Mobile device ownership among emergency department patients

Emergency Department Nurses' Perceptions of Patient Substance Use, Impact on Sexual Assault Care, and Access to Follow-up Behavioral Health Resources

INTRODUCTION

Patients may present to the emergency department for sexual assault care under the influence of drugs or alcohol. However, many emergency nurses are not prepared to meet their unique needs or aware of follow-up behavioral health resources. The purpose of this study was to (1) summarize current resources provided to patients and processes for referral to behavioral health services after sexual assault care, (2) explore emergency nurses' attitudes and behaviors toward patient substance use, and (3) explore nurses' perceptions of adjunct mobile health interventions for follow-up behavioral health care and describe anticipated barriers to use.

METHODS

Fifteen emergency nurses participated in semi-structured qualitative interviews.

RESULTS

Participants had mixed perceptions of patient intoxication during sexual assault care. They felt that conversations about substance use may be more appropriate after the ED visit. Participants recognized the opportunity to connect ED patients with substance use treatment or prevention resources but perceived that there are few local service providers. Most participants were not referring patients with substance use issues to behavioral health services after sexual assault care and said that their emergency departments did not have processes for referral to these services. Acceptability of mobile health for follow-up behavioral health care was high, but participants had concerns for patient privacy and internet access. Participants gave recommendations to improve referral practices and patient engagement with mobile health interventions.

DISCUSSION

This study highlights the need for emergency nurses to consider patient intoxication during sexual assault care and opportunities to connect patients with resources post-assault.

Media and technology usage and attitudes in emergency department patients

Introduction

Digital health technologies are increasingly being used in emergency medicine, many of which utilize smartphones and computers. Patient willingness to use these modalities is an important factor in successful implementation. Therefore, this study aimed to assess emergency department (ED) patients' use of and attitudes towards technology.

Methods

This was a pooled sub-analysis of ED patients (≥18 years old) that were enrolled in two studies evaluating the ED patient experience in response to novel technological interventions. Participants completed the Media and Technology Usage and Attitudes Scale (MTUAS) that assessed computer and smartphone ownership; frequency of use of phone calls, texting, email, and smartphones; and anxiety and dependence attitudes on these technologies.

Results

One hundred and forty-four participants completed the survey. Mean age was 47.2 years (SD 17.94); 61.8% were female; and 61.1% were white. There was high usage of smartphones (93.1%) and computers (74.3%). Participants most frequently used phone calling and texting and least commonly used email. Participants had a positive attitude (mean 3.9/5, SD 0.68) towards the use of these technologies.

Discussion

ED patients reported high ownership of smartphones and computers, had a positive attitude towards their use, and had varying frequency with which they used different technologies. Future studies can use this information to inform the development of digital health interventions that utilize technologies that patients find most acceptable.

Awareness regarding Teledentistry among Dental Professionals in Malaysia

Objective. Teledentistry is considered to be a technological advancement in providing dental care to patients while effectively addressing the time management. Furthermore, the pandemic of COVID-19 has been here for quite long now, forcing the dental practitioners to ponder upon other methods of healthcare delivery apart from the traditional in-office direct clinical examination. The aim of this study was to explore the perceptions of dental professionals of Malaysia regarding teledentistry, which can act as a future pedestal for improvements in virtual dental practice and patient care. Materials and Methods. It was a descriptive, cross-sectional study involving an electronic survey of a sample of dental professionals of Malaysia. A prevalidated, 26-item, 5-point Likert-scale questionnaire was used in assessing the perceptions of dental professionals regarding teledentistry in four domains: existing concerns about teledentistry use, the potential of teledentistry in improving practice, usefulness of teledentistry for dental practice, and its usefulness for patients. Statistical analyses involved descriptive statistics which included frequency distributions. Results. An overall response rate of 31.0% was observed with 310 dental practitioners participating in the survey. More than 60% of respondents agreed that teledentistry would benefit the dental practice through enhancement of communication with peers, guidance, and new patients’ referral. However, a substantial proportion of practitioners (70-80%) expressed uncertainty with accuracy of diagnosis, technical reliability, and privacy. Conclusion. Generally, the results of this study point towards the readiness of dental professionals of Malaysia to engage in teledentistry practice. However, further work needs to be done to assess the commercial feasibility of teledentistry, not only in Malaysia but also in other parts of the world. To start with, directed campaigns in reference to teledentistry are necessary to educate dentists and the public about the technology and its potential.

Cross-sectional study on knowledge and attitude of telemedicine in medical students of Nepal

BACKGROUND AND AIMS

Telemedicine is the delivery of healthcare services from distance using information and communication technology. It helps in overcoming the geographical physical barrier, increasing access to the healthcare services. Telemedicine has been growing in Nepal, with several hospitals and medical organizations providing services since 2006. COVID-19 pandemic ignited significant interests in it, which previously remained unnoticed, realizing its importance for the present and future. The objective of this study was to evaluate the knowledge and attitude toward telemedicine among medical students in Nepal.

METHODS

An observational study among medical students in 19 medical colleges in Nepal was performed from May to June using Google forms. The survey consisted of 27 questions including information on demography and telemedicine exposure, its status in Nepal, interest, and plans for its future utilization.

RESULTS

Of 146 total surveyed students, 77.4% (n = 113) provided their views regarding telemedicine. Among students with knowledge of telemedicine, only 8.8% (n = 10) had attended some training. Only 6% (n = 4) of those who had previously consulted through telemedicine labeled their experience as poor. Exactly 88.5% (n = 100) were not satisfied with present telemedicine practices and coverage and 43.4% (n = 49) were optimistic about using telemedicine in future. Irrespective of location of medical colleges (Kathmandu Valley or outside) or levels of study (preclinical or clinical), students had similar knowledge and attitude regarding telemedicine.

CONCLUSION

The participants have good knowledge regarding the importance of telemedicine but only few of them are educated regarding its usage. Despite limited exposure to telemedicine, participants advocate for expansion and wide use of telemedicine due to economy, technological advancement, and topographic diversities. Internet, sense of reliability, privacy issue, and lack of proper curriculum seem to have raised question on their positive attitude. Formal and structured education may enable optimistic aspirants to integrate telemedicine skills with medical care delivery with ease.

Teledentistry awareness among dental professionals in Saudi Arabia

Background

Teledentistry is believed to improve dentalcare provided to patients and time management efficiency. In addition, teledentistry can be a useful tool for peer education, consultations and ensures proper channeling for referrals.

Objective

This study aimed to explore Saudi Arabian dental professionals' perceptions of teledentistry's benefits in improving dental practice and patient care.

Methods

A descriptive cross-sectional study involving an electronic survey of a sample of Saudi Arabian dental professionals. A validated 26-item, 5-point Likert-scale questionnaire was used to assess perceptions of dental professionals in four domains: usefulness of teledentistry for patients, the usefulness of teledentistry for dental practice; the potential of teledentistry to improve practice; and existing concerns about the use of teledentistry. Statistical analyses involved descriptive statistics, bivariate analysis using SPSS software. Significant differences were considered at a p-value of 0.05.

Results

With an overall response rate of 28.6%, 286 dental professionals participated in the study. More than 70% of respondents agreed or strongly agreed that teledentistry would improve dental practice through enhancing communication with peers, guidance and referral of new patients. A substantial proportion of respondents (60–70%) expressed uncertainty with technical reliability, privacy and diagnostic accuracy. The participants' qualification was statistically significant with usefulness of teledentistry for patients (p = 0.027), while work experience in years was statistically significant with both usefulness of teledentistry for dental practice and patients (p = 0.046 and <0.0001 respectively).

Conclusion

Generally, the feedback gained by this study showed readiness of the dental professionals to be engaged in the teledentistry approach. Further investigation of the business model of teledentistry is needed to understand the readiness and challenges. Directed campaign to educate dentists and the public of the technology and it is potential is necessary.

Wound Care Follow-Up From the Emergency Department Using a Mobile Application: A Pilot Study

BACKGROUND

Many patients presenting to emergency departments (EDs) do not have primary care and risk being lost to follow-up. Technology has been used successfully in surgical populations for wound care follow-up yet this is not well studied in ED populations.

OBJECTIVE

We aimed to conduct a pilot study demonstrating "smartphone" application-based follow-up after wound care in the ED.

METHODS

We enrolled participants in 2 urban EDs using a smartphone application called Mobile Post-Operative Wound Evaluator (mPOWEr) and defined participation as photographic submission at any time during the study period. We collected demographic data, frequency of use of mPOWEr, number of photographs uploaded, and timing of uploads.

RESULTS

We approached patients for study enrollment, and 67 patients (28%) were not enrolled because they had no access to a smartphone. Seventy-one patients (30%) declined to enroll, leaving 100 (42%) successfully enrolled. Smartphone ownership was more common among patients <40 years of age (81% vs. 64%, p = 0.004), more common among white patients than nonwhite patients (75% vs. 15%, p = 0.046), more common among patients approached at the university medical center than the trauma center (84% vs. 66%, p = 0.003), and among patients with commercial or other insurance than those with Medicare or Medicaid (92% vs. 54%, p < 0.001). Of those enrolled, 58% submitted a photograph.

CONCLUSIONS

Patients presenting for wound care to the ED will participate in smartphone-based app communication for wound care follow-up and are satisfied with this option. Disparities in smartphone access must be considered when using this follow-up method.