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Messler A, Hargrave D, Sordahl J. VA psychologists' professional practices and attitudes toward tele-neuropsychology among a tele-neuropsychology interest group within the Veterans Health Administration. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:1247-1255. [PMID: 36041462 DOI: 10.1080/23279095.2022.2115911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To provide understanding of practices and attitudes toward tele-neuropsychology (teleNP) among Veterans Health Administration (VA) psychologists who have joined a related community of practice. METHODS Several VA psychologists (the authors) developed this survey to better understand dissemination of teleNP and attitudes toward teleNP among those involved in a VA teleNP community of practice. We contacted VA psychologists within this group to complete the survey. The survey was open from July to August 2021, during which time a total of 62 VA psychologists participated. RESULTS Response rate was estimated to be 41% of those receiving the survey (62 respondents). Approximately two thirds of those completing the survey reported current practice of teleNP (68%; n = 42). In contrast, only 25% of the entire sample (n = 15) conducted any teleNP pre-pandemic. Job satisfaction related to being able to perform teleNP is high. Support for continued and increased use of teleNP is high, with most respondents (84%) indicating they will be at least somewhat likely to practice teleNP post-pandemic. CONCLUSIONS The survey provides increased support for the use of teleNP by VA psychologists who responded to the survey, with significantly increased adoption since the Covid-19 pandemic, and greater likelihood of intention to use teleNP post pandemic.
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Affiliation(s)
- Ana Messler
- Boise VA Medical Center, Clinical Resource Hub 20, Boise, ID, USA
| | - David Hargrave
- Boise VA Medical Center, Clinical Resource Hub 20, Boise, ID, USA
| | - Jeffrey Sordahl
- Boise VA Medical Center, Clinical Resource Hub 20, Boise, ID, USA
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2
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Geraldo A, Dores AR, Carvalho IP, Guerreiro S, Castro-Caldas A, Barbosa F. At-distance neurocognitive rehabilitation during COVID-19 pandemic: A first glance of patients' perspectives about the process and an online platform. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:974-983. [PMID: 35856884 DOI: 10.1080/23279095.2022.2100993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Despite the use of digital communication technologies in neurocognitive rehabilitation has been widely used in face-to-face interventions, the difficulties of using ICT-based tools to provide rehabilitation services and the unfamiliarity of the neuropsychologists with internet interventions limited the use of these kinds of interventions in their clinical practices. The lockdown and mitigating measures associated with the COVID-19 pandemic, on the other hand, forced the use of at-distance and online interventions as a means to mitigate the impact of those measures on the mental health and rehabilitation processes of people with neurological disorders. Overall, little is known about the perspectives of patients with acquired neurological conditions about rehabilitation services delivered at distance. Therefore, the main goal of this study was to explore the perceptions that patients with neurological disorders have on at-distance online neurocognitive rehabilitation, namely during the COVID-19 pandemic. Sixteen patients with acquired neurological conditions attending an online neurocognitive rehabilitation program in a Portuguese rehabilitation center filled in an online questionnaire during the mandatory lockdown. The results of this study highlight the potential of delivering rehabilitation services at distance, presenting its advantages and limitations from patients' perspectives, as well as suggestions for improving both neurorehabilitation processes and the online rehabilitation platform used.
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Affiliation(s)
- Andreia Geraldo
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Artemisa R Dores
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | - Irene P Carvalho
- Department of Clinical Neurosciences and Mental Health, School of Medicine, University of Porto (FMUP), Porto, Portugal
| | - Sandra Guerreiro
- CRPG - Centro de Reabilitação Profissional de Gaia [CRPG - Vocational Rehabilitation Center], Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal
- Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal
| | | | - Fernando Barbosa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Tsiaras Y, Koutsonida M, Varthi MA, Galliou I, Zoubouli C, Aretouli E. Development of a self-administered online battery for remote assessment of executive functions and verbal memory: equivalence with face-to-face administration, preliminary norms, and acceptance. J Clin Exp Neuropsychol 2024; 46:599-613. [PMID: 38984860 DOI: 10.1080/13803395.2024.2376839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/02/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES Interest in teleneuropsychology services increased considerably after the COVID-19 pandemic. However, the utility of unsupervised administration of computerized tests remains largely unexplored. In the present study, we developed a brief computerized battery that assesses self-reported cognitive abilities and performances on executive functioning and verbal memory. We investigated the equivalence of the self-administration online (SAO) procedure and the face-to-face (FTF) administration. Preliminary normative data were developed and the acceptance of the SAO procedure was explored. METHODS A community sample of 169 Greek adults [94 women; mean age: 41.95 (SD = 13.40) years, mean years of education: 15.10 (SD = 2.65)] completed the SAO assessment. A subgroup of 40 participants was tested in a counterbalanced way both with SAO and FTF. Participants' performances were compared with paired sample t-tests and the agreement between the two methods was estimated with intraclass correlation coefficients (ICCs). Multiple linear regression analyses were applied to investigate the effect of demographic characteristics on SAO measures. RESULTS No difference between SAO and FTF scores was observed. ICCs indicated moderate to good agreement (.418-.848) for most measures. Age was positively associated with self-reported cognitive state and negatively with neuropsychological performances and the level of acceptance of the SAO procedure. Approximately 80% of participants reported satisfaction from the SAO assessment, 69% good compliance with the instructions, but less than 30% belief that the FTF assessment could be adequately replaced. CONCLUSION SAO testing is feasible and well accepted among Greek adults yielding equivalent results with FTF testing. Despite the wide satisfaction, though, notable reluctance was noted for the substitution of FTF with SAO procedures.
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Affiliation(s)
- Yiannis Tsiaras
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
- Psychiatric Department, 424 General Military Hospital, Thessaloniki, Greece
| | - Myrto Koutsonida
- Department of Hygiene and Epidemiology, University of Ioannina, School of Medicine, Ioannina, Greece
| | - Maria-Ameriso Varthi
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
| | - Iliana Galliou
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
| | - Christina Zoubouli
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
| | - Eleni Aretouli
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
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Sperling SA, Acheson SK, Fox-Fuller J, Colvin MK, Harder L, Cullum CM, Randolph JJ, Carter KR, Espe-Pfeifer P, Lacritz LH, Arnett PA, Gillaspy SR. Tele-Neuropsychology: From Science to Policy to Practice. Arch Clin Neuropsychol 2024; 39:227-248. [PMID: 37715508 DOI: 10.1093/arclin/acad066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to accelerate the number of randomized experimental studies of the reliability and validity in-home tele-neuropsychological testing (tele-np-t). METHOD We conducted a critical review of the tele-neuropsychology literature. We discuss this research in the context of the United States' public and private healthcare payer systems, including the Centers for Medicare & Medicaid Services (CMS) and Current Procedural Terminology (CPT) coding system's telehealth lists, and existing disparities in healthcare access. RESULTS The number of tele-np publications has been stagnant since the onset of the COVID-19 pandemic. There are less published experimental studies of tele-neuropsychology (tele-np), and particularly in-home tele-np-t, than other tele-np publications. There is strong foundational evidence of the acceptability, feasibility, and reliability of tele-np-t, but relatively few studies of the reliability and validity of in-home tele-np-t using randomization methodology. CONCLUSIONS More studies of the reliability and validity of in-home tele-np-t using randomization methodology are necessary to support inclusion of tele-np-t codes on the CMS and CPT telehealth lists, and subsequently, the integration and delivery of in-home tele-np-t services across providers and institutions. These actions are needed to maintain equitable reimbursement of in-home tele-np-t services and address the widespread disparities in healthcare access.
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Affiliation(s)
- Scott A Sperling
- Department of Neurology, Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA
| | | | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lana Harder
- Children's Health, Children's Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | | | - Patricia Espe-Pfeifer
- Department of Psychiatry and Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peter A Arnett
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
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Gierzynski TF, Gregoire A, Reader JM, Pantis R, Campbell S, Bhaumik A, Rahman-Filipiak A, Heidebrink J, Giordani B, Paulson H, Hampstead BM. Evaluation of the Uniform Data Set version 3 teleneuropsychological measures. J Int Neuropsychol Soc 2024; 30:183-193. [PMID: 37366070 PMCID: PMC10751395 DOI: 10.1017/s1355617723000383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Few studies have evaluated in-home teleneuropsychological (teleNP) assessment and none, to our knowledge, has evaluated the National Alzheimer's Coordinating Center's (NACC) Uniform Data Set version 3 tele-adapted test battery (UDS v3.0 t-cog). The current study evaluates the reliability of the in-home UDS v3.0 t-cog with a prior in-person UDS v3.0 evaluation. METHOD One hundred and eighty-one cognitively unimpaired or cognitively impaired participants from a longitudinal study of memory and aging completed an in-person UDS v3.0 and a subsequent UDS v3.0 t-cog evaluation (∼16 months apart) administered either via video conference (n = 122) or telephone (n = 59). RESULTS We calculated intraclass correlation coefficients (ICCs) between each time point for the entire sample. ICCs ranged widely (0.01-0.79) but were generally indicative of "moderate" (i.e., ICCs ranging from 0.5-0.75) to "good" (i.e., ICCs ranging from 0.75-0.90) agreement. Comparable ICCs were evident when looking only at those with stable diagnoses. However, relatively stronger ICCs (Range: 0.35-0.87) were found between similarly timed in-person UDS v3.0 evaluations. CONCLUSIONS Our findings suggest that most tests on the UDS v3.0 t-cog battery may serve as a viable alternative to its in-person counterpart, though reliability may be attenuated relative to the traditional in-person format. More tightly controlled studies are needed to better establish the reliability of these measures.
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Affiliation(s)
| | - Allyson Gregoire
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | | | - Rebecca Pantis
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Stephen Campbell
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Arijit Bhaumik
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Bruno Giordani
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Henry Paulson
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Benjamin M. Hampstead
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, MI, USA
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Wu J, Kuan G, Lou H, Hu X, Masri MN, Sabo A, Kueh YC. The impact of COVID-19 on students' anxiety and its clarification: a systematic review. Front Psychol 2023; 14:1134703. [PMID: 37691784 PMCID: PMC10484512 DOI: 10.3389/fpsyg.2023.1134703] [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: 04/13/2023] [Accepted: 07/25/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Since the emergence of COVID-19 in 2019, every country in the world has been affected to varying degrees. Long-term psychological pressure and anxiety will inevitably damage the physical and mental health of students. This study aimed to examine the effects of the COVID-19 pandemic on students who experienced stress and anxiety and to clarify which intervention was more effective. Methods A comprehensive literature search was conducted between January 2020 and December 2022 using online databases such as PubMed, Web of Science, Scopus, and Google Scholar by using the following keywords in combination: "COVID-19," "stress," "anxiety," "depression," and "intervention." The retrieved literature was screened and reviewed. Results A total of 2,924 articles were retrieved using subject and keyword searches. After screening through the titles and abstracts, 18 related studies were retained. Their review revealed that: (1) most studies did not use medication to control stress and anxiety; (2) the standard methods used to reduce stress and anxiety were religion, psychological counseling, learning more about COVID-19 through the media, online mindfulness courses, improving sleep quality, and physical exercise; (3) the most effective interventions were physical activity and raising awareness about COVID-19 through the media and online mindfulness programs. However, some studies show that physical activity cannot directly relieve psychological stress and anxiety. Conclusion Limited interventions are effective, but learning more about COVID-19 and using active coping strategies may help reduce stress and anxiety. The implications of COVID-19 are also discussed.
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Affiliation(s)
- Jiarun Wu
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
- School of Physical Health, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Garry Kuan
- Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Hu Lou
- School of Sports Science, Nantong University, Nantong, Jiangsu, China
| | - Xiaoyu Hu
- Dafang County No. 7 Middle School, Bijie, Guizhou, China
| | - Mohamad Najmi Masri
- Faculty of Bioengineering and Technology, Universiti Malaysia Kelantan, Kota Bharu, Kelantan, Malaysia
| | - Abdulwali Sabo
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Yee Cheng Kueh
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
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Seubert-Ravelo AN, Serrano-Juárez CA, Cabañas-Tinajero JÁ, González-Gutiérrez FA, Moreno-Villagómez J, Prieto-Corona B, Reyes-Méndez C, Téllez-Rodríguez M, Yáñez-Téllez MG. Teleneuropsychology during the COVID-19 pandemic in Mexico: the perspective from a middle-income country. J Clin Exp Neuropsychol 2023; 45:12-30. [PMID: 36912340 DOI: 10.1080/13803395.2023.2189229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
INTRODUCTION The use of teleneuropsychology (TeleNP) increased as a result of the COVID-19 pandemic; however, there have been no studies of the benefits and difficulties with this modality in middle-income countries. This study aimed to assess the current use of TeleNP in Mexico. METHOD Mexican neuropsychologists were invited to participate in an online survey regarding the use of TeleNP during the COVID-19 pandemic. The survey was based on issues from a literature review and consisted of 36 questions requiring yes/no, multiple choice, or ordinal answers. The survey was created using Google Forms and asked respondents to provide informed consent. A total of 107 clinical neuropsychologists completed the survey. RESULTS 82% of participants currently use TeleNP, and most reported learning about TeleNP through personal experience, literature research, and colleagues. Brief evaluations, delivery of results, and intervention were the principal services provided, most frequently on a home-to-home basis. Almost 30% of clinicians reported not requiring informed consent for use of the modality. Consultations included children, adolescents, and adults in similar numbers; older adults were less frequent. Technological limitations were the most frequent reason for ruling out the modality with particular patients. Perceived benefits included the ability to continue consultations despite social distancing measures, lesser risk of COVID-19 infection, and the possibility of seeing patients with limited access to neuropsychological services. Reasons for not using TeleNP included a lack of standardized instruments, not feeling comfortable with the modality, and lack of technological resources and skills. CONCLUSIONS Despite the socioeconomic differences between Mexico and high-income countries, most of our findings were similar to reports from those countries. However, technological limitations were common, and smartphones were commonly used, contrary to recommendations in the literature. The future use of TeleNP in Mexico should include formal training and ethical guidelines.
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Affiliation(s)
- Ana Natalia Seubert-Ravelo
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Carlos Alberto Serrano-Juárez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - José-Ángel Cabañas-Tinajero
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Fátima Aideé González-Gutiérrez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Julieta Moreno-Villagómez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Belén Prieto-Corona
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Carolina Reyes-Méndez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Marybeth Téllez-Rodríguez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Ma Guillermina Yáñez-Téllez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
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Koay JM, Spat-Lemus J, Cornwell MA, Sacks-Zimmerman A, Mandelbaum S, Kohn A, McLean E, Meli G, Bender HA. The Evolving Need for Neuropsychology in Neurosurgical Settings: Challenges Facing Transformative Care. World Neurosurg 2023; 170:277-285. [PMID: 36782426 DOI: 10.1016/j.wneu.2022.09.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 02/10/2023]
Abstract
Clinical neuropsychology has been a valuable asset to neurologic surgery, contributing to lateralization and localization of pathologic brain tissue, identification of eloquent cortex, and evaluation of postoperative neuropsychological functioning. Moreover, neuropsychologists provide empirically driven interventions aimed at supporting preparation and/or recovery of neurosurgery patients. Nonetheless, several challenges may limit the reliability, validity, and generalizability of the assessment data obtained and reduce the usefulness of other neuropsychological services provided. Specifically, linguistic, cultural, educational, and other biases associated with demographic characteristics can lead to a narrowed view of an individual's life experiences, which must be confronted to fulfill the mission of ensuring that all patients have access to care that is appropriate to their needs. Instead of perceiving these challenges as insurmountable barriers, such issues can be viewed as opportunities to catalyze change and foster innovation for the future of neuropsychological care in neurosurgical settings. In addition to reviewing the possible mechanisms of these obstacles, the current article offers tangible solutions at both a macro level (e.g., discipline-wide transformations) and micro level (e.g., individualized patient-centric approaches). Outlined are practical techniques to potentially improve consensus and standardization of methods, advance and globalize research, expand representativeness of measures and practices to serve diverse individuals, and increase treatment adherence through engagement of patients and their families.
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Affiliation(s)
- Jun Min Koay
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA; Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Jessica Spat-Lemus
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Melinda A Cornwell
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Sarah Mandelbaum
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Aviva Kohn
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Erin McLean
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Gabrielle Meli
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - H Allison Bender
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
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Correro AN, Hinrichs KLM, Krishnan MC, Cottingham ME, Trittschuh EH, Parmenter BA, Kang J, Stelmokas J. Neuropsychological assessment with lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals: Practice, education, and training survey. Clin Neuropsychol 2022:1-43. [PMID: 36458596 DOI: 10.1080/13854046.2022.2148379] [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: 07/12/2022] [Accepted: 11/11/2022] [Indexed: 12/04/2022]
Abstract
Objective: We sought to describe the LGBTQ + related education, training, and clinical practice of independently licensed neuropsychologists in the United States and to identify factors that predict affirmative neuropsychological practices. We hypothesized that LGBTQ + identity, female gender, more recent training, and extent of LGBTQ + education/training would predict use of LGBTQ + practice guidelines. Method: A workgroup of clinical psychologists with experience in LGBTQ + psychology and neuropsychology developed a survey to identify personal and professional factors that predict affirmative neuropsychological testing practices. The survey was distributed through professional organizations and listservs between August and September 2021 with 118 responses meeting inclusionary criteria. Results: The majority of participants identified as heterosexual (70.3%) and cisgender (97.5%), and most (48-63%) received LGBTQ + training post-licensure. Between 19% and 32% of participants reported never completing LGBTQ + specific education. Consistent with our hypotheses, factors predicting affirmative clinical practice behaviors were LGBTQ + education/training, and personal background (sexual minority status, female/feminine gender, and years since degree). Other significant factors included prior experience with LGBTQ + patients and primary patient population (child vs. adult). Qualitative responses indicated varying values, attitudes, and knowledge regarding collection of LGBTQ + information and modification of clinical practice. Conclusions: Neuropsychologists underutilize affirming practices as evidenced by low rates of querying pronouns, knowing whether LGBTQ + health information is available at their institutions, and adjusting evaluation and feedback approaches. We provide specific training and education recommendations to increase knowledge and skills and to address beliefs about LGBTQ + health that can serve to promote affirmative neuropsychological practice.
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Affiliation(s)
- Anthony N Correro
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Psychiatry, Michigan Medicine, University of Michigan Health, Ann Arbor, Michigan, USA
| | - Kate L M Hinrichs
- Mental Health Service, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Mira C Krishnan
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | | | - Emily H Trittschuh
- Geriatric Research Education and Clinical Center (GRECC), VA Puget Sound Healthcare System, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Brett A Parmenter
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
- Mental Health Service, American Lake Division, VA Puget Sound Healthcare System, Tacoma, Washington, USA
- Olympic Psychology Services, Tacoma, Washington, USA
| | - Jinkyung Kang
- Department of Internal Medicine-Geriatric and Palliative Medicine, Michigan Medicine, University of Michigan Health, Ann Arbor, Michigan, USA
| | - Julija Stelmokas
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Department of Psychiatry, Michigan Medicine, University of Michigan Health, Ann Arbor, Michigan, USA
- Mental Health Service, Brooklyn Campus, VA New York Harbor Healthcare System, Brooklyn, New York, USA
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10
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Marra DEC, Simons MU, Schwartz ES, Marston EA, Hoelzle JB. Burnt Out: Rate of Burnout in Neuropsychology Survey Respondents During the COVID-19 Pandemic, Brief Communication. Arch Clin Neuropsychol 2022; 38:258-263. [PMID: 36241192 PMCID: PMC9619778 DOI: 10.1093/arclin/acac081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Due to the COVID-19 pandemic, burnout among healthcare workers has significantly increased. This study evaluated rates of burnout in neuropsychologists one year into the COVID-19 pandemic. METHOD A survey invitation was sent across five neuropsychology-related listservs in April 2021. Burnout was assessed with the Copenhagen Burnout Inventory (CBI; Kristensen, T. S., Borritz, M., Villadsen, E., & Christensen, K. B. (2005). The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work & Stress, 19 (3), 192-207) and differences in Personal, Work, and Client burnout scores were evaluated across patient population and work setting. RESULTS 57.3% and 51.5% of respondents (N = 130) endorsed moderate-to-high levels of personal and work-related burnout, respectively. In the Personal domain, respondents working with pediatric patients had higher mean scores and a higher proportion of respondents endorsed moderate-to-high levels of burnout. CONCLUSION More than half of the survey respondents endorsed elevated levels of personal and work-related burnout. This is concerning as burnout is associated with personal challenges and diminished patient care. Potential organizational interventions are discussed.
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Affiliation(s)
- David E C Marra
- Corresponding author at: Jamaica Plain VA Medical Center, 150 S. Huntington Ave, Boston, MA 0213, USA. Tel: (857) 364-2081; Fax: (857) 364-3162; E-mail address: (D.E.C. Marra)
| | - Mary U Simons
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Eben S Schwartz
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - James B Hoelzle
- Department of Psychology, Marquette University, Milwaukee, WI, USA
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11
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Sullivan-Baca E, Babicz MA, Choudhury TK, Miller BI. The Relationship between Health Literacy and Comfort with Teleneuropsychology in a Veteran Sample. Arch Clin Neuropsychol 2022; 37:292-301. [PMID: 34599332 PMCID: PMC8500040 DOI: 10.1093/arclin/acab079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Health literacy is a strong psychosocial determinant of health disparities and has been found to relate to various aspects of health-related technology use. With the increased implementation of neuropsychological services performed via telehealth during the coronavirus disease 2019 pandemic, the relationship between health literacy and comfort with teleneuropsychology warrants further investigation. METHOD The present study examined 77 Veterans participating in neuropsychological evaluations as a part of standard clinical care. The sample was diverse in terms of age ethnicity, and psychiatric and neurocognitive diagnoses. In addition to a fixed-flexible neuropsychological battery, the Brief Health Literacy Screening Tool (BRIEF) was administered to evaluate health literacy. Self-reported comfort with the teleneuropsychological evaluation was assessed using an informal 10-point scale, and qualitative comfort responses were also recorded. RESULTS Independent samples t-tests revealed older adults were more likely to participate in the evaluation via telephone than with VA Video Connect. Although health literacy was not related to telehealth modality, it was correlated with comfort with the teleneuropsychological evaluation (r = .34, p < .01), although it is notable that average comfort levels were high across modalities (M = 8.16, SD = 2.50). CONCLUSIONS Findings support the notion that teleneuropsychological services may feasibly be implemented with a diverse group of patients, although flexibility with modality may be necessary. Those performing these services should also be aware that patients with lower health literacy may feel less comfortable with teleneuropsychology as they seek to build rapport and optimize evaluation engagement.
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Affiliation(s)
- Erin Sullivan-Baca
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Michelle A Babicz
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Tabina K Choudhury
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Brian I Miller
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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12
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Hewitt KC, Block C, Bellone JA, Dawson EL, Garcia P, Gerstenecker A, Grabyan JM, Howard C, Kamath V, LeMonda BC, Margolis SA, McBride WF, Salinas CM, Tam DM, Walker KA, Del Bene VA. Diverse experiences and approaches to tele neuropsychology: Commentary and reflections over the past year of COVID-19. Clin Neuropsychol 2022; 36:790-805. [DOI: 10.1080/13854046.2022.2027022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Kelsey C. Hewitt
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Cady Block
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - John A. Bellone
- Perspectives Psychological Services, Fullerton, California, USA
| | - Erica L. Dawson
- Department of Neurology, The Ohio State University, Columbus, Ohio, USA
| | - Patricia Garcia
- Department of Rehabilitation Neuropsychology, Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, UAB Heersink School of Medicine, Birmingham, Alabama, USA
| | - Jonathan M. Grabyan
- Michael E. DeBakey VA Medical Center, Behavioral Health Program, Houston, Texas, USA
| | - Christopher Howard
- Psychology Department, Utah State Hospital, Provo, Utah, USA
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Vidyulata Kamath
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Brittany C. LeMonda
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Psychiatry, NYU Langone, NYU Psychiatry Associates, New York, New York, USA
| | - Seth A. Margolis
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Psychiatry & Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | - Willie F. McBride
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Neurology, University of Virginia Health, Charlottesville, Virginia, USA
| | - Christine M. Salinas
- Perspectives Psychological Services, Fullerton, California, USA
- Neuropsychology Concierge®, Indialantic, Florida, USA
| | - Danny M. Tam
- VA NY Harbor Healthcare System, Division of Psychology, Mental Health Service, New York, New York, USA
| | - Keenan A. Walker
- Perspectives Psychological Services, Fullerton, California, USA
- National Institute on Aging, Laboratory of Behavioral Neuroscience, Baltimore, Maryland, USA
| | - Victor A. Del Bene
- Department of Neurology, University of Alabama at Birmingham, UAB Heersink School of Medicine, Birmingham, Alabama, USA
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13
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Balconi M, Bove M, Bossola M, Angioletti L, Fronda G, Crivelli D. Monitoring Strategies and Intervention Policies for the Enhancement and Protection of Advanced Neuroscientific Research Post COVID-19 in Italy: Preliminary Evidence. Front Public Health 2021; 9:748223. [PMID: 34900899 PMCID: PMC8655842 DOI: 10.3389/fpubh.2021.748223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/08/2021] [Indexed: 12/03/2022] Open
Affiliation(s)
- Michela Balconi
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Università Cattolica del Sacro Cuore, Milan, Italy.,Research Unit in Affective and Social Neuroscience, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Marco Bove
- Section of Human Physiology, Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy
| | - Maurizio Bossola
- Dyalisis Service, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Laura Angioletti
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Università Cattolica del Sacro Cuore, Milan, Italy.,Research Unit in Affective and Social Neuroscience, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Giulia Fronda
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Università Cattolica del Sacro Cuore, Milan, Italy.,Research Unit in Affective and Social Neuroscience, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Davide Crivelli
- International Research Center for Cognitive Applied Neuroscience (IrcCAN), Università Cattolica del Sacro Cuore, Milan, Italy.,Research Unit in Affective and Social Neuroscience, Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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14
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Abraham A, Jithesh A, Doraiswamy S, Al-Khawaga N, Mamtani R, Cheema S. Telemental Health Use in the COVID-19 Pandemic: A Scoping Review and Evidence Gap Mapping. Front Psychiatry 2021; 12:748069. [PMID: 34819885 PMCID: PMC8606591 DOI: 10.3389/fpsyt.2021.748069] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/15/2021] [Indexed: 01/07/2023] Open
Abstract
Background: The COVID-19 pandemic has highlighted telemedicine use for mental illness (telemental health). Objective: In the scoping review, we describe the scope and domains of telemental health during the COVID-19 pandemic from the published literature and discuss associated challenges. Methods: PubMed, EMBASE, and the World Health Organization's Global COVID-19 Database were searched up to August 23, 2020 with no restrictions on study design, language, or geographical, following an a priori protocol (https://osf.io/4dxms/). Data were synthesized using descriptive statistics from the peer-reviewed literature and the National Quality Forum's (NQF) framework for telemental health. Sentiment analysis was also used to gauge patient and healthcare provider opinion toward telemental health. Results: After screening, we identified 196 articles, predominantly from high-income countries (36.22%). Most articles were classified as commentaries (51.53%) and discussed telemental health from a management standpoint (86.22%). Conditions commonly treated with telemental health were depression, anxiety, and eating disorders. Where data were available, most articles described telemental health in a home-based setting (use of telemental health at home by patients). Overall sentiment was neutral-to-positive for the individual domains of the NQF framework. Conclusions: Our findings suggest that there was a marked growth in the uptake of telemental health during the pandemic and that telemental health is effective, safe, and will remain in use for the foreseeable future. However, more needs to be done to better understand these findings. Greater investment into human and financial resources, and research should be made by governments, global funding agencies, academia, and other stakeholders, especially in low- and middle- income countries. Uniform guidelines for licensing and credentialing, payment and insurance, and standards of care need to be developed to ensure safe and optimal telemental health delivery. Telemental health education should be incorporated into health professions curricula globally. With rapidly advancing technology and increasing acceptance of interactive online platforms amongst patients and healthcare providers, telemental health can provide sustainable mental healthcare across patient populations. Systematic Review Registration: https://osf.io/4dxms/.
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Affiliation(s)
- Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Anupama Jithesh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | | | | | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
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15
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Singh S, Strong RW, Jung L, Haofei Li F, Grinspoon L, Scheuer LS, Passell EJ, Martini P, Chaytor N, Soble JR, Germine L. The TestMyBrain Digital Neuropsychology Toolkit: Development and Psychometric Characteristics. J Clin Exp Neuropsychol 2021; 43:786-795. [PMID: 34907842 PMCID: PMC8922997 DOI: 10.1080/13803395.2021.2002269] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 10/31/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION To allow continued administration of neuropsychological evaluations remotely during the pandemic, tests from the not-for-profit platform, TestMyBrain.org (TMB), were used to develop the TMB Digital Neuropsychology Toolkit (DNT). This study details the psychometric characteristics of the DNT, as well as the infrastructure and development of the DNT. METHOD The DNT was primarily distributed for clinical use, with (72.8%) of individuals requesting access for clinical purposes. To assess reliability and validity of the DNT, anonymous data from DNT test administrations were analyzed and compared to a large, non-clinical normative sample from TMB. RESULTS DNT test scores showed acceptable to very good split-half reliability (.68-.99). Factor analysis revealed three latent factors, corresponding to processing speed, working memory, and a broader general cognitive ability factor that included perceptual reasoning and episodic memory. Average test scores were slightly poorer for the DNT sample than for the TMB comparison sample, as expected given the clinical use of the DNT. CONCLUSIONS Initial estimates of reliability and validity of DNT tests support their use as digital measures of neuropsychological functioning. Tests within cognitive domains correlated highly with each other and demonstrated good reliability and validity. Future work will seek to validate DNT tests in specific clinical populations and determine best practices for using DNT outcome measures to assess engagement and psychological symptomatology.
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Affiliation(s)
- Shifali Singh
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Roger W. Strong
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Laneé Jung
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Frances Haofei Li
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Liz Grinspoon
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Luke S. Scheuer
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Eliza J. Passell
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Paolo Martini
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Naomi Chaytor
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Jason R. Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
| | - Laura Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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16
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Fox-Fuller JT, Rizer S, Andersen SL, Sunderaraman P. Survey Findings About the Experiences, Challenges, and Practical Advice/Solutions Regarding Teleneuropsychological Assessment in Adults. Arch Clin Neuropsychol 2021; 37:274-291. [PMID: 34564721 PMCID: PMC8513402 DOI: 10.1093/arclin/acab076] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE In the wake of the coronavirus pandemic, teleneuropsychology utilization has increased. There is a need to characterize the first-hand experiences of individuals using teleneuropsychology, identify the common teleneuropsychology challenges, and devise practical strategies for mitigating/resolving these challenges. METHOD Survey data were collected from U.S. based neuropsychologists and other individuals (e.g., graduate students and research assistants) who were engaged in remote cognitive assessment with adults (n = 87). Frequency analyses were conducted to examine: how respondents used teleneuropsychology (e.g., duration of use, types of measures and devices/technology platforms used); challenges that were encountered with different technology platforms and teleneuropsychology use; and advice for navigating these challenges. RESULTS Most respondents began using teleneuropsychology relatively recently in the context of the coronavirus pandemic, with home-to-home or clinic-to-home settings being the most frequently reported teleneuropsychology settings. Zoom®, Doxy.Me®, and MyChart® were the most frequently used platforms, largely due to workplace mandates and/or Health Insurance Portability and Accountability Act-compliant features. Common challenges with teleneuropsychology included internet connection issues and environmental distractions in examinees' homes, and examinees having limited-to-no access to technologies requisite for teleneuropsychology. Providing clear instructions to the examinee prior to the teleneuropsychology visit was the most common advice for ensuring a successful teleneuropsychology evaluation. Similar response patterns were generally noted for those who used TeleNP for clinical or research purposes. CONCLUSIONS These survey results reflect common experiences and challenges with teleneuropsychology and identify priority targets for increasing its feasibility, reliability, and validity. Findings provide context for the development of formal teleneuropsychology competencies.
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Affiliation(s)
- Joshua T Fox-Fuller
- Boston University, Department of Psychological and Brain Sciences, Boston, MA, USA
| | - Sandra Rizer
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA
| | - Stacy L Andersen
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Preeti Sunderaraman
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA.,Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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17
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Towns SJ, Breting LMG, Butts AM, Brett BL, Leaffer EB, Whiteside DM. Neuropsychology trainee concerns during the COVID-19 pandemic: A 2021 follow-up survey. Clin Neuropsychol 2021; 36:85-104. [PMID: 34520321 DOI: 10.1080/13854046.2021.1975826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE As the COVID-19 pandemic continues, the impact on neuropsychology trainees continues to evolve. This paper describes the results of a survey of neuropsychology trainee (graduate student through postdoctoral resident) perspectives on the COVID-19 pandemic and compares them to a previous survey conducted in Spring 2020. METHOD The survey used several questions from the 2020 survey and added applicable new questions based on the results of the 2020 survey. The survey was distributed to listservs, training directors, and student organizations in neuropsychology with snowball sampling used. RESULTS Respondents were primarily female (82.4%) and white (63%). The majority of trainees (66%) reported loss of clinical hours. Interestingly, the average training time missed was approximately 3.36 weeks (SD = 9.27). Trainees continue to report that they have experienced increased anxiety, depression, and stress since the beginning of the pandemic; however, compared to a prior survey, rates of increased anxiety/stress remained stable, but more trainees reported increased depression. Approximately 31% of trainees reported that they were differentially impacted by the pandemic due to racial/ethnic background and female trainees were more likely to report increased personal stress, anxiety and depression than their male counterparts. CONCLUSIONS Results suggest continued wide-reaching pandemic related impacts on neuropsychology trainees. For example, trainees continue to be concerned about the impact of lost clinical hours on their professional futures. The most notable of the personal impacts included increased rates of mental health concerns and differential impacts on trainees from ethnoracial minority communities. Recommendations are provided to assist trainees in coping with pandemic-related disruptions.
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Affiliation(s)
- Stephanie J Towns
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | | | - Alissa M Butts
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Benjamin L Brett
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.,Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Douglas M Whiteside
- Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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18
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Webb SS, Kontou E, Demeyere N. The COVID-19 pandemic altered the modality, but not the frequency, of formal cognitive assessment. Disabil Rehabil 2021; 44:6365-6373. [PMID: 34397311 DOI: 10.1080/09638288.2021.1963855] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE We investigated the impacts of the COVID-19 pandemic on the modality of formal cognitive assessments (in-person versus remote assessments). MATERIALS AND METHODS We created a web-based survey with 34 items and collected data from 114 respondents from a range of health care professions and settings. We established the proportion of cognitive assessments which were face-to-face or via video or telephone conferencing, both pre- and post-March 2020. Further, we asked respondents about the assessment tools used and perceived barriers, challenges, and facilitators for the remote assessment of cognition. In addition, we asked questions specifically about the use of the Oxford Cognitive Screen. RESULTS We found that the frequency of assessing cognition was stable compared to pre-pandemic levels. Use of telephone and video conferencing cognitive assessments increased by 10% and 18% respectively. Remote assessment increased accessibility to participants and safety but made observing the subtleties of behaviour during test administration difficult. The respondents called for an increase in the availability of standardised, validated, and normed assessments. CONCLUSIONS We conclude that the pandemic has not been detrimental to the frequency of cognitive assessments. In addition, a shift in clinical practice to include remote cognitive assessments is clear and wider availability of validated and standardised remote assessments is necessary.IMPLICATIONS FOR REHABILITATIONWe caution the wider use and interpretation of remote formal cognitive assessments due to lack of validated, standardised, and normed assessments in a remote format.Clinicians should seek out the latest validation and normative data papers to ensure they are using the most up to date tests and respective cut offs.Support is needed for individuals who lack knowledge/have anxiety over the use of technology in formal cognitive assessments.
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Affiliation(s)
- Sam S Webb
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Eirini Kontou
- School of Medicine, University of Nottingham, Nottingham, UK.,Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Nele Demeyere
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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19
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Pulsifer MB, Grieco JA, Burstein SM, Parsons MW, Gardner MM, Sherman JC. The development and implementation of teleneuropsychology in an academic lifespan neuropsychology center: Lessons learned from the COVID-19 pandemic. J Clin Exp Neuropsychol 2021; 43:774-785. [PMID: 34384335 DOI: 10.1080/13803395.2021.1963683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Teleneuropsychology (TNP) became a critical means for providing care during the COVID-19 pandemic and may continue as an option for delivery of neuropsychological services. To understand how patient characteristics impact clinician decisions and service models, this study examines practice patterns within a lifespan outpatient neuropsychology center before, during and post-pandemic. METHODS Patient volume, demographics, and characteristics were compared across four, 3-month time intervals in 2019-2020. Two baseline intervals when the center was physically open (PO) were compared to one interval when the center was physically closed (PC) (all evaluations were conducted via direct-to-home TNP) and a fourth interval when the center was physically reopened (RO) and evaluations were conducted in one of the three modalities: in-person, virtual only or hybrid (both virtual/in-person). RESULTS A total of 1,459 total neuropsychological evaluations were conducted with a 64.6% reduction during PC. At RO, the number of evaluations returned to pre-COVID baseline during which in-person (72.4%) evaluations were conducted at a higher rate than hybrid (7.1%) or virtual only (20.4%). Across the lifespan, mean number of appointments to complete evaluations was significantly greater during PC (p< .001) than at other time intervals, and during RO, hybrid evaluations required significantly more appointments (p < .001) than in-person and virtual. The majority of evaluations were conducted with adult patients (71.4%). For adult patients, neurodegenerative/memory disorders received TNP evaluations at a higher rate during PC and RO. Pediatric patients were significantly older during PC (p < .001); neurodevelopmental referrals received more hybrid and virtual evaluations. CONCLUSIONS Results indicate that patient characteristics, especially age and referral categories, impact the feasibility of TNP. Data from the RO period suggest that in-person evaluations not surprisingly remain the mainstay; however, for adult patients, and especially older adults with neurodegenerative/memory disorders, TNP may provide an important option for delivery of neuropsychological evaluations.
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Affiliation(s)
- Margaret B Pulsifer
- Department of Psychiatry/Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Julie A Grieco
- Department of Psychiatry/Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah M Burstein
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Michael W Parsons
- Department of Psychiatry/Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.,Stephen E. & Catherine Pappas Center for Neuro-Oncology, Boston, Massachusetts, USA
| | - Melissa M Gardner
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Janet C Sherman
- Department of Psychiatry/Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
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20
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Nelson NW, Sweet JJ, Klipfel KM, Moberg PJ. Clinical neuropsychology in Canada: results from the 2020 AACN, NAN, SCN professional practice and "salary survey". Clin Neuropsychol 2021; 35:1205-1231. [PMID: 34096460 DOI: 10.1080/13854046.2021.1926543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: The current study summarizes the results of a 2020 survey that solicited information regarding backgrounds, beliefs, practices, and incomes of clinical neuropsychologists who practice in Canada. Methods: Clinical neuropsychologists who practice in Canada were invited to participate in an online survey that was available from 1/17/20 to 4/02/20. Available survey findings were obtained from 111 respondents, which reflects a response rate of 51.3% of the 216 doctoral-level Canadian neuropsychologists identified in at least one major North American or international professional organization membership list (AACN, INS, NAN, or SCN). Results: Most of the current respondents were White/Caucasian women who identified as adult providers and worked full-time in urban institutional settings. Four Canadian provinces (Alberta, British Columbia, Ontario, Quebec) accounted for more than 91% of the current respondent sample. Incomes and career satisfactions were largely encouraging, though some important variations were noted by province, work setting, and professional identity. Incomes were significantly associated with forensic practices and years of clinical experience. Most respondents made use of technician support in their practices, largely to increase productivity and patient volume. Only a small minority of respondents were board-certified and there was generally limited interest in future board certification. Conclusions: While important similarities were observed in the current Canadian sample relative to recent survey findings obtained in a U.S. sample, results also reveal a number of important differences that serve as important areas of future consideration.
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Affiliation(s)
| | - Jerry J Sweet
- NorthShore University HealthSystem, Evanston, IL, USA
| | | | - Paul J Moberg
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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21
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Singh S, Germine L. Technology meets tradition: a hybrid model for implementing digital tools in neuropsychology. Int Rev Psychiatry 2021; 33:382-393. [PMID: 33236657 DOI: 10.1080/09540261.2020.1835839] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic has significantly impacted the provision of mental health care services and the ability to provide neuropsychological evaluations. The inability to conduct traditional evaluations has left neuropsychologists with the unprecedented task of determining how to modify existing paradigms while balancing the need to provide services and adhere to safety parameters. The COVID-19 literature suggests clinicians are modifying their evaluations based on the following models: (1) continuing to administer in-person evaluations; (2) discontinuing all evaluations due to issues related to standardization, test security, and patient-specific characteristics; (3) conducting virtual evaluations; and/or (4) adopting a hybrid model incorporating both traditional and technology-based modalities. Given the challenges with models 1-3, along with the modifications in telehealth guidelines and insurance reimbursement rates, neuropsychologists are more poised than ever to solidify the implementation of a hybrid model that lasts beyond COVID-19. We introduce the term Hybrid Neuropsychology, a model for the future of neuropsychological evaluations that includes three Action Items: (1) building a technology-based practice; (2) integrating data science; and (3) engaging with innovators in other fields. Hybrid Neuropsychology will enable clinicians to effectively modernize their practice, improve health care equity, and ensure neuropsychology secures its place in a technology-based world.
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Affiliation(s)
- Shifali Singh
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Laura Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Bloch A, Maril S, Kavé G. How, when, and for whom: decisions regarding remote neuropsychological assessment during the 2020 COVID-19 pandemic. Isr J Health Policy Res 2021; 10:31. [PMID: 33941268 PMCID: PMC8090922 DOI: 10.1186/s13584-021-00465-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 04/26/2021] [Indexed: 02/06/2023] Open
Abstract
Neuropsychological assessment provides crucial information about cognitive, behavioral, and socioemotional functioning in medical, educational, legal, and social contexts. During the 2020 COVID-19 pandemic, the Israeli Ministry of Health initially mandated that all psychological assessments be postponed. However, as referrals to time-sensitive, high-need, and high-stakes assessments began to accumulate, it became necessary to consider remote solutions. In the current paper, we describe the considerations that affected the transition to remote activity in a prominent Israeli provider of neuropsychological assessment and rehabilitation services, referring to technological and environmental conditions, cognitive requirements, and tasks, as well as to legal, regulatory, and funding issues. After discussing how assessments should be conducted to maximize feasibility and validity while minimizing risks to clients and clinicians, we propose a preliminary model for deciding whether specific referrals warrant remote administration. The model delineates key factors in decisions regarding remote assessment, emphasizing the distinct roles of the referring clinician and the neuropsychologist who conducts the assessment, and highlighting the need for collaboration between them. The abrupt need for remote assessments during the pandemic required a quick response with little preparation. The lessons learned from this process can be applied in the future, so that the need for remote services can be met with greater certainty and uniformity.
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Affiliation(s)
- Ayala Bloch
- Department of Psychology, Ariel University, 65 Ramat HaGolan St, Ariel, Israel.
- The National Institute of Neuropsychological Rehabilitation, Tel Aviv, Israel.
| | - Sari Maril
- The National Institute of Neuropsychological Rehabilitation, Tel Aviv, Israel
| | - Gitit Kavé
- Department of Education and Psychology, The Open University, Ra'anana, Israel
- Center for Memory and Attention Disorders, Sourasky Medical Center, Tel Aviv, Israel
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23
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The Wisconsin Card Sorting Test: Split-Half Reliability Estimates for a Self-Administered Computerized Variant. Brain Sci 2021; 11:brainsci11050529. [PMID: 33919298 PMCID: PMC8143331 DOI: 10.3390/brainsci11050529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/13/2021] [Accepted: 04/17/2021] [Indexed: 11/16/2022] Open
Abstract
Self-administered computerized assessment has the potential to increase the reach of neuropsychological assessment. The present study reports the first split-half reliability estimates for a self-administered computerized variant of the Wisconsin Card Sorting Test (WCST), which is considered as a gold standard for the neuropsychological assessment of executive functions. We analyzed data from a large sample of young volunteers (N = 375). Split-half reliability estimates for perseveration errors, set-loss errors, and inference errors were all above 0.90. Split-half reliability estimates for response time measures on switch and repeat trials exceeded 0.95. Our results indicated sufficient split-half reliability for a self-administered computerized WCST, paving the way for an advanced digital assessment of executive functions. We discuss potential effects of test formats, administration variants, and sample characteristics on split-half reliability.
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24
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Parks AC, Davis J, Spresser CD, Stroescu I, Ecklund-Johnson E. Validity of In-Home Teleneuropsychological Testing in the Wake of COVID-19. Arch Clin Neuropsychol 2021; 36:887-896. [PMID: 33561190 PMCID: PMC7929470 DOI: 10.1093/arclin/acab002] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/16/2020] [Accepted: 12/30/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Teleneuropsychology (TNP) has been shown to be a valid assessment method compared with in-person neuropsychological evaluations. Interest in delivering TNP directly to patients' homes has arisen in response to the coronavirus disease 2019 (COVID-19) pandemic. However, prior research has typically involved patients tested in clinical settings, and the validity of in-home TNP testing has not yet been established. The present study aims to explore the validity and clinical utility of in-home TNP testing in a mixed clinical sample in the wake of COVID-19. METHODS Test profiles for 111 in-home TNP patients were retrospectively compared with 120 patients who completed in-person evaluations. The TNP test battery consisted of tests measuring attention/processing speed, verbal memory, naming, verbal fluency, and visuoconstruction. TNP scores of cognitively normal (CN) patients were compared with patients with neurocognitive disorders (NCD), and score profiles were examined among suspected diagnostic groups of Alzheimer's disease (AD), Parkinson's disease (PD), and vascular disease (VaD). RESULTS TNP test scores did not significantly differ from in-person testing across all tests except the Hopkins Verbal Learning Test-Revised Discrimination Index. Within the TNP group, significant differences between the CN and NCD groups were found for all tests, and the memory and semantic fluency tests yielded large effect sizes (d ≥ 0.8). Score profiles among the AD, PD, and VaD groups were explored. CONCLUSIONS These findings support the validity of in-home TNP testing compared with in-person neuropsychological testing. Practice considerations, limitations, and future directions are discussed.
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Affiliation(s)
- Adam C Parks
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jensen Davis
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Carrie D Spresser
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ioan Stroescu
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Eric Ecklund-Johnson
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA
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25
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Rochette AD, Rahman-Filipiak A, Spencer RJ, Marshall D, Stelmokas JE. Teleneuropsychology practice survey during COVID-19 within the United States. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1312-1322. [PMID: 33471555 DOI: 10.1080/23279095.2021.1872576] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Identify factors influencing service delivery changes during COVID-19 and examine barriers and provider satisfaction with teleneuropsychology (teleNP). METHOD Licensed clinical neuropsychologists within the United States recruited via neuropsychology-specific listservs (July-August 2020) to complete an online survey. RESULTS A total of 261 individuals completed the survey. Most (76%) reported delivering in-person testing in some capacity at the time of our survey. Relatively more private practitioners identified concerns with privacy/confidentiality (45.2% vs. 17.9%; χ2(2) = 6.99, p < 0.05), legal issues (47.6% vs. 17.9%; χ2(2) = 8.06, p < 0.05), and an undesirable precedent for legal/forensic cases (59.5% vs. 15.4%; χ2(2) = 17.54, p < 0.001) compared to hospital or other medical (non-VA) practitioners. Multiple resources informed teleNP protocols, such as organization guidelines (87.6%), literature review (75.9%), webinars (72.4%), and consultation (68%). Several factors influenced test selection, including availability of normative data (70.1%), test familiarity (66.4%), administration time (63.5%), and evidence base (60.6%). Reported barriers to continuing teleNP after COVID-19 included need for improved teleNP norms (85.9%), domain coverage (84.7%), improved patient access to technology (74.1%) and further validation studies (84.1%). CONCLUSION TeleNP may not be feasible in all settings and/or referrals. Respondents employed multiple resources in aggregating teleNP protocols and considered several factors when selecting tests. Results highlight the complex and varied decision-making processes utilized by respondents to adapt to service delivery changes. Considering the many benefits of teleNP, future research addressing some of the potentially modifiable factors (e.g., technology access, attitudes regarding teleNP) and significant development needs for teleNP itself (i.e., improved teleNP norms, further validation studies, etc.) is warranted.
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Affiliation(s)
- Amber D Rochette
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | | | - Robert J Spencer
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | - David Marshall
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | - Julija E Stelmokas
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.,Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA.,VA Ann Arbor Geriatric Research Education and Clinical Center, Ann Arbor, MI, USA
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26
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Williams LM, Coman JT, Stetz PC, Walker NC, Kozel FA, George MS, Yoon J, Hack LM, Madore MR, Lim KO, Philip NS, Holtzheimer PE. Identifying response and predictive biomarkers for Transcranial magnetic stimulation outcomes: protocol and rationale for a mechanistic study of functional neuroimaging and behavioral biomarkers in veterans with Pharmacoresistant depression. BMC Psychiatry 2021; 21:35. [PMID: 33435926 PMCID: PMC7805238 DOI: 10.1186/s12888-020-03030-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/22/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although repetitive transcranial magnetic stimulation ('TMS') is becoming a gold standard treatment for pharmacoresistant depression, we lack neural target biomarkers for identifying who is most likely to respond to TMS and why. To address this gap in knowledge we evaluate neural targets defined by activation and functional connectivity of the dorsolateral prefrontal cortex-anchored cognitive control circuit, regions of the default mode network and attention circuit, and interactions with the subgenual anterior cingulate. We evaluate whether these targets and interactions between them change in a dose-dependent manner, whether changes in these neural targets correspond to changes in cognitive behavioral performance, and whether baseline and early change in neural target and cognitive behavioral performance predict subsequent symptom severity, suicidality, and quality of life outcomes. This study is designed as a pragmatic, mechanistic trial partnering with the National Clinical TMS Program of the Veteran's Health Administration. METHODS Target enrollment consists of 100 veterans with pharmacoresistant Major Depressive Disorder (MDD). All veterans will receive a clinical course of TMS and will be assessed at 'baseline' pre-TMS commencement, 'first week' after initiation of TMS (targeting five sessions) and 'post-treatment' at the completion of TMS (targeting 30 sessions). Veterans will be assessed using functional magnetic resonance imaging (fMRI), a cognitive behavioral performance battery, and established questionnaires. Multivariate linear mixed models will be used to assess whether neural targets change with TMS as a function of dose (Aim 1), whether extent and change of neural target relates to and predicts extent of behavioral performance (Aim 3), and whether extent of neural target change predicts improvement in symptom severity, suicidality, and quality of life (Aim 3). For all three aims, we will also assess the contribution of baseline moderators such as biological sex and age. DISCUSSION To our knowledge, our study will be the first pragmatic, mechanistic observational trial to use fMRI imaging and cognitive-behavioral performance as biomarkers of TMS treatment response in pharmacoresistant MDD. The results of this trial will allow providers to select suitable candidates for TMS treatment and better predict treatment response by assessing circuit connectivity and cognitive-behavioral performance at baseline and during early treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT04663481 , December 5th, 2020, retrospectively registered. The first veteran was enrolled October 30th, 2020.
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Affiliation(s)
- Leanne M. Williams
- grid.168010.e0000000419368956Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304 USA ,grid.280747.e0000 0004 0419 2556Mental Illness Research, Education and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304 USA
| | - John T. Coman
- grid.168010.e0000000419368956Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304 USA ,grid.280747.e0000 0004 0419 2556Mental Illness Research, Education and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304 USA
| | - Patrick C. Stetz
- grid.168010.e0000000419368956Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304 USA ,grid.280747.e0000 0004 0419 2556Mental Illness Research, Education and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304 USA
| | - Nicole C. Walker
- grid.280747.e0000 0004 0419 2556Mental Illness Research, Education and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304 USA
| | - F. Andrew Kozel
- grid.255986.50000 0004 0472 0419Department of Behavioral Sciences and Social Medicine, Florida State University, 1115 W Call St, Tallahassee, FL 32304 USA ,grid.170693.a0000 0001 2353 285XDepartment of Psychiatry and Behavioral Neurosciences, University of South Florida, 3515 E Fletcher Ave, Tampa, FL 33613 USA
| | - Mark S. George
- grid.259828.c0000 0001 2189 3475Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 96 Jonathan Lucas St. Ste. 601, MSC 617, Charleston, SC 29425 USA ,grid.280644.c0000 0000 8950 3536Ralph H. Johnson VA Medical Center, Charleston, SC USA
| | - Jong Yoon
- grid.168010.e0000000419368956Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304 USA ,grid.280747.e0000 0004 0419 2556Mental Illness Research, Education and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304 USA
| | - Laura M. Hack
- grid.168010.e0000000419368956Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304 USA ,grid.280747.e0000 0004 0419 2556Mental Illness Research, Education and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304 USA
| | - Michelle R. Madore
- grid.168010.e0000000419368956Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304 USA ,grid.280747.e0000 0004 0419 2556Mental Illness Research, Education and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304 USA
| | - Kelvin O. Lim
- grid.17635.360000000419368657Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455 USA ,grid.410394.b0000 0004 0419 8667Minneapolis VA Health Care System, 1 Veterans Dr, Minneapolis, MN 55417 USA
| | - Noah S. Philip
- grid.40263.330000 0004 1936 9094Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 345 Blackstone Boulevard, Providence, RI 02908 USA ,grid.413904.b0000 0004 0420 4094VA RR&D Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, 830 Chalkstone Ave, Providence, RI 02908 USA
| | - Paul E. Holtzheimer
- grid.413480.a0000 0004 0440 749XDepartments of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth, Dartmouth Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH 03756 USA ,grid.413726.50000 0004 0420 6436Executive Division, National Center for PTSD, White River Junction VA Medical Center, 215 North Main St., White River Junction, VT 05009 USA
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27
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Sweet JJ, Klipfel KM, Nelson NW, Moberg PJ. Professional practices, beliefs, and incomes of U.S. neuropsychologists: The AACN, NAN, SCN 2020 practice and "salary survey". Clin Neuropsychol 2020; 35:7-80. [PMID: 33375892 DOI: 10.1080/13854046.2020.1849803] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This portion of the 2020 survey updates practice information, beliefs, and income data of clinical neuropsychologists who practice within the United States. Methods: Doctoral-level neuropsychology practitioners were invited via numerous methods, with multiple reminders, to participate in a web-based survey from January 17 through April 2, 2020. The useable U.S. sample of 1677 doctoral-level practitioners was 6.2% larger than the comparable group in the prior 2015 practice survey. Results: Whereas women practitioners predominate, which continues a steeply increasing trend across time, increases in overall ethnic/racial diversity continue at a slow pace. Median age has remained very similar over the last 30 years, reflecting a continuous influx of young practitioners. A relatively small minority of neuropsychologists work part time. The proportion of board-certified neuropsychologists continues to show meaningful increase; interest in subspecialization certification is relatively high. Reliance on technicians remains popular, especially for neuropsychologists who work in institutions or are board certified. Although implementation of new CPT codes in 2019 and related payor policies appear to have had more negative than positive effects, psychology-related annual incomes of neuropsychologists have again increased compared to prior surveys. Variables such as specific work setting, state, region, years in practice, forensic practice hours, board certification, and basis for determining income (e.g. hours billed, revenue collected, relative value units) have an impact on income. More than half of practitioners engage in forensic neuropsychology, with the number of related practice hours per week again increasing. There is very high agreement regarding the use of response validity measures in clinical practice and forensic practice. Neurologists remain the number one referral source whether working in an institution, private practice, or a combination of both, and regardless of maintaining a pediatric, adult, or lifespan practice. Career satisfaction ratings for income, job, and work-life balance remain high, with the majority of ratings regarding the future of the specialty in the positive range. Additional data summaries related to a wide range of professional and practice topics are provided. Conclusions: Updating and comparing survey information at five-year intervals continues to provide insights and perspectives regarding relative stabilities and changes in practice activities, beliefs, and incomes of U.S. clinical neuropsychologists. Such information also provides guidance regarding the future of the specialty.
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Affiliation(s)
- Jerry J Sweet
- Neuropsychology Service, NorthShore University HealthSystem, Evanston, IL, USA.,Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Kristen M Klipfel
- Neuropsychology Service, NorthShore University HealthSystem, Evanston, IL, USA
| | - Nathaniel W Nelson
- Morrison Family College of Health, University of St. Thomas, Minneapolis, MN, USA
| | - Paul J Moberg
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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28
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Zane KL, Thaler NS, Reilly SE, Mahoney JJ, Scarisbrick DM. Neuropsychologists' practice adjustments: The impact of COVID-19. Clin Neuropsychol 2020; 35:490-517. [PMID: 33371799 DOI: 10.1080/13854046.2020.1863473] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: The field of neuropsychology's response to the COVID-19 pandemic was characterized by a rapid change in clinical practice secondary to physical distancing policies and orders. The current study aimed to further characterize the change in neuropsychologists' professional practice, specifically related to teleneuropsychology (TNP) service provision, and also provide novel data regarding the impact of the pandemic on providers' emotional health. Method: This study surveyed 142 neuropsychologists between 3/30/2020 and 4/10/2020, who worked within a variety of settings (e.g., academic medical centers, general hospitals, Veterans Affairs medical centers, rehabilitation hospitals) across all four U.S. geographic regions. Mixed-model analyses of variance (ANOVAs) were conducted to assess for differences in neuropsychological practice (i.e., total number of patients and proportion of TNP seen per week) across time points (i.e., late February and early April) by practice setting and region. Descriptive statistics were conducted to describe respondents' perceptions of TNP, emotional responses to the pandemic, and perceptions of institutional/employers'/practices' responses. Results: Nearly all respondents (∼98%) reported making practice alterations, with ∼73% providing at least some TNP. Neuropsychologists across all settings and regions reported performing a higher proportion of TNP evaluations by April 2020. On average, respondents reported a medium amount of distress/anxiety related to COVID-19, which had a "somewhat small impact" on their ability to practice overall. Conclusions: The current study further elucidated neuropsychologists' provision of TNP services and offered initial data related to their emotional response to the pandemic. Future research is needed to examine the viability and sustainability of TNP practice.
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Affiliation(s)
| | - Nicholas S Thaler
- UCLA Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA
| | - Shannon E Reilly
- Department of Neurology, University of Virginia, Charlottesville, VA
| | - James J Mahoney
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Rockefeller Neuroscience Institute, Morgantown, WV.,Department of Neuroscience, West Virginia University School of Medicine, Rockefeller Neuroscience Institute, Morgantown, WV
| | - David M Scarisbrick
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Rockefeller Neuroscience Institute, Morgantown, WV.,Department of Neuroscience, West Virginia University School of Medicine, Rockefeller Neuroscience Institute, Morgantown, WV
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29
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Psychological Practice at Six Months of COVID-19: A Follow-Up to the First National Survey of Psychologists During the Pandemic. ACTA ACUST UNITED AC 2020; 46:145-154. [PMID: 33225314 PMCID: PMC7666879 DOI: 10.1007/s42843-020-00024-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We conducted a survey of licensed psychologists at two weeks and again at six months after the declaration of a national emergency related to the COVID-19 pandemic. This article describes the results of the second survey conducted approximately six months after the crisis began. The rapid shift to telepsychological services seen in the first survey in the pandemic has solidified in the second survey. More providers reported delivering a larger percentage of services via telepsychology than early in the pandemic. The majority of respondents do not anticipate resuming in-person services until after a vaccine is made available, although a consistent minority reports ongoing in-person service provision. A majority reported their patients had appropriate access to internet and telepsychological service platforms, although one-fifth of respondents reported their patients had difficulty accessing such services. Early concerns about technological or regulatory problems involved in telepsychology are no longer evident. Most respondents indicated they will continue to use telepsychological services for the delivery of some of their psychological services after the pandemic ends. Forty-five percent knew of individuals who contracted the disease, 13% knew someone who died of the disease, and 2% reported contracted the disease themselves.
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30
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Barry HE, Hughes CM. Managing medicines in the time of COVID-19: implications for community-dwelling people with dementia. Int J Clin Pharm 2020; 43:275-279. [PMID: 32803555 PMCID: PMC7429133 DOI: 10.1007/s11096-020-01116-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/25/2020] [Indexed: 11/25/2022]
Abstract
COVID-19 has changed life beyond recognition for millions of individuals, as countries implement social distancing measures to prevent disease transmission. For certain patient groups, such as community-dwelling older people with dementia (PwD), these restrictions may have far-reaching consequences. Medicines management may be adversely affected and deserves careful thought. PwD face unique challenges with medicines management compared to other older people, often relying upon support from family/carers and primary healthcare professionals. This article considers potential issues that PwD may face with each component of medicines management (prescribing, dispensing, administration, adherence, review), and based on previous research, highlights strategies to support PwD and their carers during this time. Primary healthcare professionals must be attentive to medicines-related needs of community-dwelling PwD, particularly those living alone, both during the pandemic and as restrictions are lifted. Carers of PwD continue to have a critical role to play in medicines management, and also require support.
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Affiliation(s)
- Heather E Barry
- Primary Care Research Group, School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
| | - Carmel M Hughes
- Primary Care Research Group, School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK
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