immediately after the three-month interventions and with a 12-week follow- up. DISCUSSION Technological approaches such as telehealth can be a viable alternative in home care service during times of pandemic. We expect that older people with dementia and their caregivers have high adherence to the telehealth program and improve their functional capacity, mental health and quality of life of older people with dementia. Telehealth is an alternative that can contribute to public policies and the development of effective intervention strategies that neutralize adverse outcomes. It can also be presented as an alternative to home care services, which could reduce demands for health resources.
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Affiliation(s)
- Carolina Tsen
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | | | - Jéssica Bianca Aily
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Paulo Henrique Silva Pelicioni
- School of Health Sciences, University of New South Wales, Randwick, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Décio Bueno Neto
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Stela Márcia Mattiello
- Department of Physiotherapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
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Little CC, Russell S, Hwang C, Goldberg L, Brown S, Kirke D, Courey M. Applications of Telemedicine in Speech-Language Pathology: Evaluation of Patient Satisfaction. Laryngoscope 2023; 133:895-900. [PMID: 35848893 DOI: 10.1002/lary.30303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The study aimed to evaluate patient satisfaction with speech-language therapy televisits and to identify factors influencing the level of satisfaction. METHODS Participants were recruited from an academic tertiary voice and swallowing center who had completed ≥1 telehealth session of speech-language therapy with a speech-language pathologist between March, 2020 and April, 2021. Patient satisfaction was assessed using the Short Assessment of Patient Satisfaction (SAPS), a validated 7-item survey. Demographic characteristics of participants were collected from a review of patient charts. RESULTS 65/239 patients completed the SAPS survey, representing a response rate of 27%. The average age of study participants was 54.92 ± 16.45 years, with 49.2% identifying as female, 33.9% as male, and 16.9% as trans-female. The mean SAPS score was 22.60 ± 3.89, with 84.62% of patients satisfied or very satisfied with their visit. Patients were most satisfied with provider respect (3.91 ± 0.34) and care received (3.74 ± 0.64), and least satisfied with visit length (2.32 ± 1.38) and explanation of treatment results (2.62 ± 1.72). Patient satisfaction was positively correlated with younger age and an increased number of televisits. Satisfaction did not differ significantly by gender identity, type of therapy received, insurance type, travel distance, or prior in-person therapy. CONCLUSION Clinicians are able to achieve high patient satisfaction with speech-language therapy when delivered by telehealth. Patient satisfaction remained high across diverse patient populations and range of clinical needs. Clinicians should remain cognizant of the unique limitations of older patients when conducting telehealth visits. LAY SUMMARY Clinicians are able to achieve high patient satisfaction with speech-language therapy when delivered via telehealth. Satisfaction remained high regardless of gender identity, type of therapy received, type of insurance, travel distance, or completion of prior in-person therapy. LEVEL OF EVIDENCE 4 Laryngoscope, 133:895-900, 2023.
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Affiliation(s)
- Christine C Little
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Stephen Russell
- Department of Otolaryngology, Naval Medical Center, San Diego, California, U.S.A
| | - Chaewon Hwang
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, U.S.A
| | - Leanne Goldberg
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Sarah Brown
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Diana Kirke
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Mark Courey
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
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Garcia Reyes EP, Kelly R, Buchanan G, Waycott J. Understanding Older Adults' Experiences With Technologies for Health Self-management: Interview Study. JMIR Aging 2023; 6:e43197. [PMID: 36943333 PMCID: PMC10131633 DOI: 10.2196/43197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Many older adults now use technologies such as wearable devices and telehealth services to support their health and well-being while living independently at home. However, older adults vary in how they use these technologies, and there is a lack of knowledge regarding the motivations that influence their acceptance and use of health-related technologies in home environments. OBJECTIVE This study aimed to understand the types of technologies that older adults use to support their health and the factors that motivate them to use their chosen technologies to support their health. In addition, we aimed to understand the factors that enable the effective use of technologies for health self-management and to identify the barriers that can negatively affect the adoption of technologies. METHODS A total of 22 older adults participated in semistructured interviews regarding their experiences of using technologies for health self-management. Interview transcripts were analyzed through an in-depth thematic analysis. RESULTS The interviews revealed that a range of technologies, such as videoconferencing software, fitness trackers, and other devices, were being used by older adults to support their health. Interviews showed that participants were motivated to use technologies to monitor health issues, to stay active and connected, and to record and change their behavior in the light of foreseen risks related to their future health status. Enablers that facilitated the effective use of technologies include social and organizational influence, convenient access to health care and safety provided by the technology, and easy setup and low cost of the technology. Barriers include information overload and a sense of futility about future health decline; telehealth being an inadequate substitute for in-person consultation; concerns about trust related to privacy and accuracy; and technologies being stigmatizing, uncomfortable to use, expensive, and unfamiliar. CONCLUSIONS This study suggested that older adults were using a variety of technologies to prevent or prepare for future health decline, evidencing a resilient attitude toward health and aging. In addition, older adults were willing to continue using the technology when there was a perceived need. The enabler mentioned by most participants was the social and organizational influence that included health care staff, family, friends, and organizations. This analysis provides a better understanding of how older adults use technologies to support their health and can guide the provision of appropriate health technologies for them.
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Affiliation(s)
- Elsy Paola Garcia Reyes
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Ryan Kelly
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - George Buchanan
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Jenny Waycott
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
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Chan YK, Tang YM, Teng L. A comparative analysis of digital health usage intentions towards the adoption of virtual reality in telerehabilitation. Int J Med Inform 2023; 174:105042. [PMID: 36965405 DOI: 10.1016/j.ijmedinf.2023.105042] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND With the rapid development of the metaverse and the problem of non-attendance in traditional rehabilitation, virtual reality in telerehabilitation has become increasingly vital in modern medicine. However, research on determining predictors that influence the public's behavioral intention to adopt VR-based telerehabilitation has not been extensively studied. OBJECTIVE This study aims to propose a new research model with a comparative analysis on understanding factors affecting the public's behavioral intention to adopt VR in telerehabilitation for different user groups. METHODS A total of 215 respondents from the general public completed an online questionnaire to validate the proposed research model. The collected data was analyzed using SPSS and AMOS. The proposed model was additionally validated using CFA and multiple linear regression. RESULTS This study found that effort expectancy, threat appraisals, and trust had a positive significant influence on the public's behavioral intention to adopt VR in telerehabilitation. However, performance expectancy and facilitating conditions had no significant relationship with behavioral intention. Notably, the average of the primary factors for older adults was generally higher than for younger adults. CONCLUSIONS The present study confirms the applicability of the proposed research model. Our findings contribute up-to-date insights for related stakeholders to minimize implementation failures and develop successful adoption strategies for the future expansion of telerehabilitation.
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Affiliation(s)
- Yee Kiu Chan
- Department of Industrial and Systems Engineering, Hong Kong Polytechnic University, Hong Kong Special Administrative Region
| | - Yuk Ming Tang
- Department of Industrial and Systems Engineering, Hong Kong Polytechnic University, Hong Kong Special Administrative Region; Faculty of Business, City University of Macau, Macau.
| | - Long Teng
- Department of Industrial and Systems Engineering, Hong Kong Polytechnic University, Hong Kong Special Administrative Region
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111
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Cataldo F, Mendoza A, Chang S, Buchanan G, Van Dam NT. Enhancing Therapeutic Processes in Videoconferencing Psychotherapy: Interview Study of Psychologists' Technological Perspective. JMIR Form Res 2023; 7:e40542. [PMID: 36927506 PMCID: PMC10019766 DOI: 10.2196/40542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 01/13/2023] [Accepted: 01/30/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic caused a surge in the use of telehealth platforms. Psychologists have shifted from face-to-face sessions to videoconference sessions. Therefore, essential information that is easily obtainable via in-person sessions may be missing. Consequently, therapeutic work could be compromised. OBJECTIVE This study aimed to explore the videoconference psychotherapy (VCP) experiences of psychologists around the world. Furthermore, we aimed to identify technological features that may enhance psychologists' therapeutic work through augmented VCP. METHODS In total, 17 psychologists across the world (n=7, 41% from Australia; n=1, 6% from England; n=5, 29% from Italy; n=1, 6% from Mexico; n=1, 6% from Spain; and n=2, 12% from the United States) were interviewed. We used thematic analysis to examine the data collected from a sample of 17 psychologists. We applied the Chaos Theory to interpret the system dynamics and collected details about the challenges posed by VCP. For collecting further information about the technology and processes involved, we relied on the Input-Process-Output (IPO) model. RESULTS The analysis resulted in the generation of 9 themes (input themes: psychologists' attitude, trust-reinforcing features, reducing cognitive load, enhancing emotional communication, and engaging features between psychologists and patients; process themes: building and reinforcing trust, decreasing cognitive load, enhancing emotional communication, and increasing psychologist-patient engagement) and 19 subthemes. Psychologists found new strategies to deal with VCP limitations but also reported the need for more technical control to facilitate therapeutic processes. The suggested technologies (eye contact functionality, emergency call functionality, screen control functionality, interactive interface with other apps and software, and zooming in and out functionality) could enhance the presence and dynamic nature of the therapeutic relationship. CONCLUSIONS Psychologists expressed a desire for enhanced control of VCP sessions. Psychologists reported a decreased sense of control within the therapeutic relationship owing to the influence of the VCP system. Great control of the VCP system could better approximate the critical elements of in-person psychotherapy (eg, observation of body language). To facilitate improved control, psychologists would like technology to implement features such as improved eye contact, better screen control, emergency call functionality, ability to zoom in and out, and an interactive interface to communicate with other apps. These results contribute to the general perception of the computer as an actual part of the VCP process. Thus, the computer plays a key role in the communication, rather than remaining as a technical medium. By adopting the IPO model in the VCP environment (VCP-IPO model), the relationship experience may help psychologists have more control in their VCP sessions.
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Affiliation(s)
- Francesco Cataldo
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia
| | - Antonette Mendoza
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia
| | - Shanton Chang
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia
| | - George Buchanan
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia
| | - Nicholas T Van Dam
- School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
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El-Mazahy H, Mekky J, Elshaer N. Medical professionals' job satisfaction and telemedicine readiness during the COVID-19 pandemic: solutions to improve medical practice in Egypt. J Egypt Public Health Assoc 2023; 98:5. [PMID: 36878998 PMCID: PMC9988361 DOI: 10.1186/s42506-023-00127-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 01/24/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND The COVID-19 pandemic has impacted medical professionals' job satisfaction and was a call to adopt telemedicine. Finding out how far medical professionals are satisfied and ready to use telemedicine would be important to improve medical practice. METHODS Data was collected from 959 medical professionals from both the governmental and private health sectors in Egypt in 2021 using a specifically designed online questionnaire, to evaluate job satisfaction, perception of telemedicine, and propose solutions to improve medical practice. RESULTS The study revealed low to moderate job satisfaction at governmental (27.2%) and private (58.7%) sectors. Underpayment was the most reported challenge at both sectors (37.8% and 28.3%, respectively). Dissatisfaction with government salary was independently predicted by working at the Ministry of Health and Population (OR = 5.54, 95%CI = 2.39,12.8; p < 0.001). Wage increase (46.10%), medical training of professionals (18.1%), and management of non-human resources (14.4%) were the most proposed solutions to improve medical practice in Egypt. During the COVID-19 pandemic, 90.7% of medical professionals had practiced telemedicine with moderate level of perception of its benefits (56%). CONCLUSIONS During the COVID-19 pandemic, medical professionals reported low to moderate job satisfaction and a moderate level of perception of telemedicine. It is recommended to analyze the healthcare financing system and provide continuous training of medical professionals to improve medical practice in Egypt.
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Affiliation(s)
| | - Jaidaa Mekky
- Department of Neuropsychiatry, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Noha Elshaer
- Industrial Medicine and Occupational Health, Department of Community Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
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Mobile health technology, exercise adherence and optimal nutrition post rehabilitation among people with Parkinson's Disease (mHEXANUT) - a randomized controlled trial protocol. BMC Neurol 2023; 23:93. [PMID: 36864377 PMCID: PMC9979434 DOI: 10.1186/s12883-023-03134-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/21/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Although it is well known that regular physical activity and exercise, as well as maintaining adequate nutritional status is important to delaying symptom development and maintaining physical capacity and function in people with Parkinson's Disease (PD), many are unable to follow self-management recommendations. Active interventions have shown short-term effects, but there is a need for interventions that facilitate self-management over the course of the disease. Until now, no studies have combined exercise and nutritional interventions with an individual self-management approach in PD. Thus, we aim to examine the effect of a six-month mobile health technology(m-health)-based follow-up programme, focusing on self-management in exercise and nutrition, after an in-service interdisciplinary rehabilitation programme. METHODS A single-blinded, two-group randomised controlled trial. Participants are Adults aged 40 or older, with idiopathic PD, Hoehn and Yahr 1-3, living at home. The intervention group receives a monthly, individualized, digital conversation with a PT, combined with use of an activity tracker. People at nutritional risk get additional digital-follow-up from a nutritional specialist. The control group receives usual care. The primary outcome is physical capacity, measured by 6-min walk test (6MWT). Secondary outcomes are nutritional status, Health related quality of life (HRQOL), physical function and exercise adherence. All measurements are performed at baseline, after 3 months and after 6 months. Sample size, based on primary outcome, is set at 100 participants randomized into the two arms, including an estimated 20% drop out. DISCUSSION The increasing prevalence of PD globally makes it even more important to develop evidence-based interventions that can increase motivation to stay active, promote adequate nutritional status and improve self-management in people with PD. The individually tailored digital follow-up programme, based on evidence-based practice, has the potential to promote evidence-based decision-making and to empower people with PD to implement exercise and optimal nutrition in their daily lives and, hopefully, increase adherence to exercise and nutritional recommendations. TRIAL REGISTRATION ClinicalTrials.gov (NCT04945876). First registration 01.03.2021.
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Balasuriya L, Briss PA, Twentyman E, Wiltz JL, Richardson LC, Bigman ET, Wright JS, Petersen R, Hannan CJ, Thomas CW, Barfield WD, Kittner DL, Hacker KA. Impacts of the COVID-19 Pandemic on Nationwide Chronic Disease Prevention and Health Promotion Activities. Am J Prev Med 2023; 64:452-458. [PMID: 36347662 PMCID: PMC9574464 DOI: 10.1016/j.amepre.2022.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/08/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Lilanthi Balasuriya
- National Clinician Scholars Program, Yale School of Medicine, New Haven, Connecticut
| | - Peter A Briss
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Evelyn Twentyman
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer L Wiltz
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lisa C Richardson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Elizabeth T Bigman
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Janet S Wright
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ruth Petersen
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Casey J Hannan
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Craig W Thomas
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wanda D Barfield
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Deirdre L Kittner
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Karen A Hacker
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
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Alkouri O, Khader Y, Al-Bashaireh A, Al Marzouqi A, Zyoud A, Jarrah M, Khassawneh B, Khamaiseh K, Schultz T. Development of a telemedicine group educational program for patients with heart failure: A delphi study. Heliyon 2023; 9:e14287. [PMID: 36950654 PMCID: PMC10025030 DOI: 10.1016/j.heliyon.2023.e14287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/09/2023] Open
Abstract
Aims Evidence regarding the most effective and feasible videoconferencing group educational program for patients with heart failure is still equivocal. This study aimed to reach consensus about the structure, acceptability, and feasibility of videoconferencing for people with heart failure in Jordan that improves access to healthcare and clinical outcomes. Methods There were two Delphi survey studies of three rounds each. Delphi one survey involved 32 healthcare staff, experienced in heart failure clinical practice and telehealth, to obtain a consensus of opinion on a proposed group videoconferencing program for patients with heart failure. Delphi two involved seven staff of the information technology center, experienced in videoconferencing and using supporting applications, to obtain their consensus on the current capabilities of the healthcare system and patients about information technology. Descriptive statistics were used for each item to determine whether consensus was achieved or not. Items that received 80% disagreement or 80% agreement of participants were not presented for re-rating in the third round, while the items that scored varying degrees of agreement were presented for experts for re-rating. Results In Delphi one a group of items reached consensus regarding structure, factors influencing, and effectiveness of the videoconferencing program. In Delphi two, the findings indicated that videoconferencing modality is applicable and feasible in Jordan. Conclusion This is the first study that addresses the equivocal evidence for the design and implementation of heart failure videoconferencing programs. The framework of the current proposed program can be utilized as a guideline to test or develop a future videoconference program.
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Affiliation(s)
- Osama Alkouri
- Faculty of Nursing Yarmouk University, Irbid, P.O Box 566, 2116, Jordan
- Corresponding author.
| | - Yousef Khader
- Department of Public Health, Community Medicine, Jordan University of Science and Technology, P.O.Box: 3030, Irbid, 22110, Jordan
| | | | - Amina Al Marzouqi
- College of Health Sciences, Health Services Administration, University of Sharjah, P. O.Box 27272, Sharjah, United Arab Emirates
| | - Amr Zyoud
- Faculty of Nursing, Al-Ahliyya Amman University, Amman, 19328, Jordan
| | - Mohamad Jarrah
- Department of Internal Medicine, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan
| | | | | | - Tim Schultz
- Flinders Health and Medical Research Institute, Flinders University, Sturt Road, Bedford Park South Australia 5042, GPO Box 2100, Adelaide, SA, 5001, Australia
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Cacciotti C, Chua IS, Cuadra J, Ullrich NJ, Cooney TM. Pediatric central nervous system tumor survivor and caregiver experiences with multidisciplinary telehealth. J Neurooncol 2023; 162:191-198. [PMID: 36890398 PMCID: PMC9994776 DOI: 10.1007/s11060-023-04281-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/25/2023] [Indexed: 03/10/2023]
Abstract
PURPOSE Telehealth use to facilitate cancer survivorship care is accelerating; however, patient satisfaction and barriers to facilitation have not been studied amongst pediatric central nervous system (CNS) tumor survivors. We assessed the telehealth experiences of survivors and caregivers in the Pediatric Neuro-Oncology Outcomes Clinic at Dana-Farber/ Boston Children's Hospital. METHODS Cross-sectional study of completed surveys among patients and caregivers with ≥ 1 telehealth multidisciplinary survivorship appointment from January 2021 through March 2022. RESULTS Thirty-three adult survivors and 41 caregivers participated. The majority agreed or strongly agreed that telehealth visits started on time [65/67 (97%)], scheduling was convenient [59/61 (97%)], clinician's explanations were easy-to-understand [59/61 (97%)], listened carefully/addressed concerns [56/60 (93%)], and spent enough time with them [56/59 (95%)]. However, only 58% (n = 35/60) of respondents agreed or strongly agreed they would like to continue with telehealth and 48% (n = 32/67) agreed telehealth was as effective as in person office visits. Adult survivors were more likely than caregivers to prefer office visits for personal connection [23/32 (72%) vs. 18/39 (46%), p = 0.027]. CONCLUSION Offering telehealth multi-disciplinary services may provide more efficient and accessible care for a subset of pediatric CNS tumor survivors. Despite some advantages, patients and caregivers were divided on whether they would like to continue with telehealth and whether telehealth was as effective as office visits. To improve survivor and caregiver satisfaction, initiatives to refine patient selection as well as enhance personal communication through telehealth systems should be undertaken.
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Affiliation(s)
- Chantel Cacciotti
- Dana-Farber / Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA.
- Division of Pediatric Hematology/Oncology, Western University, 800 Commissioners Road East, Rm B1-114, London, Ontario N6A 5W9, Canada.
| | - Isaac S Chua
- Brigham and Women's Hospital, Division of General Internal Medicine and Primary Care, Boston, MA, USA
- Division of Palliative Care, Dana-Farber Cancer Center, Boston, MA, USA
| | - Jennifer Cuadra
- Dana-Farber / Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
| | - Nicole J Ullrich
- Dana-Farber / Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Tabitha M Cooney
- Dana-Farber / Boston Children's Cancer and Blood Disorder Center, Boston, MA, USA
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Thomas LT, Lee CMY, McClelland K, Nunis G, Robinson S, Norman R. Health workforce perceptions on telehealth augmentation opportunities. BMC Health Serv Res 2023; 23:182. [PMID: 36810089 PMCID: PMC9943033 DOI: 10.1186/s12913-023-09174-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/13/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND The availability and use of telehealth to support health care access from a distance has expanded in response to the COVID-19 pandemic. Telehealth services have supported regional and remote health care access for many years and could be augmented to improve health care accessibility, acceptability and overall experiences for both consumers and clinicians. This study aimed to explore health workforce representatives' needs and expectations to move beyond existing telehealth models and plan for the future of virtual care. METHODS To inform recommendations for augmentation, semi-structured focus group discussions were held (November-December 2021). Health workforce representatives with experience in health care delivery via telehealth across country Western Australia were approached and invited to join a discussion. RESULTS Focus group participants included 53 health workforce representatives, with between two and eight participants per discussion. In total, 12 focus groups were conducted: seven were specific to regions, three with staff in centralised roles, and two with a mixture of participants from regional and central roles. Findings identified four key areas for telehealth augmentation: improvements required to existing service practice and processes; equity and access considerations; health workforce-focussed opportunities; and consumer-focussed opportunities. CONCLUSIONS Following the onset of the COVID-19 pandemic and the rapid increase in health services delivered via telehealth modalities, it is timely to explore opportunities to augment pre-existing models of care. Workforce representatives consulted in this study suggested modifications to existing process and practice that would improve the current models of care, and recommendations on ways to improve clinician and consumer experiences with telehealth. Improving experiences with virtual delivery of health care is likely to support continued use and acceptance of this modality in health care delivery.
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Affiliation(s)
- L. T. Thomas
- grid.1032.00000 0004 0375 4078 School of Population Health, Curtin University, Perth, WA Australia
| | - C. M. Y. Lee
- grid.1032.00000 0004 0375 4078 School of Population Health, Curtin University, Perth, WA Australia
| | - K. McClelland
- grid.413880.60000 0004 0453 2856Government of Western Australia Department of Health, Perth, WA Australia
| | - G. Nunis
- WA Primary Health Alliance, Perth, WA Australia
| | - S. Robinson
- grid.1032.00000 0004 0375 4078 School of Population Health, Curtin University, Perth, WA Australia ,grid.1021.20000 0001 0526 7079Deakin University, Melbourne, VIC Australia
| | - R. Norman
- grid.1032.00000 0004 0375 4078 School of Population Health, Curtin University, Perth, WA Australia
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Jiang S, Liu PL, Chia CWJ. Can Online Patient-Provider Communication Improve Emotional Well-Being? Examining the Roles of Social Presence and Patient Empowerment. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023; 26:366-370. [PMID: 36800227 DOI: 10.1089/cyber.2022.0289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
China has long been suffering from the problem of having health care that is expensive and difficult to access. Online patient-provider communication (OPPC) can offer a viable channel to increase access to care. However, through what underlying mechanisms OPPC can be associated with better health outcome is under-researched. To fill this research gap, this study investigated OPPC usage in China and identified psychological processes linking OPPC to emotional well-being. With two-wave panel surveys conducted in China, we found that mobile health app, social media, and health information service website were three common platforms for OPPC, followed by patient portal, whereas e-mail was used least frequently. Overall, OPPC did not have any direct effect on emotional well-being. Instead, OPPC first increased users' perceived social presence of providers in OPPC, which in turn triggered sense of patient empowerment, which finally enhanced emotional well-being.
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Affiliation(s)
- Shaohai Jiang
- Department of Communications and New Media, National University of Singapore, Singapore, Singapore
| | | | - Christopher Wen Jie Chia
- Department of Communications and New Media, National University of Singapore, Singapore, Singapore
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Brady B, Saberi G, Santalucia Y, Gorgees P, Nguyen TT, Le H, Sidhu B. ' Without support CALD patients will be left behind': A mixed-methods exploration of culturally and linguistically diverse (CALD) client perspectives of telehealth and those of their healthcare providers. J Telemed Telecare 2023:1357633X231154943. [PMID: 36798034 DOI: 10.1177/1357633x231154943] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
INTRODUCTION The rapid adoption of telehealth during the global pandemic has the potential to widen disparities for culturally and linguistically diverse (CALD) consumers. We explored the perspectives and experiences of CALD consumers accessing telehealth during the global pandemic and those of their healthcare providers. METHODS A multistakeholder mixed-methods study involving two parallel samples comprising consumer-participants (n = 56) and healthcare provider-participants (n = 81). Multicultural consumer-participants, recruited from consecutive referrals to Health Language Services for telehealth support, were assisted to complete two surveys (before and after their clinical telehealth appointment) in their preferred language. A purposive sample of consumer-participants was interviewed to understand their perceived barriers and enablers of successful telehealth consultations. Simultaneously, all healthcare providers within the local health district were eligible to participate in an online survey if they had provided telehealth care to a consumer during the recruitment period. Closed-ended responses were descriptively summarised, while open-ended responses and interview transcripts were analysed thematically. RESULTS Despite 86% of consumer-participants inexperienced with telehealth, 80% achieved a successful appointment with a healthcare provider. Consumer perceptions were shaped by cultural and diagnostic concepts of legitimacy, in the context of known accessibility and technology literacy challenges. Healthcare provider perspectives were less favourable towards telehealth, with equity of healthcare delivery a major concern. DISCUSSION Our findings highlight unintended consequences arising from a rapid transition to telehealth. Adopting collaborative approaches to the design and implementation of telehealth is imperative to mitigate health inequities faced by CALD communities and maximise their opportunity to realise potential health benefits associated with telehealth.
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Affiliation(s)
- Bernadette Brady
- Liverpool Hospital, South Western Sydney Local Health District, Liverpool, Australia
- School of Health Sciences, 67422Western Sydney University, Campbelltown, Australia
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Golsa Saberi
- Multicultural Health Unit, 1511South Western Sydney Local Health District, Bankstown, Australia
| | - Yvonne Santalucia
- Multicultural Health Unit, 1511South Western Sydney Local Health District, Bankstown, Australia
| | - Paul Gorgees
- Multicultural Health Unit, 1511South Western Sydney Local Health District, Bankstown, Australia
| | - Tran Thao Nguyen
- Multicultural Health Unit, 1511South Western Sydney Local Health District, Bankstown, Australia
| | - Hien Le
- Multicultural Health Unit, 1511South Western Sydney Local Health District, Bankstown, Australia
| | - Balwinder Sidhu
- Multicultural Health Unit, 1511South Western Sydney Local Health District, Bankstown, Australia
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Gupta N, Gupta MK, Joshi NK, Mantri N, Sridevi G, Patel M, Goel AD, Singh K, Garg MK, Bhardwaj P. Is telemedicine a holy grail in healthcare policy: clinicians' and patients' perspectives from an Apex Institution in Western India. BMC Health Serv Res 2023; 23:161. [PMID: 36793030 PMCID: PMC9930698 DOI: 10.1186/s12913-022-09013-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/27/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND This study aimed to explore the perception of doctors regarding telemedicine consultations and the level of patient satisfaction with the services received through teleconsultations. METHODS This cross-sectional study was conducted on clinicians who provided teleconsultations and patients who received teleconsultations in an Apex healthcare institution in Western India. Semi-structured interview schedules were used to record the quantitative and qualitative information. Clinicians' perceptions and patients' satisfaction were assessed using two different 5-point Likert scales. Data were analyzed using SPSS v.23 using non-parametric tests (Kruskal Wallis and Mann-Whitney U). RESULTS A total of 52 clinicians who delivered teleconsultations and 134 patients who received teleconsultations from those doctors were interviewed in this study. For 69% of doctors, telemedicine was feasible to implement, and for the rest, it was challenging. Doctors believe telemedicine is convenient for patients (77%) and prevents the transmission of infection (94.2%). Difficulty in clinical evaluation (73%), communication (55.7%), network connectivity (34%), diagnosis and investigations (32%), and patients' e-illiteracy (32%) were the most common challenges faced by clinicians. Patients' experiences were positive in terms of ease of registration (82.1%), audio quality (100%), freedom to discuss medicine (94.8%), and comprehension of the diagnoses (88.1%). Patients expressed satisfaction with the length of the teleconsultation (81.4%), the advice and care they received (78.4%), and the manner and communication of the clinicians (78.4%). CONCLUSIONS Though there were some challenges in the implementation of telemedicine, the clinicians perceived it quite helpful. The majority of the patients were satisfied with teleconsultation services. Difficulty in registration, lack of communication, and a deep-rooted mindset of physical consultations were the primary concerns from the patient side.
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Affiliation(s)
- Nainsi Gupta
- grid.463267.20000 0004 4681 1140School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Manoj Kumar Gupta
- School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India. .,Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan, India.
| | - Nitin Kumar Joshi
- grid.463267.20000 0004 4681 1140School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Neha Mantri
- grid.463267.20000 0004 4681 1140School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - G. Sridevi
- grid.463267.20000 0004 4681 1140Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Mamta Patel
- grid.463267.20000 0004 4681 1140School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Akhil Dhanesh Goel
- grid.463267.20000 0004 4681 1140Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Kuldeep Singh
- grid.463267.20000 0004 4681 1140Department of Pediatrics, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - M. K. Garg
- grid.463267.20000 0004 4681 1140Department of Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
| | - Pankaj Bhardwaj
- grid.463267.20000 0004 4681 1140School of Public Health, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India ,grid.463267.20000 0004 4681 1140Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences Jodhpur, Jodhpur, Rajasthan India
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Kundury KK, Bovilla VR, Kumar KSP, Chandrashekarappa SM, Madhunapantula SV, Hathur B. Providing Diabetes Education through Phone Calls Assisted in the Better Control of Hyperglycemia and Improved the Knowledge of Patients on Diabetes Management. Healthcare (Basel) 2023; 11:healthcare11040528. [PMID: 36833068 PMCID: PMC9957542 DOI: 10.3390/healthcare11040528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/04/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
Purpose: A recent single-arm pilot study from our group showed a significant decrease in HbA1C in Type-2 diabetes individuals provided with SMS and phone call-based education on glycemic control. Considering the preference of participants to phone call-based education, a randomized control trial (RCT) with parallel design was conducted to determine the impact of phone call-based diabetes educational intervention on the control of hyperglycemia and improvement in the knowledge about diabetes management. Objectives: To determine the impact of phone call-based educational intervention on the control of hyperglycemia and improvement in the knowledge about diabetes management. Methodology: The study was conducted for a period of 12 months on a total of 273 Type-2 diabetic patients (interventional group (n = 135); non-interventional group (n = 138)) who had provided consent to participate. Subjects in the case group received weekly phone calls on diabetes education; whereas the control group received no education. HbA1C investigations were carried out at baseline and at every fourth month until the completion of the study period for the subjects in both the groups. The impact of phone call-based education was measured by comparing HbA1C values as well as by measuring the questionnaire-based knowledge scores on diabetes management. Results: At the end of the study period, there was a significant reduction in HbA1C in 58.8% participants (n = 65) and a manifold (2-5-fold) increase in knowledge on diabetes management among participants in the case group (n = 110). However, no significant difference in HbA1C and knowledge score was observed in participants from the control group (n = 115). Conclusion: Phone call-based diabetes education is a viable option to empower patients for better management of Type-2 diabetes.
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Affiliation(s)
- Kanakavalli K. Kundury
- Department of Health System Management Studies, JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India
- Special Interest Group in Patient Care Management (SIG-PCM); JSS Medical College, JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India
| | - Venugopal R. Bovilla
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR, a DST-FIST Supported Center), Department of Biochemistry (a DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India
| | - K. S. Prathap Kumar
- Department of Health System Management Studies, JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India
| | - Smitha M. Chandrashekarappa
- Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India
| | - SubbaRao V. Madhunapantula
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR, a DST-FIST Supported Center), Department of Biochemistry (a DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India
- Special Interest Group in Cancer Biology and Cancer Stem Cells (SIG-CBCSC), JSS Medical College, JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India
| | - Basavanagowdappa Hathur
- Special Interest Group in Patient Care Management (SIG-PCM); JSS Medical College, JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India
- Department of General Medicine, JSS Medical College & Hospital, JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India
- Correspondence:
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Mavragani A, Batterham PJ, Gulliver A, Morse A, Calear AL, McCallum S, Banfield M, Shou Y, Newman E, Dawel A. The Factors Associated With Telehealth Use and Avoidance During the COVID-19 Pandemic: Longitudinal Survey. J Med Internet Res 2023; 25:e43798. [PMID: 36649254 PMCID: PMC9947771 DOI: 10.2196/43798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/16/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Social distancing requirements due to the COVID-19 pandemic saw a rapid increase in the delivery of telehealth consultations as an alternative to face-to-face health care services. OBJECTIVE The aims of this study were to assess the use and acceptability of telehealth during the early stages of the pandemic and identify factors associated with telehealth avoidance during this period. METHODS Data were obtained from waves 4 and 7 of a longitudinal survey designed to assess the impact of the COVID-19 pandemic on the health and behavior of a representative sample of Australian adults. Participants reported on their use or avoidance of telehealth during the assessment period, as well as the mode of telehealth used and acceptability. RESULTS Approximately 30% of participants reported using telehealth during the assessment periods, with the most common telehealth modality being the telephone. Acceptance of telehealth was generally high and was higher among those who used telehealth compared with those who did not. Approximately 18% of participants reported avoiding health care due to telehealth. Across assessment waves, avoidance was associated with younger age, speaking a language other than or in addition to English, having a current medical diagnosis, and lower levels of telehealth acceptability. CONCLUSIONS While most participants in this study were accepting of telehealth services, there remain barriers to use, especially among those from particular sociodemographic groups. At a population level, avoidance of health services in nearly one in five adults may have considerable long-term impacts on morbidity and potentially mortality. Targeted efforts to promote engagement with telehealth services are critical if these adverse outcomes are to be avoided, particularly during periods when access to face-to-face services may be limited.
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Affiliation(s)
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Amelia Gulliver
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Alyssa Morse
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Sonia McCallum
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Michelle Banfield
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Yiyun Shou
- Research School of Psychology, The Australian National University, Canberra, Australia.,Saw See Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Lloyd's Register Foundation Institute for the Public Understanding of Risk, National University of Singapore, Singapore, Singapore
| | - Eryn Newman
- Research School of Psychology, The Australian National University, Canberra, Australia
| | - Amy Dawel
- Research School of Psychology, The Australian National University, Canberra, Australia
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Fraticelli F, Nicola MD, Vitacolonna E. A nutritional web-based approach in obesity and diabetes before and during the COVID-19 lockdown. J Telemed Telecare 2023; 29:91-102. [PMID: 33081596 PMCID: PMC9816630 DOI: 10.1177/1357633x20966933] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Obesity and type 2 diabetes (T2D) are two closely related pandemic conditions. Novel technologies represent promising tools for their management, the use of which has been greatly encouraged during the COVID-19 pandemic. The aim of the present study is to compare a web-based nutritional intervention versus a traditional one, before and during the Italian 'lockdown' period due to the COVID-19 outbreak, in overweight and obese subjects affected by T2D or impaired glucose regulation (IGR). METHODS For the study, 36 subjects were randomly allocated into two arms: a traditional arm, providing face-to-face individual and group-based intervention; and a web arm, deploying the in-presence traditional approach with intervention provided through web technologies. The outcomes were the data resulting from the comparison between the subjects' anthropometric and clinical parameters as well as PREDIMED scores at baseline with those at 3 months (T3), 6 months (T6) and at lockdown. RESULTS In the web arm we detected a progressive reduction in weight and body mass index (BMI) from baseline to T6 and a minimal increase of both parameters during the lockdown. Improvement of these parameters compared with baseline was observed in controls during the lockdown. The PREDIMED score improved at T6 compared with baseline in both arms. Significant variations were observed considering weight (p < 0.001), BMI (p = 0.001) and PREDIMED scores (p = 0.023) over time. DISCUSSION The study showed the effectiveness and feasibility of a short-term nutritional web-based intervention in patients affected by T2D or IGR before and during the COVID 19 pandemic.Clinical Trial registration number: NCT04386200, ClinicalTrials.gov.
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Affiliation(s)
- Federica Fraticelli
- Department of Medicine and Aging,
School of Medicine and Health Sciences, “G. d’Annunzio” University of
Chieti-Pescara, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics,
Department of Medical, Oral and Biotechnological Sciences, “G. d'Annunzio”
University of Chieti-Pescara, Italy
| | - Ester Vitacolonna
- Department of Medicine and Aging,
School of Medicine and Health Sciences, “G. d’Annunzio” University of
Chieti-Pescara, Italy,Ester Vitacolonna, MD, Department of
Medicine and Aging, School of Medicine and Health Sciences, “G. d'Annunzio”
University, Via dei Vestini 66100 Chieti, Chieti-Pescara, Chieti, Italy.
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Meneses ADFP, Pimentel FF, da Cruz JPF, Candido Dos Reis FJ. Experiences of Women With Breast Cancer Using Telehealth: A Qualitative Systematic Review. Clin Breast Cancer 2023; 23:101-107. [PMID: 36464603 DOI: 10.1016/j.clbc.2022.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/20/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022]
Abstract
Breast cancer is the most prevalent malignant neoplasm among women. Its treatment comprises different strategies. Telehealth can ensure continuity of care in distant locations. This study aimed to synthesize qualitative evidence of women's experiences with telehealth during the treatment and follow-up of breast cancer. We performed a qualitative systematic review and meta-synthesis. The databases included in the search were: Pubmed, EMBASE, CINAHAL, and Web of Science. The search combined the terms: breast cancer, telemedicine, telehealth, and qualitative study. The studies included were: qualitative design and mixed methods studies with qualitative components. The COREQ Checklist assisted in assessing the quality of included studies and an adaptation of thematic analysis for the qualitative meta-synthesis. We included twelve articles in the review. In the meta-synthesis, 3 themes emerged. (1) Structure: simple design and space to obtain information but in need of adjustments. (2) Usability: about the benefits and limitations of telehealth. (3) Interaction with health professionals. Telehealth is an accepted strategy for the clinical care of women with breast cancer. Patients identified the need for improvements in structure, usability, and interaction. PROTOCOL REGISTRATION: PROSPERO registration number CRD42021228326, registered 06/02/2021.
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Affiliation(s)
| | - Franklin Fernandes Pimentel
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - João Pedro Ferreira da Cruz
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
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Zhang W, Zhou F, Fei Y. Repetitions in online doctor-patient communication: Frequency, functions, and reasons. PATIENT EDUCATION AND COUNSELING 2023; 107:107565. [PMID: 36428169 DOI: 10.1016/j.pec.2022.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 10/23/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To attain insights into language repetition during online doctor-patient communication (DPC), understand why doctors and patients use repetition, and improve the current deficiencies in online medical platforms. METHODS The study performed a content analysis of 72 sets of textual doctor-patient conversations on the Chinese online medical consultation platform Chunyu Doctor. RESULTS Repetitions occurred 1412 times in the 72 sets of online DPC. Patient self-repetitions were the most prevalent (30.7 %), while patient repetitions of doctors were the least common (17.1 %). Doctors used repetitions for explanations and affirmations. Patients used repetition for emphasis, verification, and turn-taking. The repetition frequencies of doctors and patients were primarily influenced by personal factors. However, doctor-dimension factors exerted a greater impact on the frequency of patient repetitions. CONCLUSIONS The reasons for repetitions in online DPC differ from those offline. Online DPC increases patient initiative and reduces doctor authority. Nevertheless, it could be affected by gender stereotypes generated during offline consultations. Doctors still dominated the conversations but attended sufficiently to the patient discourse. Online DPC is gradually attempting to fulfill the expectations of a new patient-centered healthcare pattern. PRACTICAL IMPLICATIONS The findings yield suggestions for healthcare providers and the designers of online healthcare platforms.
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Affiliation(s)
- Wen Zhang
- School of Journalism and Culture Communication, Zhongnan University of Economics and Law, Wuhan 430073, PR China.
| | - Fangzhou Zhou
- Institute of Communication Studies, Communication University of China, Beijing 100024, PR China.
| | - Yifeng Fei
- School of Computer Science and Technology, Dalian University of Technology, Dalian 116024, PR China.
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Changes to Prenatal Care Visit Frequency and Telehealth: A Systematic Review of Qualitative Evidence. Obstet Gynecol 2023; 141:299-323. [PMID: 36649343 DOI: 10.1097/aog.0000000000005046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/20/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To systematically review patient, partner or family, and clinician perspectives, preferences, and experiences related to prenatal care visit schedules and televisits for routine prenatal care. DATA SOURCES PubMed, the Cochrane databases, EMBASE, CINAHL, ClinicalTrials.gov , PsycINFO, and SocINDEX from inception through February 12, 2022. METHODS OF STUDY SELECTION This review of qualitative research is a subset of a larger review on both the qualitative experiences and quantitative benefits and harms of reduced prenatal care visit schedules and televisits for routine prenatal care that was produced by the Brown Evidence-based Practice Center for the Agency for Healthcare Research and Quality. For the qualitative review, we included qualitative research studies that examined perspectives, preferences, and experiences about the number of scheduled visits and about televisits for routine prenatal care. TABULATION, INTEGRATION, AND RESULTS We synthesized barriers and facilitators to the implementation of reduced care visits or of televisits into 1 of 14 domains defined by the Theoretical Domains Framework (TDF) and a Best Fit Framework approach. We summarized themes within TDF domains. We assessed our confidence in the summary statements using the GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation-Confidence in Evidence from Reviews of Qualitative research) tool. Four studies addressed the number of scheduled routine prenatal visits, and five studies addressed televisits. Across studies, health care professionals believed fewer routine visits may be more convenient for patients and may increase clinic capacity to provide additional care for patients with high-risk pregnancies. However, both patients and clinicians had concerns about potential lesser care with fewer visits, including concerns about quality of care and challenges with implementing new delivery-of-care models. CONCLUSION Although health care professionals and patients had some concerns about reduced visit schedules and use of televisits, several potential benefits were also noted. Our synthesis of qualitative evidence provides helpful insights into the perspectives, preferences, and experiences of important stakeholders with respect to implementing changes to prenatal care delivery that may complement findings of traditional quantitative evidence syntheses. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42021272287.
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Abstract
Telemedicine has become fundamental for the challenges posed to healthcare. This set of instruments turns pivotal for facing one of the most relevant emergencies in human history: the COVID-19 pandemic. The multisectoral crisis led to a vigorously sustained adoption of innovations, including telemedicine technology. Telehealth was proven, in this context, to be a relevant tool to reduce healthcare costs, reduce not-needed hospitalizations, and improve the results in health care. Some barriers such as the costs of technologies, patient privacy and technical literacy have slowed down telemedicine adoption. Amidst the COVID-19 era, telemedicine calls for a managerial duty to change healthcare's organizational models. The present work aims to explore the growing literature to illuminate the relationships between telemedicine, innovations and healthcare in the COVID-19 framework. A bibliometric analysis of the existing literature based on 285 published works in 2019–2020 is put forward with the aim to detect the relevant literature, themes and approaches on telemedicine and COVID-19. Making use of community detection on the co-occurrence keywords network, we identify the “semantic cores” in the literature representing the relevant results on critical themes. The sorting implications are important for researchers and policymakers by mapping the existing literature and results in evidence-based analysis. We provide the key communities as the “semantic core” of the publications and results for the considered period. This allows for future research to be oriented towards perduring health policies that could lead to the adoption of telemedicine technologies in a post-pandemic scenario.
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Nyoni T, Evers EC, Pérez M, Jeffe DB, Fritz SA, Colditz GA, Burnham JP. Perceived barriers and facilitators to the adoption of telemedicine infectious diseases consultations in southeastern Missouri hospitals. J Telemed Telecare 2023:1357633X221149461. [PMID: 36659820 PMCID: PMC10354216 DOI: 10.1177/1357633x221149461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Telemedicine infectious diseases consultations (tele-ID consults) improves access to healthcare for underserved/resource-limited communities. However, factors promoting or hindering implementation of tele-ID consults in low-resource settings are understudied. This study sought to fill this gap by describing perceived barriers and facilitators tele-ID consults at three rural hospitals in southeastern Missouri. METHODS Twelve in-depth, semi-structured interviews were conducted with a purposively sampled group of information-rich hospital stakeholders from three rural, southeastern Missouri hospitals with partial or no on-site availability of ID physicians. Our literature-informed interview guide elicited participants' knowledge and experience with tele-ID consults, perceptions on ID consultation needs, and perceived barriers to and facilitators of tele-ID consults. Interview transcripts were coded using an iterative process of inductive analysis to identify core themes related to barriers and facilitators. RESULTS Perceived barriers to adopting and implementing tele-ID consults included logistical challenges, technology and devices, negative emotional responses, patient-related factors, concerns about reduced quality of care when using telemedicine, lack of acceptance or buy-in from physicians or staff, and legal concerns. Key facilitators included perceived need, perceived benefits to patients and physicians, flexibility and openness to change among staff members and patients, telemedicine champions, prior experiences, and enthusiasm. DISCUSSION Our findings demonstrate that rural hospitals need tele-ID consults and have the capacity to implement tele-ID consults, but operational and technical feasibility challenges remain. Adoption and implementation of tele-ID consults may reduce ID-physician shortage-related service gaps by permitting ID physician's greater geographic reach.
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Affiliation(s)
- Thabani Nyoni
- Brown School, Washington University in Saint Louis, St. Louis, Missouri, USA
| | - Emily C. Evers
- Brown School, Washington University in Saint Louis, St. Louis, Missouri, USA
| | - Maria Pérez
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Donna B. Jeffe
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Stephanie A. Fritz
- Department of Pediatrics, Washington University in St. Louis, Missouri, USA
| | - Graham A. Colditz
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jason P. Burnham
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, USA
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Kukafka R, Gupta A, Gilbert C, Huggins CE, Browning C, Chapman W, Haines T, Peeters A. Virtual Care Initiatives for Older Adults in Australia: Scoping Review. J Med Internet Res 2023; 25:e38081. [PMID: 36652291 PMCID: PMC9892987 DOI: 10.2196/38081] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/03/2022] [Accepted: 09/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND There has been a rapid shift toward the adoption of virtual health care services in Australia. It is unknown how widely virtual care has been implemented or evaluated for the care of older adults in Australia. OBJECTIVE We aimed to review the literature evaluating virtual care initiatives for older adults across a wide range of health conditions and modalities and identify key challenges and opportunities for wider adoption at both patient and system levels in Australia. METHODS A scoping review of the literature was conducted. We searched MEDLINE, Embase, PsycINFO, CINAHL, AgeLine, and gray literature (January 1, 2011, to March 8, 2021) to identify virtual care initiatives for older Australians (aged ≥65 years). The results were reported according to the World Health Organization's digital health evaluation framework. RESULTS Among the 6296 documents in the search results, we identified 94 that reported 80 unique virtual care initiatives. Most (69/80, 89%) were at the pilot stage and targeted community-dwelling older adults (64/79, 81%) with chronic diseases (52/80, 65%). The modes of delivery included videoconference, telephone, apps, device or monitoring systems, and web-based technologies. Most initiatives showed either similar or better health and behavioral outcomes compared with in-person care. The key barriers for wider adoption were physical, cognitive, or sensory impairment in older adults and staffing issues, legislative issues, and a lack of motivation among providers. CONCLUSIONS Virtual care is a viable model of care to address a wide range of health conditions among older adults in Australia. More embedded and integrative evaluations are needed to ensure that virtually enabled care can be used more widely by older Australians and health care providers.
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Affiliation(s)
| | - Adyya Gupta
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Cecily Gilbert
- Centre for Digital Transformation of Health, University of Melbourne, Melbourne, Australia
| | - Catherine E Huggins
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Colette Browning
- Health Innovation and Transformation Centre, Federation University, Ballarat, Australia.,Institute of Health and Wellbeing, Federation University, Ballarat, Australia
| | - Wendy Chapman
- Centre for Digital Transformation of Health, University of Melbourne, Melbourne, Australia
| | - Terry Haines
- National Centre for Healthy Ageing, Monash University, Frankston, Australia.,School of Primary and Allied Health Care, Monash University, Frankston, Australia
| | - Anna Peeters
- Institute for Health Transformation, Deakin University, Geelong, Australia
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Esber A, Teufel M, Jahre L, in der Schmitten J, Skoda EM, Bäuerle A. Predictors of patients' acceptance of video consultation in general practice during the coronavirus disease 2019 pandemic applying the unified theory of acceptance and use of technology model. Digit Health 2023; 9:20552076221149317. [PMID: 36815005 PMCID: PMC9940186 DOI: 10.1177/20552076221149317] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 12/18/2022] [Indexed: 01/20/2023] Open
Abstract
Background The coronavirus disease 2019 pandemic has led to an increase in remote consultations in health care. This study aimed to assess the acceptance of video consultation as an alternative to face-to-face in-office visits in general practice (GP) and to investigate its drivers and barriers. Methods A cross-sectional study was conducted in Germany during the coronavirus disease 2019 pandemic from December 2020 to April 2021. Participants were recruited among patients in 16 GP surgeries. Assessed were sociodemographic and medical data as well as information and communications technology related data. Acceptance of video consultation and its predictors were determined using a modified questionnaire based on a short version of the renowned unified theory of acceptance and use of technology model. Results In total, 371 participants were included in the data analysis. Acceptance of video consultation was moderate. A hierarchical regression revealed acceptance was significantly predicted by the PHQ-2, taking no regular medication, computer proficiency, knowledge about digital health care solutions, no prior use of video consultation, and the unified theory of acceptance and use of technology predictors performance expectancy, effort expectancy, and social influence. The extended unified theory of acceptance and use of technology model explained significantly more variance than the restricted unified theory of acceptance and use of technology model in acceptance of video consultation. Conclusions In this study computer proficiency, existing knowledge about digital health care solutions and depressive symptoms functioned as drivers to acceptance, no prior use of video consultation could be identified as a potential barrier. Patients with regular medication have been particularly receptive to video consultation. The study confirmed the validity of the unified theory of acceptance and use of technology model in determining acceptance of video consultation. Considering that there is growing demand and acceptance for different approaches to engage with health care providers, additional steps should be taken to establish video consultation as a genuine alternative.
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Affiliation(s)
- André Esber
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Lisa Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Jürgen in der Schmitten
- Institute of General Practice, Center for Translational Neuro- and Behavioral Sciences, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany,Alexander Bäuerle, Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
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Cerdan de las Heras J, Andersen SL, Matthies S, Sandreva TV, Johannesen CK, Nielsen TL, Fuglebjerg N, Catalan-Matamoros D, Hansen DG, Fischer TK. Hospitalisation at Home of Patients with COVID-19: A Qualitative Study of User Experiences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1287. [PMID: 36674043 PMCID: PMC9858642 DOI: 10.3390/ijerph20021287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Hospitalisation at Home (HaH) is a new model providing hospital-level care at home as a substitute for traditional care. Biometric monitoring and digital communication are crucial, but little is known about user perspectives. We aim to explore how in-patients with severe COVID-19 infection and clinicians engage with and experience communication and self-monitoring activities following the HaH model. A qualitative study based on semi-structured interviews of patients and clinicians participating in the early development phase of HaH were conducted. We interviewed eight clinicians and six patients. Five themes emerged from clinicians: (1) staff fear and concerns, (2) workflow, (3) virtual closeness, (4) patient relatives, and (5) future HaH models; four themes emerged from patients: (1) transition to home, (2) joint responsibility, (3) acceptability of technologies, and (4) relatives. Despite technical problems, both patients and clinicians were enthusiastic about the conceptual HaH idea. If appropriately introduced, treatment based on self-monitoring and remote communication was perceived acceptable for the patients; however, obtaining vitals at night was an overwhelming challenge. HaH is generally acceptable, perceived patient-centred, influencing routine clinical workflow, role and job satisfaction. Therefore, it calls for educational programs including more perspective than issues related to technical devices.
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Affiliation(s)
- Jose Cerdan de las Heras
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
| | - Signe Lindgård Andersen
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
| | - Sophie Matthies
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
- Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
| | | | - Caroline Klint Johannesen
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
- Department of Virology and Microbiological Special Diagnostics, Statens Serum Institut, 2300 Copenhagen, Denmark
| | - Thyge Lynghøj Nielsen
- Department of Respiratory Medicine and Infectious Diseases, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
| | - Natascha Fuglebjerg
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
| | | | - Dorte Gilså Hansen
- Institute of Public Health, Research Unit of General Practice, University of Southern Denmark, 5230 Odense, Denmark
| | - Thea K. Fischer
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hillerød, Denmark
- Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark
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Lovis C, Hefner J, Chen C, Huang Y, Wang X, Yang Q, Zhu X, Zhang X, Hao M, Shui L. Developing a Capsule Clinic-A 24-Hour Institution for Improving Primary Health Care Accessibility: Evidence From China. JMIR Med Inform 2023; 11:e41212. [PMID: 36622737 PMCID: PMC9871876 DOI: 10.2196/41212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/18/2022] [Accepted: 12/08/2022] [Indexed: 01/10/2023] Open
Abstract
Telehealth is an effective combination of medical service and intelligent technology. It can improve the problem of remote access to medical care. However, an imbalance in the allocation of health resources still occurs. People spend more time and money to access higher-quality services, which results in inequitable access to primary health care (PHC). At the same time, patients' usage of telehealth services is limited by the equipment and their own knowledge, and the PHC service suffers from low usage efficiency and lack of service supply. Therefore, improving PHC accessibility is crucial to narrowing the global health care coverage gap and maintaining health equity. In recent years, China has explored several new approaches to improve PHC accessibility. One such approach is the capsule clinic, an emerging institution that represents an upgraded version of the internet hospital. In coordination with the United Nations, the Yinzhou district of Ningbo city in Zhejiang, China, has been testing this new model since 2020. As of October 2022, the number of applications in Ningbo was 15, and the number of users reached 12,219. Unlike internet hospitals, the entire process-from diagnosis to prescription services-can be completed at the capsule clinic. The 24-hour telehealth service could also solve transportation problems and save time for users. Big data analysis can accurately identify regional populations' PHC service needs and improve efficiency in health resource allocation. The user-friendly, low-cost, and easily accessible telehealth model is of great significance. Installation of capsule clinics would improve PHC accessibility and resolve the uneven distribution of health resources to promote health equity.
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Affiliation(s)
| | | | - Chun Chen
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Yunyun Huang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Xiaoyi Wang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Qingren Yang
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Xuebo Zhu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Xiangyang Zhang
- Engineering Research Center of Intelligent Medicine (2016E10011), The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mo Hao
- School of Public Health, Fudan University, Shanghai, China
| | - Liming Shui
- Yinzhou District Health Bureau, Ningbo, China
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Boran P, Dönmez M, Barış E, Us MC, Altaş ZM, Nisar A, Atif N, Sikander S, Hıdıroğlu S, Save D, Rahman A. Delivering the Thinking Healthy Programme as a universal group intervention integrated into routine antenatal care: a randomized-controlled pilot study. BMC Psychiatry 2023; 23:14. [PMID: 36604685 PMCID: PMC9816542 DOI: 10.1186/s12888-022-04499-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/26/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Women with perinatal depression and their children are at increased risk of poor health outcomes. There is a need to implement non-stigmatizing interventions into existing health systems which reduce psychosocial distress during pregnancy and prevent perinatal depression. We adapted the WHO-endorsed Thinking Healthy Programme (THP) to be delivered universally to all women attending routine online pregnancy schools in Istanbul, Turkey. This study aimed to evaluate the feasibility and acceptability of this intervention. METHODS This mixed-methods study incorporated a two-arm pilot randomized controlled trial and qualitative evaluation of the feasibility and acceptability of the adapted THP - Brief Group version (THP-BGV) to a range of stakeholders. We recruited pregnant women at 12-30 weeks' gestation through pregnancy schools within the University Hospital's catchment area. Women in the intervention arm received five online sessions of the THP-BGV delivered by antenatal nurses. The intervention employed principles of cognitive behaviour therapy to provide psychoeducation, behaviour activation, problem-solving strategies and group support to participants. In the control arm, women received usual care consisting of routine online educational pregnancy classes aided by the antenatal nurses. The women were assessed for depressive symptoms with the Edinburgh Postnatal Depression Scale at baseline and 4-6 weeks post-intervention and also evaluated for anxiety, perceived social support, partner relationship, level of disability and sleep quality. In-depth interviews were conducted with women and other key stakeholders. RESULTS Of the 99 consecutive women referred to the pregnancy schools, 91 (91.9%) were eligible and 88 (88.8%) consented to participate in the study and were randomized. Eighty-two (83%) completed the final assessments. Our main findings were that this preventive group intervention was feasible to be integrated into routine antenatal educational classes and it was valued by the women and delivery-agents. While the study was not powered to detect differences between intervention and control conditions, we found small trends towards reduction in anxiety and depressive symptoms favoring the intervention arm. No serious adverse events were reported. CONCLUSIONS Given the paucity of preventive interventions for perinatal depression in low and middle-income countries, a fully powered definitive randomized controlled trial of this feasible and acceptable intervention should be conducted. TRIAL REGISTRATION The study was registered at Clinical Trails.gov ( NCT04819711 ) (Registration Date: 29/03/2021).
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Affiliation(s)
- Perran Boran
- grid.16477.330000 0001 0668 8422Marmara University, School of Medicine, Division of Social Pediatrics, Istanbul, Turkey
| | - Melike Dönmez
- grid.16477.330000 0001 0668 8422Marmara University, School of Medicine, Department of Psychiatry, Istanbul, Turkey
| | - Ezgi Barış
- grid.16477.330000 0001 0668 8422Marmara University, School of Medicine, Division of Social Pediatrics, Istanbul, Turkey ,grid.16477.330000 0001 0668 8422Marmara University, Institute of Health Sciences, Social Pediatrics Doctorate Program, Istanbul, Turkey
| | - Mahmut Caner Us
- grid.16477.330000 0001 0668 8422Marmara University, Institute of Health Sciences, Social Pediatrics Doctorate Program, Istanbul, Turkey
| | - Zeynep Meva Altaş
- grid.16477.330000 0001 0668 8422Marmara University, School of Medicine, Department of Public Health, Istanbul, Turkey
| | - Anum Nisar
- grid.43169.390000 0001 0599 1243School of Public Health, Xi’an Jiaotong University, Xi’an, China
| | - Najia Atif
- grid.490844.5Human Development Research Foundation, Islamabad, Pakistan
| | - Siham Sikander
- grid.490844.5Human Development Research Foundation, Islamabad, Pakistan
| | - Seyhan Hıdıroğlu
- grid.16477.330000 0001 0668 8422Marmara University, School of Medicine, Department of Public Health, Istanbul, Turkey
| | - Dilşad Save
- grid.16477.330000 0001 0668 8422Marmara University, School of Medicine, Department of Public Health, Istanbul, Turkey
| | - Atif Rahman
- University of Liverpool, Department of Primary Care and Mental Health, Waterhouse Buildings Block B, Liverpool, L69 3LH, UK.
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Wu M, Li Y, Ma C. Patients' choice preferences for specialist outpatient online consultations: A discrete choice experiment. Front Public Health 2023; 10:1075146. [PMID: 36684861 PMCID: PMC9850164 DOI: 10.3389/fpubh.2022.1075146] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023] Open
Abstract
Background Internet hospitals are multiplying with solid support from the Chinese government. In internet hospitals, specialist outpatient online consultations (SOOC) are the primary services. However, the acceptance and utilization rates of this service are still low. Thus, the study of patients' choice preferences for SOOC is needed. Objective To analyze the choice preference of patients' SOOC via a discrete choice experiment, understand the influence of each factor and promote the development of internet hospitals. Methods Via a discrete selection experiment, a total of 162 patients from two general hospitals and three specialized hospitals in Beijing were selected for the questionnaire survey. The choice preferences were analyzed by conditional logit regression. Results From high to low, patients' willingness to pay (WTP) for the attributes of SOOC is as follows: doctors' recommendation rate (β highly recommend = 0.999), the convenience of applying SOOC services (β Convenient = 0.760), the increasing ratio of medical insurance payment for online services compared to offline (β Increase by 10% = 0.545), and the disease's severity (β severe = -3.024). The results of the subgroup analysis showed differences in patient choice preference by age, whether the patients had chronic diseases, income, and medical insurance types. Conclusion Both price and nonprice attributes influence the choice preference of SOOC for patients. Among them, patients are more inclined to choose SOOC when doctors highly recommend it, when it is convenient to apply, when medical insurance increases by 10%, and when disease severity is mild. The current findings show the government and medical institutions formulate auxiliary policies and welfare strategies by clarifying core attributes and adjusting the levels of different attributes to improve patients' acceptance of SOOC. The utility of SOOC and the further development of internet hospitals are radically promoted.
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Affiliation(s)
- Mengqiu Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital and Institute, Beijing, China
| | - Yuhan Li
- School of Public Health, Capital Medical University, Beijing, China
| | - Chengyu Ma
- School of Public Health, Capital Medical University, Beijing, China
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135
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Tenfelde K, Bol N, Schoonman GG, Bunt JEH, Antheunis ML. Exploring the impact of patient, physician and technology factors on patient video consultation satisfaction. Digit Health 2023; 9:20552076231203887. [PMID: 37780066 PMCID: PMC10540607 DOI: 10.1177/20552076231203887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/08/2023] [Indexed: 10/03/2023] Open
Abstract
Objective Video consultations (VCs) were made available to the general population during the COVID-19 pandemic to compensate for the cutback of face-to-face doctor-patient interactions. However, little is known about what patient-related (e.g. age), physician-related (e.g. patient-physician relationship) and technology-related (e.g. online privacy concerns) factors contribute to video consultation satisfaction among patients. This study aims to gain a better understanding of what makes patients satisfied with video consultations. Methods A total of 180 patients who recently engaged in a video consultation were invited to answer questions about patient-, physician- and technology-related variables and their satisfaction with the video consultation. To examine which factors predict patient video consultation satisfaction, a multiple hierarchical regression analysis was performed. Results Overall, patients were satisfied with their video consultation. The final hierarchical model, including all patient-related, physician-related and technology-related factors, significantly contributed to patient video consultation satisfaction. Predictors of higher patient video consultation satisfaction were experiencing less technical issues, having higher general positive attitudes towards online communication, reporting higher importance of less travel time and being more satisfied with physicians' affective and instrumental communication. Conclusions Video consultations can be appropriate in a variety of situations, provided that technical issues can be minimized, patients have a positive attitude towards online communication and attach value to reduced travel time and online patient-physician interactions can be experienced as affective and instrumental. Findings from this study contribute to understanding how video consultations can be best utilized for effective patient-physician communication.
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Affiliation(s)
- Kim Tenfelde
- Department of Communication and Cognition, Tilburg University, Tilburg, The Netherlands
| | - Nadine Bol
- Department of Communication and Cognition, Tilburg University, Tilburg, The Netherlands
| | - Guus G Schoonman
- Department of Communication and Cognition, Tilburg University, Tilburg, The Netherlands
- Department of Neurology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Jan Erik H Bunt
- Department of Pediatrics, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Marjolijn L Antheunis
- Department of Communication and Cognition, Tilburg University, Tilburg, The Netherlands
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136
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Assessment of the reliability of virtual preanesthetic airway evaluation compared to traditional in-person airway evaluation: a prospective observational study. Can J Anaesth 2023; 70:79-86. [PMID: 36376750 PMCID: PMC9663174 DOI: 10.1007/s12630-022-02345-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/07/2022] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Airway evaluation is a fundamental component of the preanesthetic examination. Virtual care has increased during the COVID-19 pandemic. We aimed to assess the reliability of a virtual preanesthetic airway evaluation compared with a traditional in-person airway evaluation. METHODS This prospective observational study compared the inter-rater agreement of an in-person airway evaluation performed by a consultant anesthesiologist with a virtual airway evaluation (VAE) performed by consultant anesthesiologists and medical students. The airway evaluation was completed using a comprehensive airway evaluation and scoring tool. The primary outcome was the inter-rater agreement of total scores between in-person anesthesiologist airway evaluations and the VAEs of both the anesthesiologists and medical students, assessed using Cohen's Kappa (CK). Secondary outcomes included the inter-rater agreement for each airway evaluation component between the in-person anesthesiologists and both the anesthesiologist and medical student VAEs, assessed using prevalence-adjusted and bias-adjusted Kappa. RESULTS One hundred out of 111 participants completed all three evaluations. The in-person anesthesiologist airway evaluations had fair and good levels of agreement of total scores with the VAEs of the anesthesiologists (CK, 0.21; 97.5% confidence interval [CI], 0.07 to 0.34) and the medical students (CK, 0.74; 97.5% CI, 0.62 to 0.86), respectively. One participant was reported to have a difficult intubation. CONCLUSION Virtual airway evaluations performed by anesthesiologists and medical students had fair and good inter-rater agreement, respectively, with in-person anesthesiologist airway evaluations. Further study with a focus on patients with difficult airways is required to define the predictive value of VAEs regarding difficult intubations.
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137
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Turkmani S, Smith RM, Tan A, Kamkong CB, Anderson R, Sakulku S, Jat TR, Biswas A, Homer CSE. An evaluation of the introduction of telehealth for remote antenatal and postnatal contacts in Bangladesh and Lao People's Democratic Republic during the COVID-19 pandemic. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000786. [PMID: 37163506 PMCID: PMC10171645 DOI: 10.1371/journal.pgph.0000786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 04/18/2023] [Indexed: 05/12/2023]
Abstract
From 2020, COVID-19 spread rapidly around the globe and continues to have a major impact on health system functioning, with a disproportionate impact on low- and middle-income countries (LMIC). Reduced service utilisation and coverage of essential childbirth interventions is likely impacting maternal and newborn morbidity and mortality. Telehealth has been identified as an important tool in the continued provision of essential healthcare services. The aim of this study was to explore the experience and impact of implementing telehealth services for the provision of remote antenatal (ANC) and postnatal (PNC) contacts in regions of Bangladesh and Lao People's Democratic Republic through 100 semi-structured interviews with health service leaders and providers, and childbearing women who organised, provided, or were the recipients of ANC and PNC telehealth during the COVID-19 pandemic response. The findings showed that a sudden pivot from face-to-face to telehealth services posed both health system and provision of care challenges. Health systems lacked funding to support telehealth and the infrastructure needed for service changes; however, some were able to work with key maternal child health departments within Ministries of Health to find the resources to implement the services. Health providers found telehealth beneficial during the pandemic response but identified a lack of training, guidance, and support as a barrier to changing practice. Childbearing women reported being fearful of accessing care at health services due to COVID-19, and whilst they appreciated the telehealth contacts, many continued to prefer face-to-face delivery of ANC and PNC care. Telehealth, however, was a good alternative in a time when face-to-face care was not possible. Considerations for post-pandemic broader implementation or scale-up of telehealth for routine antenatal and postnatal maternity care provision include the need for further research on issues such as accessibility, acceptability, quality of care, and sustainability of service provision.
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Affiliation(s)
- Sabera Turkmani
- Burnet Institute, Melbourne, Victoria, Australia
- University of Technology Sydney, Melbourne, Australia
| | | | - Annie Tan
- Burnet Institute, Melbourne, Victoria, Australia
| | | | | | | | - Tej Ram Jat
- UNFPA Lao PDR Country Office, Vientiane, Laos
| | | | - Caroline S E Homer
- Burnet Institute, Melbourne, Victoria, Australia
- University of Technology Sydney, Melbourne, Australia
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138
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Liu C, Li Y, Fang M, Liu F. Using machine learning to explore the determinants of service satisfaction with online healthcare platforms during the COVID-19 pandemic. SERVICE BUSINESS 2023; 17:449-476. [PMCID: PMC10187523 DOI: 10.1007/s11628-023-00535-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 05/01/2023] [Indexed: 07/02/2024]
Abstract
This study investigates the determinants of service satisfaction with online healthcare platforms using machine learning (ML) algorithms. By training and testing eleven ML models based on data mined from a leading online healthcare platform in China, we obtained the best-performing ML algorithm for service satisfaction prediction, namely, Light Gradient Boosting Machine. Furthermore, our empirical results indicate that gifts, patient votes, popularity, fee-based consultation volume, gender, and thank-you letters positively impact service satisfaction, while the impacts of consultation volume, free consultation volume, views, waiting time, articles, physician title, and hospital level are negative. We discuss the theoretical and managerial implications.
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Affiliation(s)
- Chengyu Liu
- Business School, Shandong University, Weihai, China
| | - Yan Li
- Business School, Shandong University, Weihai, China
| | - Mingjie Fang
- Department of Logistics, Service & Operations Management, Korea University Business School, Seoul, Korea
| | - Feng Liu
- Business School, Shandong University, Weihai, China
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139
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Swed S, Alibrahim H, Bohsas H, Aljabali A, Hamouda HM, Sawaf B, albuni MK, Battikh E, Ahmed SMA, Sharif Ahmed EM, Motawea KR, Abdelazeem B, Shoib S, Rakab A, Hafez W. Awareness, knowledge, attitude, and skills regarding telemedicine among Syrian healthcare providers: A cross-sectional study. Digit Health 2023; 9:20552076231211662. [PMID: 37936959 PMCID: PMC10627024 DOI: 10.1177/20552076231211662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 11/09/2023] Open
Abstract
Background After the widespread of coronavirus disease (COVID-19) around the globe, it was imperative to establish preventative measures to restrict the virus's transmission. The purpose of this research was to present an overview of the awareness, knowledge, attitude, and abilities of Syrian physicians about telemedicine technology. Methods An online cross-sectional study was conducted from April 1 to May 15, 2022. The questionnaire was taken from published study, and the inclusion criteria consist the Syrian doctors who worked in hospitals during the COVID-19 pandemic, mainly those who had direct contact with patients. Results Among 385 responses, 52.72% of them were females, 83.9% of them were aged less than 30 years old, and 66% were working in the governmental sector; 66% of participants have moderate knowledge about using computers and the internet, 80% have heard about telemedicine. Despite that, 95.1% of participants have not attended any training workshop on telemedicine, and most of them have reported no availability of a telemedicine unit in their department. Only 31.7% participants have shown high awareness of telemedicine. Furthermore, no significant correlation was identified between the academic level with the age and telemedicine awareness, knowledge, attitude, or computer skills. Despite that, there was an obvious correlation between age and computer skills (P-value < 0.05). There was a significant correlation between the medical specialty and awareness, and computer abilities, especially the anesthesiology (88.5 ± 5.2), (84 ± 8.7), respectively. Spearman's rho test showed mild positive significant association in various subscales (awareness and experience, experience and skills, knowledge and attitude, knowledge and skills, and attitude and skills). Conclusion The study results demonstrate that most of the participating clinical doctors have a neutral view of telemedicine, even though they do not know much about it and do not have considerable experience with it. It is practical to educate and train academic staff, practicing physicians, residents and medical students within the clinical stages about telemedicine.
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Affiliation(s)
- Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria
| | | | | | - Ahmed Aljabali
- Faculty of Medicine, Jordan University of Science and Technology, Amman, Jordon
| | | | - Bisher Sawaf
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Elias Battikh
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Karam R Motawea
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Basel Abdelazeem
- Internal Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Sheikh Shoib
- Psychiatry, JLNM Hospital, Rainawari, Srinagar Directorate of Health Services, J&K, India
| | - Amine Rakab
- Internal Medicine, Weill Cornell Medical College, Qatar
| | - Wael Hafez
- Internal Medicine, NMC Royal Hospital, Khalifa City, Abu Dhabi, UAE
- Medical Research Division, Department of Internal Medicine, The National Research Centre, Cairo, Egypt
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140
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Sobaih AEE, Baquee A, Palla IA, Munshi SA. Perceived Use Behavior of Social Networking Sites Among the Healthcare Students in India. SAGE Open Nurs 2023; 9:23779608231201040. [PMID: 37691723 PMCID: PMC10492473 DOI: 10.1177/23779608231201040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/08/2023] [Accepted: 08/27/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction The use of social networking sites (SNSs) is growing among higher education students, including healthcare students. Nonetheless, limited research has examined the perceived use behavior among healthcare students in developing countries such as India. Objective This study attempts to assess the use behavior of SNSs by undergraduate students in the fields of nursing and pharmacy in India through the lens of Connectivism and New Social Learning theories. Method The study used a Google form to collect data through an online questionnaire. A sample of 483 participants included 258 Bachelor of Science in Nursing students, 161 General Nursing and Midwifery students, and 64 Bachelor of Pharmacy students from various Indian nursing and pharmacy schools. Results The majority of the respondents prefer to use SNSs for several purposes such as watching academic videos on YouTube, sharing their ideas, thoughts, and current development in their respective fields through WhatsApp, getting job-related information from different Facebook pages, etc. A substantial number of nursing students believed that these SNSs help them build relationships with professionals across the country. At the same time, many students also indicated that extensive use of SNSs might cause sleep difficulties, data privacy concerns, and a lack of focus while studying. Conclusion To have an impact on how SNSs are used in healthcare education, more attention should be paid to build connectivism between educators and their students on social learning environment, which the findings of this study's suggestions could be put into practice.
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Affiliation(s)
- Abu Elnasr E. Sobaih
- Management Department, College of Business Administration, King Faisal University, Al-Ahsa, Saudi Arabia
- Faculty of Tourism and Hotel Management, Helwan University, Cairo, Egypt
| | - Abdul Baquee
- Department of Library and Information Science, Pondicherry University, Puducherry, India
| | - Ishfaq Ahmad Palla
- Department of Library and Information Science, Pondicherry University, Puducherry, India
| | - Shamim Aktar Munshi
- Ananda Chandra College, University of North Bengal, Darjeeling, West Bengal, India
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141
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Nizeyimana E, Joseph C, Louw QA. Organizational readiness and rehabilitation professionals' views on integrating telerehabilitation into service delivery and students' clinical training: A qualitative study. Digit Health 2023; 9:20552076231212314. [PMID: 38025095 PMCID: PMC10631339 DOI: 10.1177/20552076231212314] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To assess the readiness of healthcare institutions that serve as clinical platforms for Stellenbosch University' rehabilitation students, and to explore the opinions of rehabilitation professionals regarding the integration of telerehabilitation (TR) into service delivery and students clinical training. Methods This study employed a qualitative research design and involved the participation of fourteen rehabilitation managers. Semi-structured interviews were conducted using both face-to-face and online platforms. Thematic analysis was employed to analyse the collected data. Results The readiness for implementing TR services varies across different dimensions. Facilities faced challenges related to funding for TR equipment and the absence of policies and guidelines, indicating a lack of financial and governance readiness. Rehabilitation professionals demonstrated high attitudinal readiness but low technical readiness due to a lack of knowledge and skills. Rehabilitation students particularly lacked practical experience, confidence, clinical reasoning and decision-making skills further contributing to low technical readiness. Conclusion Health care institutions are generally not ready for a successful implementation of TR. To improve the readiness, senior management should actively participate and provide financial support, develop policies, guidelines and training programs for rehabilitation professionals. Educational institutions should incorporate TR program into curricula to prepare students to gain practical experience and familiarity with the use of TR technology for their future clinical practice.
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Affiliation(s)
- Eugene Nizeyimana
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Conran Joseph
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
| | - Quinette A Louw
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, South Africa
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142
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Virtanen L, Kaihlanen AM, Kainiemi E, Saukkonen P, Heponiemi T. Patterns of acceptance and use of digital health services among the persistent frequent attenders of outpatient care: A qualitatively driven multimethod analysis. Digit Health 2023; 9:20552076231178422. [PMID: 37256014 PMCID: PMC10226178 DOI: 10.1177/20552076231178422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 05/10/2023] [Indexed: 06/01/2023] Open
Abstract
Objective Utilising digital health services in the treatment of patients who frequently attend outpatient care could be beneficial for patients' health and the sustainability of health systems but carries the risk of digital exclusion. This study aimed to explore the patterns of acceptance and use of digital health services among frequent attenders (FAs), which may help in the assessment of patients' digital suitability. Methods Persistent FAs (N = 30) were recruited by random sampling from one Finnish municipality. The semistructured interviews were conducted in February-May 2021. We analysed the data with qualitative content analysis using the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Additionally, we quantified the data for two-step cluster analyses to create separate cluster models that grouped FAs based on acceptance and use of (a) digital services for self-management of health and (b) telemedicine services. Results Based on digital self-management, FAs were defined as Self-Managers, Supported Self-Managers, and Non-Self-Managers. Based on telemedicine use, they were grouped into Telemedicine Users, Doubtful Telemedicine Users, and Telemedicine Refusers. The clusters described different opportunities, awareness, and interest in using digital health services. Referral from professionals seemed to promote digital service use. For some, digital services were not accessible. Conclusions Our findings emphasise the importance of assessing the suitability of FAs to digital health services, as their readiness to use may vary. Professionals should recommend digital services that support individual health to suitable patients. More accessible digital services could promote digital suitability despite functional limitations.
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Affiliation(s)
- Lotta Virtanen
- Welfare State Research and Reform Unit, Finnish Institute for Health and
Welfare (THL), Helsinki, Finland
| | - Anu-Marja Kaihlanen
- Welfare State Research and Reform Unit, Finnish Institute for Health and
Welfare (THL), Helsinki, Finland
| | - Emma Kainiemi
- Welfare State Research and Reform Unit, Finnish Institute for Health and
Welfare (THL), Helsinki, Finland
| | - Petra Saukkonen
- Welfare State Research and Reform Unit, Finnish Institute for Health and
Welfare (THL), Helsinki, Finland
| | - Tarja Heponiemi
- Welfare State Research and Reform Unit, Finnish Institute for Health and
Welfare (THL), Helsinki, Finland
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143
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Werdhani RA, Findyartini A, Kusumoningrum DA, Hanum C, Muktiarti D, Safitry O, Wisnu W, Soemarko DS, Sutanto RL. A COVID-19 self-isolation monitoring module for FMUI undergraduate medical students: Linking learning and service needs during the pandemic surge in Indonesia. PLoS One 2022; 17:e0279742. [PMID: 36584189 PMCID: PMC9803291 DOI: 10.1371/journal.pone.0279742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 12/13/2022] [Indexed: 01/01/2023] Open
Abstract
To ensure that students continued receiving adequate yet safe clinical exposure during the COVID-19 pandemic, the Faculty of Medicine at Universitas Indonesia (FMUI) created the Module of COVID-19 Self-Isolation Monitoring which aims to equip students with the knowledge and skill to monitor confirmed and close contact cases of COVID-19. Module development, divided into four phases: preparation, orientation, implementation, and evaluation phase, started as soon as the delta wave of COVID-19 cases forced medical students to halt their offline clinical rotations. A quantitative secondary data were obtained from student and patient satisfaction questionnaires and on students' performance and reflection. We analyzed the distribution of module evaluation, the student's discussion score during the module, the students' interest in participating as Covid-19 volunteers before and after the module's deployment, and the correlation between learning outcomes and satisfaction. A total of 372 patients were monitored by 208 students during the 4-week module. The response rates were above 80%, with the majority agreeing that students found this module well-organized and fulfilled their expectations. There was a significant increase in discussion scores from weeks 1 to 4, a significant difference in the proportion of students interested in COVID-19 volunteering before and after the module completion as well as a significant low correlation between the patient's monitoring score sheet and the reflection essay towards the patient's satisfaction. We should still improve tutors' time management, tutors' provision of triggering questions for critical thinking skills, and tutors' feedback for students. The module met patient expectations and is expected to assist tutors in providing feedback and examples of doctor-patient communication, thus accelerating students' competence in patient interaction. Further evaluation is needed regarding knowledge transfer, the impact on community health, and the faculty development program, especially regarding how tutors fulfill their roles as medical educators.
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Affiliation(s)
- Retno Asti Werdhani
- Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- * E-mail:
| | - Ardi Findyartini
- Medical Education Center, Indonesian Medical Education & Research Institute (IMERI) Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Department of Medical Education, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | | | - Chaina Hanum
- Medical Education Center, Indonesian Medical Education & Research Institute (IMERI) Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dina Muktiarti
- Department of Child Health, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Oktavinda Safitry
- Department of Forensic and Medicolegal, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Wismandari Wisnu
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Dewi Sumaryani Soemarko
- Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Reynardi Larope Sutanto
- Undergraduate Program in Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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144
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Cox NS, Lee JYT, McDonald CF, Mahal A, Alison JA, Wootton R, Hill CJ, Zanaboni P, O'Halloran P, Bondarenko J, Macdonald H, Barker K, Crute H, Mellerick C, Wageck B, Boursinos H, Lahham A, Nichols A, Czupryn P, Corbett M, Handley E, Burge AT, Holland AE. Perceived Autonomy Support in Telerehabilitation by People With Chronic Respiratory Disease: A Mixed Methods Study. Chest 2022:S0012-3692(22)04344-6. [PMID: 36574926 DOI: 10.1016/j.chest.2022.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/29/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Autonomy-supportive health environments can assist patients in achieving behavior change and can influence adherence positively. Telerehabilitation may increase access to rehabilitation services, but creating an autonomy-supportive environment may be challenging. RESEARCH QUESTION To what degree does telerehabilitation provide an autonomy-supportive environment? What is the patient experience of an 8-week telerehabilitation program? STUDY DESIGN AND METHODS Individuals undertaking telerehabilitation or center-based pulmonary rehabilitation within a larger randomized controlled equivalence trial completed the Health Care Climate Questionnaire (HCCQ; short form) to assess perceived autonomy support. Telerehabilitation participants were invited 1:1 to undertake semistructured interviews. Interviews were transcribed verbatim and coded thematically to identify major themes and subthemes. RESULTS One hundred thirty-six participants (n = 69 telerehabilitation) completed the HCCQ and 30 telerehabilitation participants (42%) undertook interviews. HCCQ summary scores indicated that participants strongly agreed that the telerehabilitation environment was autonomy supportive, which was similar to center-based participants (HCCQ summary score, P = .6; individual HCCQ items, P ≥ .3). Telerehabilitation interview data supported quantitative findings identifying five major themes, with subthemes, as follows: (1) making it easier to participate in pulmonary rehabilitation, because telerehabilitation was convenient, saved time and money, and offered flexibility; (2) receiving support in a variety of ways, including opportunities for peer support and receiving an individualized program guided by expert staff; (3) internal and external motivation to exercise as a consequence of being in a supervised group, seeing results for effort, and being inspired by others; (4) achieving success through provision of equipment and processes to prepare and support operation of equipment and technology; and (5) after the rehabilitation program, continuing to exercise, but dealing with feelings of loss. INTERPRETATION Telerehabilitation was perceived as an autonomy-supportive environment, in part by making it easier to undertake pulmonary rehabilitation. Support for behavior change, understanding, and motivation were derived from clinicians and patient-peers. The extent to which autonomy support translates into ongoing self-management and behavior change is not clear. TRIAL REGISTRY ClinicalTrials.gov; No.: ACTRN12616000360415; URL: www. CLINICALTRIALS gov.
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Affiliation(s)
- Narelle S Cox
- Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne; Institute for Breathing and Sleep, Melbourne.
| | - Joanna Y T Lee
- Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne
| | - Christine F McDonald
- Institute for Breathing and Sleep, Melbourne; Respiratory and Sleep Medicine Clinic, Melbourne; Faculty of Medicine, Melbourne
| | - Ajay Mahal
- Melbourne School of Population and Global Health, University of Melbourne; Melbourne
| | - Jennifer A Alison
- Faculty of Medicine and Health, Sydney School of Health Sciences, University of Sydney, Sydney, NSW, Australia; Allied Health Research and Education Unit, Sydney Local Health District, Sydney, NSW, Australia
| | - Richard Wootton
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Catherine J Hill
- Institute for Breathing and Sleep, Melbourne; Department of Physiotherapy, Austin Health, Melbourne
| | - Paolo Zanaboni
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Paul O'Halloran
- School of Psychology and Public Health, La Trobe University, Melbourne
| | | | | | - Kathryn Barker
- Community Based Rehabilitation Service, Western Health, Melbourne
| | - Hayley Crute
- Physiotherapy Service, Wimmera Health Care Group, Horsham
| | - Christie Mellerick
- Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne
| | - Bruna Wageck
- Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne
| | - Helen Boursinos
- Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne
| | - Aroub Lahham
- Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne
| | - Amanda Nichols
- Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne
| | - Pawel Czupryn
- Physiotherapy Service, West Wimmera Health Service, Nhill, VIC
| | - Monique Corbett
- Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne; Department of Physiotherapy, Alfred Health, Melbourne
| | - Emma Handley
- Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne
| | - Angela T Burge
- Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne; Institute for Breathing and Sleep, Melbourne; Department of Physiotherapy, Alfred Health, Melbourne
| | - Anne E Holland
- Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne; Institute for Breathing and Sleep, Melbourne; Department of Physiotherapy, Alfred Health, Melbourne
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145
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Bonnechère B. Integrating Rehabilomics into the Multi-Omics Approach in the Management of Multiple Sclerosis: The Way for Precision Medicine? Genes (Basel) 2022; 14:63. [PMID: 36672802 PMCID: PMC9858788 DOI: 10.3390/genes14010063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/05/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
Over recent years, significant improvements have been made in the understanding of (epi)genetics and neuropathophysiological mechanisms driving the different forms of multiple sclerosis (MS). For example, the role and importance of the bidirectional communications between the brain and the gut-also referred to as the gut-brain axis-in the pathogenesis of MS is receiving increasing interest in recent years and is probably one of the most promising areas of research for the management of people with MS. However, despite these important advances, it must be noted that these data are not-yet-used in rehabilitation. Neurorehabilitation is a cornerstone of MS patient management, and there are many techniques available to clinicians and patients, including technology-supported rehabilitation. In this paper, we will discuss how new findings on the gut microbiome could help us to better understand how rehabilitation can improve motor and cognitive functions. We will also see how the data gathered during the rehabilitation can help to get a better diagnosis of the patients. Finally, we will discuss how these new techniques can better guide rehabilitation to lead to precision rehabilitation and ultimately increase the quality of patient care.
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Affiliation(s)
- Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium;
- Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Hasselt University, 3590 Diepenbeek, Belgium
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146
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Holt JM, Cusatis R, Mortensen N, Wolfrath N, Hyun N, Winn AN, Brown SA, Somai MM, Crotty BH. Twenty-first century house calls: a survey of ambulatory care providers to inform organisational telehealth strategy. BMJ Health Care Inform 2022; 29:bmjhci-2022-100626. [PMID: 36564094 PMCID: PMC9791455 DOI: 10.1136/bmjhci-2022-100626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/13/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES While patient interest in telehealth increases, clinicians' perspectives may influence longer-term adoption. We sought to identify facilitators and barriers to continued clinician incorporation of telehealth into practice. METHODS A cross-sectional 24-item web-based survey was emailed to 491 providers with ≥50 video visits (VVs) within an academic health system between 1 March 2020 and 31 December 2020. We quantitatively summarised the characteristics and perceptions of respondents by using descriptive and test statistics. We used systematic content analysis to qualitatively code open-ended responses, double coding at least 25%. RESULTS 247 providers (50.3%) responded to the survey. Seventy-nine per cent were confident in their ability to deliver excellent clinical care through VV. In comparison, 48% were confident in their ability to troubleshoot technical issues. Most clinicians (87%) expressed various concerns about VV. Providers across specialties generally agreed that VV reduced infection risk (71%) and transportation barriers (71%). Three overarching themes in the qualitative data included infrastructure and training, usefulness and expectation setting for patients and providers. DISCUSSION As healthcare systems plan for future delivery directions, they must address the tension between patients' and providers' expectations of care within the digital space. Telehealth creates new friction, one where the healthcare system must fit into the patient's life rather than the usual dynamic of the patient fitting into the healthcare system. CONCLUSION Telehealth infrastructure and patient and clinician technological acumen continue to evolve. Clinicians in this survey offered valuable insights into the directions healthcare organisations can take to right-size this healthcare delivery modality.
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Affiliation(s)
- Jeana M Holt
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA,Family and Community Medicine, Medical College of Wisconsin Department of Family and Community Medicine, Milwaukee, Wisconsin, USA
| | - Rachel Cusatis
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Natalie Mortensen
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Nathan Wolfrath
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Noorie Hyun
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente, Seattle, Washington, USA
| | - Aaron N Winn
- School of Pharmacy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sherry-Ann Brown
- Cardio-Oncology, Medical College of Wisconsin Cardiovascular Center, Milwaukee, Wisconsin, USA
| | - Melek M Somai
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Bradley H Crotty
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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147
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Leung T, Sveistrup H, Bayley M, Egan M, Rathbone M, Taljaard M, Marshall S. Identification of Clinical Measures to Use in a Virtual Concussion Assessment: Protocol for a Mixed Methods Study. JMIR Res Protoc 2022; 11:e40446. [PMID: 36548031 PMCID: PMC9816949 DOI: 10.2196/40446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Workplace concussions can have a significant impact on workers. The impact of concussion symptoms, combined with challenges associated with clinical environments that are loud, bright, and busy, create barriers to conducting effective in-person assessments. Although the opportunity for remote care in rural communities has long been recognized, the COVID-19 pandemic has catalyzed the transition to virtual assessments and care into the mainstream. With this rapid shift, many clinicians have been completing remote assessments. However, the approaches and measures used in these assessments have not yet been standardized. Furthermore, the psychometric properties of the assessments when completed remotely using videoconference have not yet been documented. OBJECTIVE Through this mixed methods study, we aim to (1) identify the concussion assessment measures clinicians are currently using in person and are most relevant to the following 5 physical domains: neurological examination (ie, cranial nerve, coordination, motor, and sensory skills), cervical spine, vestibular, oculomotor, and effort assessment; (2) document the psychometric properties of the measures identified; (3) identify measures that appear feasible in a virtual context; and (4) identify practical and technical barriers or challenges, facilitators, and benefits to conducting or engaging in virtual concussion assessments. METHODS This study will follow a sequential mixed methods design using a survey and Delphi approach, working groups with expert clinicians, and focus groups with experienced clinicians and people living with concussions. Our target sample sizes are 50 clinicians for the Delphi surveys, 4 clinician-participants for the working group, and 5-7 participants for each focus group (roughly 6-10 total groups being planned with at least two groups consisting of people living with concussions). The results from this study will inform the decision regarding the measures that should be included in a virtual assessment tool kit to be tested in a future planned prospective evaluation study. RESULTS The study is expected to be completed by January 2023. CONCLUSIONS This mixed methods study will document the clinical measures that are currently used in person and will identify those that are most relevant to assessing the physical domains impacted by concussions. Potential feasibility of using these measures in a virtual context will be explored. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40446.
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Affiliation(s)
| | - Heidi Sveistrup
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyere Research Institute, Ottawa, ON, Canada
| | - Mark Bayley
- Kite Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mary Egan
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,Bruyere Research Institute, Ottawa, ON, Canada
| | - Michel Rathbone
- Division of Neurology, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Shawn Marshall
- Bruyere Research Institute, Ottawa, ON, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Medicine, University of Ottawa, Ottawa, ON, Canada
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148
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Dinh A, Tseng E, Yin AL, Estrin D, Greenwald P, Fortenko A. Perceptions of Augmented Reality in Remote Medical Care: Interview Study of Emergency Telemedicine Providers (Preprint). JMIR Form Res 2022; 7:e45211. [PMID: 36976628 PMCID: PMC10131657 DOI: 10.2196/45211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Augmented reality (AR) and virtual reality (VR) have increasingly appeared in the medical literature in the past decade, with AR recently being studied for its potential role in remote health care delivery and communication. Recent literature describes AR's implementation in real-time telemedicine contexts across multiple specialties and settings, with remote emergency services in particular using AR to enhance disaster support and simulation education. Despite the introduction of AR in the medical literature and its potential to shape the future of remote medical services, studies have yet to investigate the perspectives of telemedicine providers regarding this novel technology. OBJECTIVE This study aimed to understand the applications and challenges of AR in telemedicine anticipated by emergency medicine providers with a range of experiences in using telemedicine and AR or VR technology. METHODS Across 10 academic medical institutions, 21 emergency medicine providers with variable exposures to telemedicine and AR or VR technology were recruited for semistructured interviews via snowball sampling. The interview questions focused on various potential uses of AR, anticipated obstacles that prevent its implementation in the telemedicine area, and how providers and patients might respond to its introduction. We included video demonstrations of a prototype using AR during the interviews to elicit more informed and complete insights regarding AR's potential in remote health care. Interviews were transcribed and analyzed via thematic coding. RESULTS Our study identified 2 major areas of use for AR in telemedicine. First, AR is perceived to facilitate information gathering by enhancing observational tasks such as visual examination and granting simultaneous access to data and remote experts. Second, AR is anticipated to supplement distance learning of both minor and major procedures and nonprocedural skills such as cue recognition and empathy for patients and trainees. AR may also supplement long-distance education programs and thereby support less specialized medical facilities. However, the addition of AR may exacerbate the preexisting financial, structural, and literacy barriers to telemedicine. Providers seek value demonstrated by extensive research on the clinical outcome, satisfaction, and financial benefits of AR. They also seek institutional support and early training before adopting novel tools such as AR. Although an overall mixed reception is anticipated, consumer adoption and awareness are key components in AR's adoption. CONCLUSIONS AR has the potential to enhance the ability to gather observational and medical information, which would serve a diverse set of applications in remote health care delivery and education. However, AR faces obstacles similar to those faced by the current telemedicine technology, such as lack of access, infrastructure, and familiarity. This paper discusses the potential areas of investigation that would inform future studies and approaches to implementing AR in telemedicine.
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Affiliation(s)
- Alana Dinh
- Medical College, Weill Cornell Medicine, New York, NY, United States
| | - Emily Tseng
- Department of Information Science, Cornell Tech, New York, NY, United States
| | - Andrew Lukas Yin
- Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Deborah Estrin
- Department of Computer Science, Cornell Tech, New York, NY, United States
| | - Peter Greenwald
- Emergency Medicine, NewYork-Presbyterian Hospital, New York, NY, United States
| | - Alexander Fortenko
- Emergency Medicine, NewYork-Presbyterian Hospital, New York, NY, United States
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149
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Machado PM, Verschueren P, Grainger R, Jones H, Piercy J, van Beneden K, Caporali R, Dejaco C, Fautrel B. Impact of COVID-19 pandemic on the management of patients with RA: a survey of rheumatologists in six European countries. Rheumatol Adv Pract 2022; 7:rkac108. [PMID: 36601518 PMCID: PMC9800854 DOI: 10.1093/rap/rkac108] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Objective We aimed to describe, from the perspective of rheumatologists in Europe, how the coronavirus disease 2019 (COVID-19) pandemic has impacted their management of people with RA and the continuing medical education of physicians. Methods Rheumatologists participating in the Adelphi RA Disease Specific ProgrammeTM in six European countries were contacted in August and September 2020 for a telephone survey. Rheumatologists were asked seven attitudinal questions on changes to patient management, prescription behaviour and continuing education owing to COVID-19. Results were summarized with descriptive statistics. Results The telephone survey was completed by 284 rheumatologists. The most commonly reported changes to patient management were increased utilization of video/telephone consultations (66.5% of respondents), fewer visits (58.5%) and limiting physical contact (58.1%). Furthermore, 67.9% of rheumatologists who indicated that prescribing behaviour had changed switched their patients to self-administered medication, and 60.7% reported not starting patients on targeted synthetic DMARDs, biologic originator DMARDs or biosimilar DMARDs. In total, 57.6% of rheumatologists believed that changes in management would persist. Rheumatologists reported that 38.0% of patients expressed concerns about how COVID-19 would impact treatment, including access to treatment and the risk of infection. The biggest impact on rheumatologist education was a switch to online training and conferences. Conclusion All countries saw changes in patient management and prescribing behaviour, including the rapid uptake of telemedicine. It is important that the international rheumatology community learns from these experiences to prepare better for future pandemics and to address ongoing rheumatologist shortages.
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Affiliation(s)
- Pedro M Machado
- Correspondence to: Pedro M. Machado, Centre for Rheumatology and Department of Neuromuscular Diseases, University College London, 1st Floor, Russell Square House, 10–12 Russell Square, London WC1B 5EH, UK. E-mail:
| | | | - Rebecca Grainger
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Hannah Jones
- Autoimmune Franchise, Adelphi Real World, Bollington, UK
| | - James Piercy
- Health Economics and Outcomes Research, Adelphi Real World, Bollington, UK
| | | | - Roberto Caporali
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy,Division of Clinical Rheumatology, ASST Pini-CTO, Milan, Italy
| | | | - Bruno Fautrel
- Service de Rhumatologie, Sorbonne Université-Assistance Publique-Hôpitaux de Paris, Paris, France
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150
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Markan A, Kishore A, Agarwal A, Akella M, Singh A, Goyal S, Roy M, Singh M, Singh M. Demographic profile of patients seeking teleophthalmology consultations through e-Sanjeevani: Retrospective analysis of 5138 patients from North India. Indian J Ophthalmol 2022; 70:4238-4243. [PMID: 36453323 PMCID: PMC9940582 DOI: 10.4103/ijo.ijo_781_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To report the demographic profile of patients registered through e-Sanjeevani OPD seeking teleophthalmology services. Methods This was a cross-sectional data analysis of patients with ocular complaints registered through the e-Sanjeevani platform at a tertiary care center. It was a doctor-to-doctor consultation, where teleophthalmology consultants provided teleconsultation services at subcenters (SCs), primary health centers (PHCs), and community health centers (CHCs). Data regarding the patient's age, gender, residential address, provisional diagnosis, and treatment prescribed were recorded from May 2021 to February 2022 (9 months). Results In total, 5138 patients were teleconsulted from the mean age of the patients was 37.64 ± 19.34 years. Among these patients, 44% were males and 56% were females. Most of the teleconsultation calls were made from Palwal district (19.8%), followed by Hisar (14.5%) and Sonipat. The most common provisional diagnosis was dry eyes (21%), followed by allergic conjunctivitis (18%), refractive error (15%), and cataract (14%). These constituted approximately 70% of the diagnosis made through teleconsultations. The rest of the eye problems were diagnosed as stye, blepharitis, nasolacrimal duct obstruction, pterygium, subconjunctival hemorrhage, etc., The majority of the patients were managed medically (56.6%) and approximately 11.6% of the patients were referred for surgical intervention. Conclusion e-Sanjeevani is an effective way to provide teleconsultations to patients in remote locations. The majority of the patients seeking ophthalmology consultations can be managed conservatively. Patients requiring surgical intervention can be referred timely, thus avoiding any delay in treatment.
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Affiliation(s)
- Ashish Markan
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Alisha Kishore
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Agarwal
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India,Correspondence to: Dr. Amit Agarwal, Department of Telemedicine, First Floor, PGIMER, Chandigarh, India. E-mail:
Prof. Meenu Singh, Department of Telemedicine, First Floor, PGIMER, Chandigarh, India. E-mail:
| | - Madhuri Akella
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aruna Singh
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sonu Goyal
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manaswita Roy
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manvi Singh
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Meenu Singh
- Department of Telemedicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India,Correspondence to: Dr. Amit Agarwal, Department of Telemedicine, First Floor, PGIMER, Chandigarh, India. E-mail:
Prof. Meenu Singh, Department of Telemedicine, First Floor, PGIMER, Chandigarh, India. E-mail:
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