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Auger C, Guay C, Pysklywec A, Bier N, Demers L, Miller WC, Gélinas-Bronsard D, Ahmed S. What's behind the Dashboard? Intervention Mapping of a Mobility Outcomes Monitoring System for Rehabilitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13303. [PMID: 36293885 PMCID: PMC9602496 DOI: 10.3390/ijerph192013303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/03/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Training and follow-up for older adults who received new assistive technology can improve device use adoption and function, but there is a lack of systematic and coordinated services. To address this gap, the Internet-based MOvIT+™ was designed to provide remote monitoring and support for assistive technology users and their caregivers. This paper presents the intervention mapping approach that was used. In step 1, we established a project governance structure and a logic model emerged from interviews with stakeholders and a systematic review of literature. In step 2, a modified TRIAGE consensus process led to the prioritization of thirty-six intervention components. In step 3, we created use cases for all intervention end users. In step 4, the intervention interface was created through iterative lab testing, and we gathered training resources. In step 5, a two-stage implementation plan was devised with the recruited rehabilitation sites. In step 6, we proposed an evaluation protocol. This detailed account of the development of MOvIT+™ demonstrates how the combined use of an intervention mapping approach and participatory processes with end users can help linking evidence-based, user-centered, and pragmatic reasoning. It makes visible the complexities behind the development of Internet-based interventions, while guiding future program developers.
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Affiliation(s)
- Claudine Auger
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Cassioppée Guay
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Alex Pysklywec
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Nathalie Bier
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada
| | - Louise Demers
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada
| | - William C. Miller
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Dominique Gélinas-Bronsard
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Sara Ahmed
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
- School of Physical and Occupational Therapy, McGill University, Montréal, QC H3A 0G4, Canada
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Miao M, Rietdijk R, Brunner M, Debono D, Togher L, Power E. Implementation of Web-Based Psychosocial Interventions for Adults With Acquired Brain Injury and Their Caregivers: Systematic Review. J Med Internet Res 2022; 24:e38100. [PMID: 35881432 PMCID: PMC9328122 DOI: 10.2196/38100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/16/2022] [Accepted: 06/15/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND More than 135 million people worldwide live with acquired brain injury (ABI) and its many psychosocial sequelae. This growing global burden necessitates scalable rehabilitation services. Despite demonstrated potential to increase the accessibility and scalability of psychosocial supports, digital health interventions are challenging to implement and sustain. The Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework can offer developers and researchers a comprehensive overview of considerations to implement, scale, and sustain digital health interventions. OBJECTIVE This systematic review identified published, peer-reviewed primary evidence of implementation outcomes, strategies, and factors for web-based psychosocial interventions targeting either adults with ABI or their formal or informal caregivers; evaluated and summarized this evidence; synthesized qualitative and quantitative implementation data according to the NASSS framework; and provided recommendations for future implementation. Results were compared with 3 hypotheses which state that complexity (dynamic, unpredictable, and poorly characterized factors) in most or all NASSS domains increases likelihood of implementation failure; success is achievable, but difficult with many complicated domains (containing multiple interacting factors); and simplicity (straightforward, predictable, and few factors) in most or all domains increases the likelihood of success. METHODS From a comprehensive search of MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, speechBITE, and neuroBITE, we reviewed primary implementation evidence from January 2008 to June 2020. For web-based psychosocial interventions delivered via standard desktop computer, mobile phone, tablet, television, and virtual reality devices to adults with ABI or their formal or informal caregivers, we extracted intervention characteristics, stakeholder involvement, implementation scope and outcomes, study design and quality, and implementation data. Implementation data were both narratively synthesized and descriptively quantified across all 7 domains (condition, technology, value proposition, adopters, organization, wider system, and their interaction over time) and all subdomains of the NASSS framework. Study quality and risk of bias were assessed using the 2018 Mixed Methods Appraisal Tool. RESULTS We identified 60 peer-reviewed studies from 12 countries, including 5723 adults with ABI, 1920 carers, and 50 health care staff. The findings aligned with all 3 hypotheses. CONCLUSIONS Although studies were of low methodological quality and insufficient number to statistically test relationships, the results appeared consistent with recommendations to reduce complexity as much as possible to facilitate implementation. Although studies excluded individuals with a range of comorbidities and sociocultural challenges, such simplification of NASSS domain 1 may have been necessary to advance intervention value propositions (domain 3). However, to create equitable digital health solutions that can be successfully implemented in real-world settings, it is recommended that developers involve people with ABI, their close others, and health care staff in addressing complexities in domains 2 to 7 from the earliest intervention design stages. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020186387; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020186387. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1177/20552076211035988.
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Affiliation(s)
- Melissa Miao
- University of Technology Sydney, Sydney, Australia
| | | | | | | | | | - Emma Power
- University of Technology Sydney, Sydney, Australia
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Bergquist TF, Moessner AM, Mandrekar J, Ransom JE, Dernbach NL, Kendall KS, Brown AW. CONNECT: A pragmatic clinical trial testing a remotely provided linkage to service coordination after hospitalization for TBI. Brain Inj 2022; 36:147-155. [PMID: 35192438 DOI: 10.1080/02699052.2022.2042601] [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: 11/02/2022]
Abstract
OBJECTIVE To test whether a complex behavioral intervention delivered remotely to connect individuals to clinical resources after hospitalization for TBI improved their quality of life. DESIGN/METHODS Community-based randomized pragmatic clinical trial. Main measures TBI-QOL, Activity Measure for Post-Acute Care (AM-PAC), Clinical Satisfaction and Competency Rating Scale. RESULTS 332 individuals ≥18 years-old hospitalized for TBI in four upper Midwest states were randomized to Remote (n = 166) and Usual Care (n = 166) groups. The groups were equivalent and representative of their state population's racial and ethnic composition, age, and proportion living in rural communities. There were no significant differences within or between experimental groups over the study period in TBI-QOL t-scores. There was a significant improvement in AM-PAC Daily Activities within the Remote group and a significant between-group improvement in clinical satisfaction for the Remote group. CONCLUSION Enrolling a representative, regional community-based sample of individuals with TBI can be successful, and delivering a customized complex behavioral intervention remotely is feasible. The overall lack of intervention effectiveness was likely due to enrolling individuals without pre-identified clinical needs, initiating intervention after the immediate post-acute phase when needs are often highest, inability to provide direct clinical care remotely, and potential lack of outcome measure responsiveness in our sample.
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Affiliation(s)
- Thomas F Bergquist
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA.,Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Anne M Moessner
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Jay Mandrekar
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Jeanine E Ransom
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Nicole L Dernbach
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Kathryn S Kendall
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
| | - Allen W Brown
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
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Niknejad N, Ismail W, Bahari M, Nazari B. Understanding Telerehabilitation Technology to Evaluate Stakeholders' Adoption of Telerehabilitation Services: A Systematic Literature Review and Directions for Further Research. Arch Phys Med Rehabil 2021; 102:1390-1403. [PMID: 33484693 DOI: 10.1016/j.apmr.2020.12.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 12/12/2020] [Accepted: 12/26/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To examine the adoption of telerehabilitation services from the stakeholders' perspective and to investigate recent advances and future challenges. DATA SOURCES A systematic review of English articles indexed by PubMed, Thomson Institute of Scientific Information's Web of Science, and Elsevier's Scopus between 1998 and 2020. STUDY SELECTION The first author (N.N.) screened all titles and abstracts based on the eligibility criteria. Experimental and empirical articles such as randomized and nonrandomized controlled trials, pre-experimental studies, case studies, surveys, feasibility studies, qualitative descriptive studies, and cohort studies were all included in this review. DATA EXTRACTION The first, second, and fourth authors (N.N., W.I., B.N.) independently extracted data using data fields predefined by the third author (M.B.). The data extracted through this review included study objective, study design, purpose of telerehabilitation, telerehabilitation equipment, patient/sample, age, disease, data collection methods, theory/framework, and adoption themes. DATA SYNTHESIS A telerehabilitation adoption process model was proposed to highlight the significance of the readiness stage and to classify the primary studies. The articles were classified based on 6 adoption themes, namely users' perception, perspective, and experience; users' satisfaction; users' acceptance and adherence; TeleRehab usability; individual readiness; and users' motivation and awareness. RESULTS A total of 133 of 914 articles met the eligibility criteria. The majority of papers were randomized controlled trials (27%), followed by surveys (15%). Almost 49% of the papers examined the use of telerehabilitation technology in patients with nervous system problems, 23% examined physical disability disorders, 10% examined cardiovascular diseases, and 8% inspected pulmonary diseases. CONCLUSION Research on the adoption of telerehabilitation is still in its infancy and needs further attention from researchers working in health care, especially in resource-limited countries. Indeed, studies on the adoption of telerehabilitation are essential to minimize implementation failure, as these studies will help to inform health care personnel and clients about successful adoption strategies.
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Affiliation(s)
- Naghmeh Niknejad
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam; Faculty of Information Technology, Duy Tan University, Da Nang, Vietnam; School of Computing, Faculty of Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
| | - Waidah Ismail
- Faculty of Science and Technology, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia; Information System Study Program, Universitas Airlangga, Indonesia Kampus C, Mulyorejo, Surabaya, Indonesia.
| | - Mahadi Bahari
- Department of Information Systems, Azman Hashim International Business School, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
| | - Behzad Nazari
- Department of Information Systems, Azman Hashim International Business School, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
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Shin JY, Chaar D, Kedroske J, Vue R, Chappell G, Mazzoli A, Hassett AL, Hanauer DA, Park SY, Debra B, Choi SW. Harnessing mobile health technology to support long-term chronic illness management: exploring family caregiver support needs in the outpatient setting. JAMIA Open 2020; 3:593-601. [PMID: 33758797 PMCID: PMC7969961 DOI: 10.1093/jamiaopen/ooaa053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 08/18/2020] [Accepted: 09/24/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Family caregiving is an important public health issue, particularly with the aging population. In recent years, mobile health (mHealth) technology has emerged as a potential low-cost, scalable platform to address caregiver support needs, and thereby alleviate the burden on caregivers. This study sought to examine the support needs of family caregivers in their lived experiences of outpatient care to inform the development of a future mHealth intervention. MATERAILS AND METHODS We conducted 20 semi-structured interviews in 2 outpatient hematopoietic cell transplant (HCT) clinics at a large academic medical center in the Midwestern United States. A thematic analysis was performed to define emerging themes. RESULTS Qualitative data analysis identified 5 primary themes that HCT caregivers faced: (I) lifestyle restrictions due to the patient's immunocompromised state; (II) Unmet needs due to limitations in the current resources, including unfamiliar medical tasks without necessary trainings; and (III) caregivers' adaptive strategies, including reformation of social relationships with family and friends. Based on these findings, we suggest 3 design considerations to guide the development of a future mHealth intervention. CONCLUSIONS The findings herein captured the family caregiver's lived experiences during outpatient care. There was broad agreement that caregiving was challenging and stressful. Thus, effective and scalable interventions to support caregivers are needed. This study provided data to guide the content and design of a future mHealth intervention in the outpatient setting.
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Affiliation(s)
- Ji Youn Shin
- Department of Media and Information, College of Communication Arts and Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Dima Chaar
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
| | - Jacob Kedroske
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebecca Vue
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Grant Chappell
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Amanda Mazzoli
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
| | - Afton L Hassett
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - David A Hanauer
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Sun Young Park
- School of Information, University of Michigan, Ann Arbor, Michigan, USA
- Stamps School of Arts and Design, University of Michigan, Ann Arbor, Michigan, USA
| | - Barton Debra
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Sung Won Choi
- Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, Michigan, USA
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Acceptance of Rehabilitation Technology in Adults With Moderate to Severe Traumatic Brain Injury, Their Caregivers, and Healthcare Professionals: A Systematic Review. J Head Trauma Rehabil 2020; 34:E67-E82. [PMID: 30608310 DOI: 10.1097/htr.0000000000000462] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Moderate to severe traumatic brain injuries (TBIs) commonly result in persistent physical, cognitive, and/or emotional deficits that require long-term rehabilitation. Technology-enabled rehabilitation provides an innovative alternative to traditional intervention models. End-user acceptance of these interventions, however, is a critical factor in determining the effective implementation and acceptance of these technologies. OBJECTIVE To systematically review the literature to identify methods and measures used to evaluate user acceptance relating to rehabilitation technologies for adults with moderate to severe TBI, their caregivers, and healthcare professionals. METHODS Six key databases including Medline, Embase, CINAHL, Cochrane, Scopus, and Web of Science were searched using the relevant search terms. RESULTS From a yield of 2059 studies, 13 studies met the eligibility criteria. The review revealed limited research that formally evaluated user acceptance in relation to rehabilitation technologies designed for adults with TBI. Furthermore, where such evaluations were conducted, comprehensive research designs incorporating theoretical frameworks of technology acceptance were sparse. Importantly, a range of technologies and recommendations that positively influenced user acceptance were identified. Future directions for research in this area include the use of theory-driven research designs to enhance our understanding of technology acceptance, to support the development of rehabilitation technologies that maximize functional outcomes for individuals with TBI.
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Wake E, Atkins H, Willock A, Hawkes A, Dawber J, Weir KA. Telehealth in trauma: A scoping review. J Telemed Telecare 2020; 28:412-422. [PMID: 32715866 DOI: 10.1177/1357633x20940868] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The purpose of this scoping review was to ascertain how 'telehealth' is utilised within health care, from pre hospital to admission, discharge and post discharge, with patients who have suffered major trauma. METHODS A scoping review of the literature published in English since 1980 was conducted using MEDLINE, Ovid EMBASE, PsychINFO, CINAHL, Austhealth, Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane library) and Web of Science MEDLINE and MEBASE to identify relevant studies. RESULTS We included 77 eligible studies with both randomised controlled trial and cohort design methodology. A variety of trauma was included such as traumatic brain injuries (n = 52; 67.5%), spinal cord injury (n = 14; 18.2%) and multi-trauma (n = 9; 11.7%) to both adult (n = 38) and paediatric (n = 32) participants. Telehealth is used in pre-hospital and acute-care settings (n = 11; 14.3%) to facilitate assessment, and in rehabilitation and follow-up (n = 61; 79.2%) to deliver therapy. Effects on health were reported the most (n = 46), with no negative outcomes. The feasibility of telehealth as a delivery mode was established, but coordination and technical issues are barriers to use. Overall, both patients and clinicians were satisfied using this mode of delivery. CONCLUSION This review demonstrates how telehealth is utilised across a spectrum of patients with traumatic injuries and to facilitate delivery of therapy, specialist consultations and assessments, with many studies reporting improvements to health. There is a paucity of high-quality rigorous research, which makes replication of findings and uptake of the intervention problematic. Future telehealth and trauma research should focus on the quality and reproducibility of telehealth interventions and the economic feasibility of using this platform to deliver trauma care.
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Affiliation(s)
- Elizabeth Wake
- Gold Coast Hospital and Health Service, Australia.,Griffith University, Australia
| | - Heidi Atkins
- Clinical Excellence Queensland, Queensland Health, Australia
| | | | | | - Jessica Dawber
- Gold Coast Hospital and Health Service, Australia.,Menzies Health Institute, Australia
| | - Kelly A Weir
- Gold Coast Hospital and Health Service, Australia.,Menzies Health Institute, Australia
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Rietdijk R, Power E, Attard M, Togher L. Acceptability of telehealth-delivered rehabilitation: Experiences and perspectives of people with traumatic brain injury and their carers. J Telemed Telecare 2020; 28:122-134. [PMID: 32460583 DOI: 10.1177/1357633x20923824] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Communication skills training for people with traumatic brain injury (TBI) and their carers is recommended best practice. Delivery via telehealth could improve access to this training. This paper focuses on the acceptability of telehealth delivery of communication skills training. METHODS A mixed-methods investigation of acceptability of telehealth to people with TBI and their carers was incorporated into a clinical trial. Thirty-six people with TBI (23 metropolitan and 13 regional) and their carers were recruited. Metropolitan participants were randomly allocated to telehealth or in-person intervention at a 1:3 ratio. Regional participants were allocated to telehealth. Telehealth and in-person participants were compared on retention, time to complete the programme, home practice completion and therapeutic alliance ratings. Participants completed semi-structured interviews regarding their views on telehealth, which were analysed using thematic analysis. RESULTS There were no significant differences between telehealth and in-person participants in retention rate, time to complete the programme, degree of home practice completion or therapeutic alliance ratings. Three themes were identified: 'telehealth delivery opens a window for access to rehabilitation in the context of my daily life', 'in-person delivery offers rehabilitation based on natural human interaction' and 'weighing telehealth against in-person delivery'. DISCUSSION Participants found telehealth delivery acceptable, as indicated by the similarity between groups in the quantitative process measures, and as reported in interviews. Some reported a preference for in-person delivery if there had been a choice of delivery mode. Participants described characteristics of the two delivery modes which were relevant to their attitudes towards telehealth.
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Affiliation(s)
- Rachael Rietdijk
- The University of Sydney, Faculty of Medicine and Health, Australia
| | - Emma Power
- The University of Technology Sydney, Graduate School of Health, Australia.,The University of Sydney, Faculty of Medicine and Health, Australia
| | - Michelle Attard
- The University of Sydney, Faculty of Medicine and Health, Australia
| | - Leanne Togher
- The University of Sydney, Faculty of Medicine and Health, Australia
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Perceived Usability and Acceptability of Videoconferencing for Delivering Community-Based Rehabilitation to Individuals with Acquired Brain Injury: A Qualitative Investigation. J Int Neuropsychol Soc 2020; 26:47-57. [PMID: 31983367 DOI: 10.1017/s135561771900078x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES There is limited research on the use of telerehabilitation platforms in service delivery for people with acquired brain injury (ABI), especially technologies that support delivery of services into the home. This qualitative study aimed to explore the perspectives of rehabilitation coordinators, individuals with ABI, and family caregivers on the usability and acceptability of videoconferencing (VC) in community-based rehabilitation. Participants' experiences and perceptions of telerehabilitation and their impressions of a particular VC system were investigated. METHODS Guided by a theory on technology acceptance, semi-structured interviews were conducted with 30 participants from a community-based ABI service, including 13 multidisciplinary rehabilitation coordinators, 9 individuals with ABI, and 8 family caregivers. During the interview, they were shown a paper prototype of a telehealth portal for VC that was available for use. Interview transcripts were coded by two researchers and analysed thematically. RESULTS The VC was used on average for 2% of client consultations. Four major themes depicted factors influencing the uptake of VC platforms; namely, the context or impetus for use, perceived benefits, potential problems and parameters around use, and balancing the service and user needs. Participants identified beneficial uses of VC in service delivery and strategies for promoting a positive user experience. CONCLUSIONS Perceptions of the usability of VC to provide services in the home were largely positive; however, consideration of use on a case-by-case basis and a trial implementation was recommended to enhance successful uptake into service delivery.
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Soendergaard PL, Wolffbrandt MM, Biering-Sørensen F, Nordin M, Schow T, Arango-Lasprilla JC, Norup A. A manual-based family intervention for families living with the consequences of traumatic injury to the brain or spinal cord: a study protocol of a randomized controlled trial. Trials 2019; 20:646. [PMID: 31775831 PMCID: PMC6880634 DOI: 10.1186/s13063-019-3794-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/10/2019] [Indexed: 01/07/2023] Open
Abstract
Background Acquiring a traumatic injury constitutes a severe life change for the survivor, but also for the surrounding family. The paradigm of helping the family has primarily been on psychosocial interventions targeting caregivers. However, interventions including both survivor and caregivers should be an essential part of treatment, as the whole family’s functional level and mental health can be affected. The current study protocol presents a manualized family intervention for families living with traumatic injury to the brain (TBI) or spinal cord (tSCI). The objectives are to investigate if the intervention improves quality of life (QoL) and decreases burden. It is hypothesized that the family intervention improves problem-solving strategies and family dynamics, which will reduce the burden. This may improve the caregivers’ mental health, which will improve the support to the survivor and QoL. Methods The study is an interventional, two-arm, randomized controlled trial. During a 2-year period, a total of 132 families will be included. Participants will be recruited from East-Denmark. Inclusion criteria are (1) TBI or tSCI, (2) ≥ 18 years of age, (3) ≥ 6 months to ≤ 2 years since discharge from hospital, (4) ability to understand and read Danish, (5) cognitive abilities that enable participation, and (6) a minimum of one family member actively involved in the survivor’s life. Exclusion criteria are (1) active substance abuse, (2) aphasia, (3) prior neurologic or psychiatric diagnose, and (4) history of violence. Within each disease group, families will be allocated randomly to participate in an intervention or a control group with a ratio 1:1. The intervention groups receive the family intervention consisting of eight sessions of 90 min duration. Families in the control groups receive 2 h of psychoeducation. All participants complete questionnaires on QoL, self-perceived burden, family dynamics, problem-solving strategies, mental health, and resilience at pre-intervention, post-intervention, and 6-month follow up. Conclusion If the intervention is found to have effect, the study will contribute with novel knowledge on the use of a manual-based intervention including the entire family. This would be of clinical interest and would help families living with the consequences of TBI or tSCI. Trials registration ClinicalTrials.gov, NCT03814876. Retrospectively registered on 24 January 2019.
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Affiliation(s)
- Pernille Langer Soendergaard
- Department of Neurorehabilitation, TBI Unit, Rigshospitalet, Kettegaard Allé 30, 2650, Hvidovre, Denmark. .,Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
| | - Mia Moth Wolffbrandt
- Department of Neurorehabilitation, TBI Unit, Rigshospitalet, Kettegaard Allé 30, 2650, Hvidovre, Denmark
| | - Fin Biering-Sørensen
- Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Havnevej 25, 3100, Hornbæk, Denmark.,Institute for Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Malin Nordin
- Department of Neurosurgery, Karolinska University Hospital, Eugeniavägen 3, 171 76, Stockholm, Sweden
| | - Trine Schow
- Research and Development, Brain Injury Center BOMI, Maglegaardsvej 15, 4000, Roskilde, Denmark
| | - Juan Carlos Arango-Lasprilla
- BioCruces Vizcaya Health Research Institute, Cruces University Hospital, Barakaldo, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.,Department of Cell Biology, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Anne Norup
- Department of Neurorehabilitation, TBI Unit, Rigshospitalet, Kettegaard Allé 30, 2650, Hvidovre, Denmark.,Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
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Oyesanya TO, Thompson N, Arulselvam K, Seel RT. Technology and TBI: Perspectives of persons with TBI and their family caregivers on technology solutions to address health, wellness, and safety concerns. Assist Technol 2019; 33:190-200. [DOI: 10.1080/10400435.2019.1612798] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Tolu O. Oyesanya
- Duke University School of Nursing, Durham, North Carolina, USA
- Shepherd Center, Crawford Research Institute, Atlanta, Georgia, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA
| | - Nicole Thompson
- Duke University School of Nursing, Durham, North Carolina, USA
- Shepherd Center, Crawford Research Institute, Atlanta, Georgia, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA
| | - Karthik Arulselvam
- Duke University School of Nursing, Durham, North Carolina, USA
- Shepherd Center, Crawford Research Institute, Atlanta, Georgia, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA
| | - Ronald T. Seel
- Duke University School of Nursing, Durham, North Carolina, USA
- Shepherd Center, Crawford Research Institute, Atlanta, Georgia, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, School of Medicine, Richmond, Virginia, USA
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Hart T, Driver S, Sander A, Pappadis M, Dams-O'Connor K, Bocage C, Hinkens E, Dahdah MN, Cai X. Traumatic brain injury education for adult patients and families: a scoping review. Brain Inj 2018; 32:1295-1306. [PMID: 30084694 DOI: 10.1080/02699052.2018.1493226] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Traumatic brain injury (TBI) is increasingly viewed as a chronic condition, bringing long-term needs for patient and caregiver knowledge pertaining to symptom and problem management over time. In light of these needs, we performed a scoping review of the literature on brain injury education provided to adult patients and/ or family members affected by TBI. Objectives were to describe the types of educational interventions that have been developed; to review the effects of these interventions; and to determine gaps that might be filled by future research efforts. Of 88 articles meeting search criteria and subjected to data extraction, 34 concerned education about mild TBI and 54, moderate to severe TBI. Most mild TBI articles focused on education in the Emergency Room, while most moderate/ severe TBI education was directed toward family members/ caregivers and was frequently combined with other treatment components, making the effects of education difficult to discern. Only 1 article incorporated elements of self-management training (SMT), a model proved effective in other chronic health conditions. We recommend further exploration of SMT principles in long-term TBI care, as well as more precise definition of treatment components in all patient and family interventions, so that the specific effects of education and other treatment elements may be more readily evaluated.
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Affiliation(s)
- Tessa Hart
- a Moss Rehabilitation Research Institute , Elkins Park , PA , USA
| | - Simon Driver
- b Department of Rehabilitation Research , Baylor Scott and White Institute for Rehabilitation , Dallas , TX , USA
| | - Angelle Sander
- c Department of Physical Medicine and Rehabilitation , Baylor College of Medicine , Houston , TX , USA.,d Brain Injury Research Center , TIRR Memorial Hermann , Houston , TX , USA
| | - Monique Pappadis
- d Brain Injury Research Center , TIRR Memorial Hermann , Houston , TX , USA.,e Division of Rehabilitation Sciences, School of Health Professions , University of Texas Medical Branch at Galveston , TX , USA
| | - Kristen Dams-O'Connor
- f Department of Rehabilitation Medicine, Department of Neurology Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Claire Bocage
- g American Institutes for Research , Washington , DC , USA
| | - Emma Hinkens
- g American Institutes for Research , Washington , DC , USA
| | - Marie N Dahdah
- b Department of Rehabilitation Research , Baylor Scott and White Institute for Rehabilitation , Dallas , TX , USA.,h Department of Medical Psychology , Baylor Scott and White Medical Center , Plano , TX , USA
| | - Xinsheng Cai
- g American Institutes for Research , Washington , DC , USA
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Gentry MT, Lapid MI, Clark MM, Rummans TA. Evidence for telehealth group-based treatment: A systematic review. J Telemed Telecare 2018; 25:327-342. [DOI: 10.1177/1357633x18775855] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Interest in the use of telehealth interventions to increase access to healthcare services is growing. Group-based interventions have the potential to increase patient access to highly needed services. The aim of this study was to systematically review the available literature on group-based video teleconference services. Methods The English-language literature was searched using Ovid MEDLINE, PubMed, PsycINFO and CINAHL for terms related to telehealth, group therapy and support groups. Abstracts were reviewed for relevance based on inclusion criteria. Multiple study types were reviewed, including open-label, qualitative and randomised controlled trial study designs. Data were compiled regarding participants, study intervention and outcomes. Specific areas of interest were the feasibility of and satisfaction with telehealth technology, as well as the effect of video teleconference delivery on group dynamics, including therapeutic alliance. Results Forty published studies met the inclusion criteria and were included in the review. Six were randomised controlled trials. Among the studies, there was a broad range of study designs, participants, group interventions and outcome measures. Video teleconference groups were found to be feasible and resulted in similar treatment outcomes to in-person groups. However, few studies were designed to demonstrate noninferiority of video teleconference groups compared with in-person groups. Studies that examined group process factors showed small decreases in therapeutic alliance in the video teleconference participants. Conclusions Video teleconference groups are feasible and produce outcomes similar to in-person treatment, with high participant satisfaction despite technical challenges. Additional research is needed to identify optimal methods of video teleconference group delivery to maximise clinical benefit and treatment outcomes.
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Affiliation(s)
| | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, USA
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14
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Poulin V, Dawson DR, Bottari C, Verreault C, Turcotte S, Jean A. Managing cognitive difficulties after traumatic brain injury: a review of online resources for families. Disabil Rehabil 2018; 41:1955-1965. [DOI: 10.1080/09638288.2018.1451560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Valérie Poulin
- Department of Occupational Therapy, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Québec, Canada
| | - Deirdre R. Dawson
- Department of Occupational Science & Occupational Therapy & Rehabilitation Science Institute, University of Toronto, Toronto, Canada
- Rotman Research Institute, Baycrest, Toronto, Canada
| | - Carolina Bottari
- Occupational Therapy Program, School of Rehabilitation, Université de Montréal, Montreal, Canada
- Centre of Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada
| | - Cynthia Verreault
- Department of Occupational Therapy, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Samantha Turcotte
- Department of Occupational Therapy, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Department of Rehabilitation, Université Laval, Québec, Canada
| | - Alexandra Jean
- Department of Occupational Therapy, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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15
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Therapy Online: A Web-Based Video Support Group for Family Caregivers of Survivors With Traumatic Brain Injury. J Head Trauma Rehabil 2018; 31:E12-20. [PMID: 26291634 DOI: 10.1097/htr.0000000000000178] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This innovative descriptive study explores the benefits of a traumatic brain injury (TBI) caregiver support group intervention provided using videoconferencing within a password protected Web-based platform. METHODS Ten caregivers of family members with TBI were registered to a password-protected Web site (Caring for Others) that provided information about caring for a person with TBI and access to a videoconferencing support group intervention program. Where needed, caregivers were provided with computer equipment, Internet access, and training to negotiate the Web site links. Two groups of 5 caregivers of survivors of TBI participated (average age of survivor-20 years, average time since injury-4.6 years) and met online with a trained clinician weekly for 10 sessions. Using directed content analysis, transcripts of each session were coded with NVivo software. RESULTS The content analysis reported group process themes, therapeutic interventions used, caregiver outcomes, and the challenges for clinicians delivering a therapeutic intervention online. CONCLUSIONS Traumatic brain injury caregivers shared similar concerns and problem-solving strategies for managing caregiving tasks. Overall, participants found the sessions helpful for managing the emotional impact of caring for a family member with TBI.
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16
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Sin J, Henderson C, Spain D, Cornelius V, Chen T, Gillard S. eHealth interventions for family carers of people with long term illness: A promising approach? Clin Psychol Rev 2018; 60:109-125. [PMID: 29429856 DOI: 10.1016/j.cpr.2018.01.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 11/29/2017] [Accepted: 01/31/2018] [Indexed: 12/22/2022]
Abstract
Family carers of people who have long term illness often experience physical and mental health morbidities, and burden. While there is good evidence to suggest that carers benefit from psychosocial interventions, these have primarily been delivered via face-to-face individual or group-formats. eHealth interventions offer a novel, accessible and self-paced approach to care delivery. Whether these are effective for carers' wellbeing has been little explored. This paper reports the first comprehensive systematic review in this area. A total of 78 studies, describing 62 discrete interventions, were identified. Interventions commonly aimed to promote carers' knowledge, self-efficacy, caregiving appraisal, and reduce global health morbidities. Interventions were offered to carers of people with a wide range of long term illness; dementia has been the most researched area, as reported in 40% of studies. Clinical and methodological heterogeneity in interventions precluded meta-analyses, and so data were analysed narratively. The most popular approach has comprised psychoeducational interventions delivered via an enriched online environment with supplementary modes of communication, such as network support with professionals and peers. Overall, carers appreciate the flexibility and self-paced nature of eHealth interventions, with high rates of satisfaction and acceptability. More studies using robust designs are needed to extend the evidence base.
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Affiliation(s)
- Jacqueline Sin
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, England, UK; School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, Reading RG6 6AL, England, UK.
| | - Claire Henderson
- Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, England, UK.
| | - Debbie Spain
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, England, UK.
| | - Victoria Cornelius
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, England, UK.
| | - Tao Chen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, England, UK.
| | - Steve Gillard
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, England, UK.
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17
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Reliability of Videoconferencing Administration of a Communication Questionnaire to People With Traumatic Brain Injury and Their Close Others. J Head Trauma Rehabil 2017; 32:E38-E44. [DOI: 10.1097/htr.0000000000000282] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Guay C, Auger C, Demers L, Mortenson WB, Miller WC, Gélinas-Bronsard D, Ahmed S. Components and Outcomes of Internet-Based Interventions for Caregivers of Older Adults: Systematic Review. J Med Internet Res 2017; 19:e313. [PMID: 28928109 PMCID: PMC5627044 DOI: 10.2196/jmir.7896] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/11/2017] [Accepted: 07/11/2017] [Indexed: 12/02/2022] Open
Abstract
Background When trying to access interventions to improve their well-being and quality of life, family caregivers face many challenges. Internet-based interventions provide new and accessible opportunities to remotely support them and can contribute to reducing their burden. However, little is known about the link existing between the components, the use of behavior change techniques, and the outcomes of these Internet-based interventions. Objective This study aimed to provide an update on the best available evidence about the efficacy of Internet-based interventions for caregivers of older adults. Specifically, the components and the use of behavior change techniques and how they impact on the efficacy of the intervention were sought. Methods A systematic review searched primary source studies published between 2000 and 2015. Included studies were scored with a high level of evidence by independent raters using the GRADE criteria and reported caregiver-specific outcomes about interventions delivered through the Internet for caregivers of people aged 50 years and older. A narrative synthesis identified intervention components (eg, content, multimedia use, interactive online activities, and provision of support), behavior change techniques, and caregiver outcomes (eg, effects on stressors, mediators, and psychological health). The risk of bias within the included studies was assessed. Results A total of 2338 articles were screened and 12 studies describing 10 Internet-based interventions were identified. Seven of these interventions led to statistically significant improvements in caregiver outcomes (eg, reducing depression or anxiety, n=4). These efficacious interventions used interactive components, such as online exercises and homework (n=4) or questionnaires on health status (n=2) and five of them incorporated remote human support, either by professionals or peers. The most frequently used behavior change techniques included in efficacious interventions were provision of social support (n=6) and combinations of instructions to guide behavior change and barrier identification (n=5). The design and aim of the included studies did not permit determining exactly which component and/or behavior change technique was more efficacious in producing positive outcomes in caregivers. The risk for selection bias was low for all the studies, and low to high for performance, detection, and attrition biases. Conclusions In sum, Internet-based interventions that incorporate professional and social support, and provide instructions to change behavior and problem solve in an interactive manner appear to lead to positive outcomes in caregivers. Studies isolating the specific effect of components are needed to improve our understanding of the underlying mechanism of action.
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Affiliation(s)
- Cassioppée Guay
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| | - Claudine Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| | - Louise Demers
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,GF Strong Rehabilitation Center, Vancouver, BC, Canada.,International Collaboration on Repair Discoveries, Vancouver, BC, Canada
| | - William C Miller
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,GF Strong Rehabilitation Center, Vancouver, BC, Canada
| | - Dominique Gélinas-Bronsard
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
| | - Sara Ahmed
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada.,School of Physical and Occupational Therapy, Faculty of Medicine, McGill University Health Centre, Clinical Epidemiology, McGill University, Montreal, QC, Canada
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19
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Cotton Z, Russell T, Johnston V, Legge J. Training therapists to perform Pre-Employment Functional Assessments: A telerehabilitation approach. Work 2017; 57:475-482. [PMID: 28777763 DOI: 10.3233/wor-172578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Pre-Employment Functional Assessments (PEFA) are increasingly used in an attempt to obtain objective information on a potential employee's functional capabilities. In rural and remote communities, there is typically reduced access to qualified therapists to perform these assessments, in part attributable to the time and costs associated with travelling to training courses. One potential method of providing the relevant training to conduct PEFAs is through the use of technologies such as videoconferencing or internet-based modules. OBJECTIVE The purpose of this project is to investigate the effectiveness of training therapists and therapy students in performing JobFit System PEFAs via technology when compared with a face-to-face control group. METHODS Fifty-three participants, consisting of 28 professional physiotherapists and occupational therapists, and 25 final year University of Queensland (UQ) physiotherapy and occupational therapy students, underwent JobFit Systems International PEFA training via one of four intervention groups: face-to-face, realtime videoconferencing, group-based online module and individual online module. RESULTS Of the 53 participants, 49 achieved the minimum competency level of 75% in post-training competency assessments. No significant difference was found in training levels between intervention groups. CONCLUSIONS The results of this study suggest that technology, such as real-time videoconference and online learning modules, can be used to train both therapists and students in how to perform JobFit System PEFAs.
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Affiliation(s)
- Zoë Cotton
- Division of Physiotherapy, The University of Queensland, Brisbane, St Lucia, QLD, Australia
| | - Trevor Russell
- Division of Physiotherapy, The University of Queensland, Brisbane, St Lucia, QLD, Australia
| | - Venerina Johnston
- Division of Physiotherapy, The University of Queensland, Brisbane, St Lucia, QLD, Australia
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20
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Coffey NT, Cassese J, Cai X, Garfinkel S, Patel D, Jones R, Shaewitz D, Weinstein AA. Identifying and Understanding the Health Information Experiences and Preferences of Caregivers of Individuals With Either Traumatic Brain Injury, Spinal Cord Injury, or Burn Injury: A Qualitative Investigation. J Med Internet Res 2017; 19:e159. [PMID: 28490418 PMCID: PMC5443912 DOI: 10.2196/jmir.7027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/20/2017] [Accepted: 03/08/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In order to meet the challenges of caring for an injured person, caregivers need access to health information. However, caregivers often feel that they lack adequate information. Previous studies of caregivers have primarily focused on either their time and emotional burdens or their health outcomes, but the information needs of caregivers have not been thoroughly investigated. OBJECTIVE The purpose of this investigation was to identify the preferred sources of health information for caregivers supporting individuals with injuries and to explore how access to this information could be improved. METHODS A total of 32 caregivers participated in semistructured interviews, which were used in order to develop a more in-depth understanding of these caregivers' information needs. Digital audio recordings of the interviews were used for analysis purposes. These audio recordings were analyzed using a thematic analysis or qualitative content analysis. All of participant's interviews were then coded using the qualitative analysis program, Nvivo 10 for Mac (QSR International). RESULTS The caregivers endorsed similar behaviors and preferences when seeking and accessing health information. Medical professionals were the preferred source of information, while ease of access made the Internet the most common avenue to obtain information. The challenges faced by participants were frequently a result of limited support. In describing an ideal health system, participants expressed interest in a comprehensive care website offering support network resources, instructive services about the injury and caregiving, and injury-specific materials. CONCLUSIONS According to the participants, an ideal health information system would include a comprehensive care website that offered supportive network resources, instructive services about the injury and caregiving, and materials specific to the type of patient injury.
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Affiliation(s)
- Nathan T Coffey
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA, United States
| | - James Cassese
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA, United States
| | - Xinsheng Cai
- American Institutes for Research, Washington, DC, United States
| | | | - Drasti Patel
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA, United States
| | - Rebecca Jones
- American Institutes for Research, Washington, DC, United States
| | - Dahlia Shaewitz
- American Institutes for Research, Washington, DC, United States
| | - Ali A Weinstein
- Center for the Study of Chronic Illness and Disability, George Mason University, Fairfax, VA, United States
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21
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Brunner M, Hemsley B, Togher L, Palmer S. Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI). Brain Inj 2017; 31:1028-1043. [DOI: 10.1080/02699052.2017.1292429] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Melissa Brunner
- Speech Pathology, Faculty of Education and Arts, University of Newcastle, Newcastle, Australia
| | - Bronwyn Hemsley
- Speech Pathology, Faculty of Education and Arts, University of Newcastle, Newcastle, Australia
| | - Leanne Togher
- Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, Australia
- NHMRC Centre of Research Excellence in Brain Recovery, Sydney, Australia
| | - Stuart Palmer
- Faculty of Science, Engineering & Built Environment, Deakin University, Geelong, Australia
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22
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Kovaleva M, Blevins L, Griffiths PC, Hepburn K. An Online Program for Caregivers of Persons Living With Dementia: Lessons Learned. J Appl Gerontol 2017; 38:159-182. [PMID: 28460557 DOI: 10.1177/0733464817705958] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The population of individuals living with dementia and their caregivers and the need to provide caregiver training will increase in the next several decades. In-person caregiver educational programs are delimited by logistical and resource boundaries that could be overcome with online programs. The purpose of this qualitative descriptive study was to explore the acceptability and ways to improve the content and delivery of an online 7-week psychoeducational pilot program-Tele-Savvy. Thirty-six caregivers who completed the pilot were interviewed about their experience with Tele-Savvy and their suggestions for its improvement. Conventional content analysis allowed for the identification of three themes: barriers and facilitators to establishing rapport with participants and instructors, content enrichment and diversification, and structural refinement. These lessons learned directly from the caregivers provide evidence to guide the refinement of analogous online interventions and highlight the need for their wider availability.
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Affiliation(s)
- Mariya Kovaleva
- 1 Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Lindsey Blevins
- 2 Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Patricia C Griffiths
- 3 Atlanta VA Medical Center, Decatur, GA, USA.,4 Emory University School of Medicine, Atlanta, GA, USA.,5 Emory University Alzheimer's Disease Research Center, Atlanta, GA, USA
| | - Kenneth Hepburn
- 1 Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.,5 Emory University Alzheimer's Disease Research Center, Atlanta, GA, USA
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23
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Overby MS, Baft-Neff A. Perceptions of telepractice pedagogy in speech-language pathology: A quantitative analysis. J Telemed Telecare 2016; 23:550-557. [PMID: 27365319 DOI: 10.1177/1357633x16655939] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Despite the growth of telecommunication applications to provide clinical healthcare services, there has been little attention to the pedagogical framework needed to train healthcare students to deliver these services. Methods In this exploratory investigation, perceptions of speech-language pathology/therapy (SLP/SLT) faculty ( n = 31), graduate students ( n = 16), and telehealth ("telepractice") clinicians ( n = 16) were examined with a 15-item survey regarding the 1) comparative pedagogical importance of four skills common to telepractice and face-to-face service (f2f) delivery, and 2) relative pedagogical value of seven skills and competencies unique to telepractice. Results Statistical analyses revealed nonverbal communication skills and knowledge of the literature related to service delivery methods were more important in telepractice than in f2f service delivery. Among seven skills unique to telepractice, participants believed the most important was solving problems related to the Internet and recommended at least two hours of instruction each in telepractice technology, patient confidentiality, and role-playing telepractice. Results suggest that SLP/SLT students may need additional and/or focused academic training in nonverbal communication, telepractice literature, and in solving connectivity issues to enter the telepractice marketplace with sufficient preparation. Discussion Further study is needed to compare the relative importance of additional SLP/SLT skills and competencies, describe components of effective healthcare training telepractice programs, and explore effective pedagogical strategies for healthcare telepractice instruction.
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Affiliation(s)
- Megan S Overby
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, USA
| | - Annette Baft-Neff
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, USA
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24
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Comparing the Injury Profile, Service Use, Outcomes, and Comorbidities of People With Severe TBI Across Urban, Regional, and Remote Populations in New South Wales. J Head Trauma Rehabil 2016; 31:E26-38. [DOI: 10.1097/htr.0000000000000160] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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25
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Luauté J, Hamonet J, Pradat-Diehl P. Behavioral and affective disorders after brain injury: French guidelines for prevention and community supports. Ann Phys Rehabil Med 2015; 59:68-73. [PMID: 26697992 DOI: 10.1016/j.rehab.2015.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 10/30/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The purpose of this study was to elaborate practice guidelines for the prevention of behavioral and affective disorders in adult outpatients after traumatic brain injury (TBI); but also to identify the support systems available for family, caregivers of patients with TBI within the community. METHODS The elaboration of these guidelines followed the procedure validated by the French health authority for good practice recommendations, close to the Prisma statement. This involved a systematic and critical review of the literature looking for studies that investigated the impact of programs in community settings directed to behavioral and affective disorders post-TBI. Recommendations were than elaborated by a group of professionals and family representatives. RESULTS Only six articles were found comprising 4 studies with a control group. Two studies showed a beneficial effect of personalized behavior management program delivered within natural community settings for persons with brain injury and their caregivers. Two other studies showed the relevance of scheduled telephone interventions to improve depressive symptoms and one study emphasized the usefulness of physical training. One study investigated the relevance of an outreach program; this study showed an improvement of the patients' independence but did not yield any conclusions regarding anxiety and depression. DISCUSSION AND RECOMMENDATIONS In addition to the application of care pathways already established by the SOFMER, prevention of behavioral and affective disorders for brain-injured outpatients should involve pain management, as well as development of therapeutic partnerships. It is recommended to inform patients, their family and caregivers regarding the local organization and facilities involved in the management of traumatic brain injury. The relevance of therapeutic education for implementing coping strategies, educating caregivers on behavioral disorder management, follow-up telephone interventions, and holistic therapy seems established. The level of evidence is low and preliminary studies should be confirmed with larger controlled trials.
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Affiliation(s)
- J Luauté
- Service de médecine physique et de réadaptation, rééducation neurologique, hôpital Henry-Gabrielle, CHU de Lyon, 69230 Saint-Genis-Laval, France; Équipe IMPACT, Inserm, U1028, CNRS, UMR 5292, centre de recherche en neuroscience de Lyon (CRNL), Lyon, France.
| | - J Hamonet
- Service de médecine physique et réadaptation, CHU de Limoges, 87042 Limoges, France
| | - P Pradat-Diehl
- Service de rééducation, hôpital de la Salpetrière, AP-HP, CHU de Paris, Paris, France
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26
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Zgaljardic DJ, Seale GS, Schaefer LA, Temple RO, Foreman J, Elliott TR. Psychiatric Disease and Post-Acute Traumatic Brain Injury. J Neurotrauma 2015; 32:1911-25. [DOI: 10.1089/neu.2014.3569] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dennis J. Zgaljardic
- Transitional Learning Center, Galveston, Texas
- University of Texas Medical Branch, Galveston, Texas
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27
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A Randomized Controlled Trial to Evaluate the Veterans' In-home Program for Military Veterans With Traumatic Brain Injury and Their Families: Report on Impact for Family Members. PM R 2015; 8:495-509. [PMID: 26514790 DOI: 10.1016/j.pmrj.2015.10.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 10/14/2015] [Accepted: 10/18/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) creates many challenges for families as well as for patients. Few intervention studies have considered both the needs of the person with TBI and his or her family and included both in the intervention process. To address this gap, we designed an innovative intervention for veterans with TBI and families-the Veterans' In-home Program (VIP)-targeting veterans' environment, delivered in veterans' homes, and involving their families. OBJECTIVES To determine whether the VIP is more effective than standard outpatient clinic care in improving family members' well-being in 3 domains (depressive symptoms, burden, and satisfaction) and to assess its acceptability to family members. DESIGN In this randomized controlled trial, 81 dyads (veteran/family member) were randomly assigned to VIP or an enhanced usual care control condition. Randomization occurred after the baseline interview. Follow-up interviews occurred 3-4 months after baseline, and the interviewer was blinded to group assignment. SETTING Interviews and intervention sessions were conducted in veterans' homes or by telephone. PARTICIPANTS A total of 81 veterans with TBI recruited from a Veterans Affairs (VA) polytrauma program and a key family member for each participated. Of the 81 family members, 63 completed the follow-up interview. INTERVENTION The VIP, guided by the person-environment fit model, consisted of 6 home visits and 2 telephone calls delivered by occupational therapists over a 3- to 4-month period. Family members were invited to participate in the 6 home sessions. MAIN OUTCOME MEASURES Family member well-being was operationally defined as depressive symptomatology, caregiver burden, and caregiver satisfaction 3-4 months after baseline. Acceptability was operationally defined through 3 indicators. RESULTS Family members in the VIP showed significantly lower depressive symptom scores and lower burden scores when compared to controls at follow-up. Satisfaction with caregiving did not differ between groups. Family members' acceptance of the intervention was high. CONCLUSIONS VIP represents the first evidence-based intervention that considers both the veteran with TBI and the family. VIP had a significant impact on family member well-being and thus addresses a large gap in previous research and services for families of veterans with TBI.
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Fisher A, Lennon S, Bellon M, Lawn S. Family involvement in behaviour management following acquired brain injury (ABI) in community settings: A systematic review. Brain Inj 2015; 29:661-75. [DOI: 10.3109/02699052.2015.1004751] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | | | - Sharon Lawn
- Department of Psychiatry, School of Health Sciences, Flinders University, Adelaide, Australia
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Boots LMM, de Vugt ME, van Knippenberg RJM, Kempen GIJM, Verhey FRJ. A systematic review of Internet-based supportive interventions for caregivers of patients with dementia. Int J Geriatr Psychiatry 2014; 29:331-44. [PMID: 23963684 DOI: 10.1002/gps.4016] [Citation(s) in RCA: 299] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 07/17/2013] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Because of the expected increase in the number of dementia patients, the unlikelihood of a cure in the near future, and the rising cost of care, there is an increasing need for effective caregiver interventions. Internet interventions hold considerable promise for meeting the educational and support needs of informal dementia caregivers at reduced costs. The current study aims to provide an overview of the evidence for the effectiveness, feasibility, and quality of Internet interventions for informal caregivers of people with dementia. METHODS A systematic literature search of five scientific databases was performed, covering literature published up to 10 January 2013. Twelve studies were identified. The quality of the included studies was assessed according to the Cochrane level of evidence and the criteria list of the Cochrane Back Review Group. RESULTS The intervention types, dosage, and duration differed widely, as did the methodological quality of the included studies. The overall level of evidence was low. However, the results demonstrate that Internet interventions for informal dementia caregivers can improve various aspects of caregiver well-being, for example, confidence, depression, and self-efficacy, provided they comprise multiple components and are tailored to the individual. Furthermore, caregivers could benefit from interaction with a coach and other caregivers. CONCLUSIONS Internet interventions for informal dementia caregivers may improve caregiver well-being. However, the available supporting evidence lacks methodological quality. More randomized controlled studies assessing interventions performed according to protocol are needed to give stronger statements about the effects of supportive Internet interventions and their most promising elements.
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Affiliation(s)
- L M M Boots
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
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Predictors of Emotional Distress in Family Caregivers of Persons with Traumatic Brain Injury: A Systematic Review. BRAIN IMPAIR 2013. [DOI: 10.1017/brimp.2013.12] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The purpose of the current paper was to conduct a systematic review of the literature on predictors of emotional distress in caregivers of persons with traumatic brain injury (TBI), and to provide evidence-based classification for prognostic variables to guide future research and clinical practice. A search was conducted using PubMed, CINAHL and PsycINFO databases. The citations of resulting articles were also reviewed. Twenty-eight articles met inclusion criteria and were retained for review. Reviews were conducted in accordance with the 2011 edition of the American Academy of Neurology (AAN) Guidelines for classifying evidence for prognostic studies. Data abstraction revealed one Class I study, four Class II studies, eight Class III studies, and 15 Class IV studies. Results of the review indicated that caregivers’ report of neurobehavioural problems in the person with injury is a probable predictor of emotional distress for caregivers of persons with complicated mild, moderate or severe TBI (Class B evidence). The level of participation in the person with injury, level of support needed by the person with injury, and family systems functioning are probably predictors of emotional distress for caregivers of persons with severe TBI (Class B evidence). Executive functioning impairment in the person with injury, pre-injury emotional distress in caregivers, caregiver age, caregivers’ use of emotion-focused coping, and social support may possibly be risk factors for caregivers’ emotional distress (Class C evidence). Recommendations for future research and implications for assessment and treatment of family caregivers are discussed.
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31
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O’Connell ME, Crossley M, Cammer A, Morgan D, Allingham W, Cheavins B, Dalziel D, Lemire M, Mitchell S, Morgan E. Development and evaluation of a telehealth videoconferenced support group for rural spouses of individuals diagnosed with atypical early-onset dementias. DEMENTIA 2013; 13:382-95. [DOI: 10.1177/1471301212474143] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Atypical and early-onset dementias can be particularly problematic for family caregivers, and support groups aimed at memory loss and Alzheimer’s disease are not always helpful. Unfortunately, little has been developed specifically for caregivers of individuals with atypical dementias such as the frontotemporal dementias. Compounding the lack of access to interventions targeted specifically at caregivers of individuals with atypical and early-onset dementias are the unique needs of rural caregivers. Due to the relative infrequency of these particular dementias and the large geographical distances between rural caregivers, technology-facilitation is required for any group-based intervention. This paper describes the development of a secure telehealth videoconferenced support group for rural spouses of individuals with atypical and early-onset dementias. In addition, we provide preliminary evidence of effectiveness and describe a template for future groups based on the key therapeutic aspects of this novel technology-facilitated intervention.
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Affiliation(s)
| | | | | | | | - Wendy Allingham
- Participant collaborator, Canada
- Participant collaborators are listed in alphabetical order, but all contributed equally to the project
| | - Betty Cheavins
- Participant collaborator, Canada
- Participant collaborators are listed in alphabetical order, but all contributed equally to the project
| | - Donna Dalziel
- Participant collaborator, Canada
- Participant collaborators are listed in alphabetical order, but all contributed equally to the project
| | - Maurice Lemire
- Participant collaborator, Canada
- Participant collaborators are listed in alphabetical order, but all contributed equally to the project
| | - Sheri Mitchell
- Participant collaborator, Canada
- Participant collaborators are listed in alphabetical order, but all contributed equally to the project
| | - Ernie Morgan
- Participant collaborator, Canada
- Participant collaborators are listed in alphabetical order, but all contributed equally to the project
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Martin K. Carers and traumatic brain injury: a qualitative synthesis. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2012. [DOI: 10.12968/ijtr.2012.19.9.504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hickey KT, Johnson MP, Biviano A, Aboelela S, Thomas T, Bakken S, Garan H, Zimmerman JL, Whang W. Cardiac e-Learning: Development of a Web-Based Implantable Cardioverter Defibrillator Educational System. Telemed J E Health 2011; 17:196-200. [DOI: 10.1089/tmj.2010.0108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kathleen T. Hickey
- School of Nursing, Columbia University, New York, New York
- College of Physicians & Surgeons, Columbia University, New York, New York
| | | | - Angelo Biviano
- College of Physicians & Surgeons, Columbia University, New York, New York
| | - Sally Aboelela
- School of Nursing, Columbia University, New York, New York
| | - Tami Thomas
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Suzanne Bakken
- School of Nursing, Columbia University, New York, New York
- College of Physicians & Surgeons, Columbia University, New York, New York
| | - Hasan Garan
- College of Physicians & Surgeons, Columbia University, New York, New York
| | - John L. Zimmerman
- College of Physicians & Surgeons, Columbia University, New York, New York
- College of Dental Medicine, Columbia University, New York, New York
- College of Physicians & Surgeons, Columbia University, New York, New York
| | - William Whang
- College of Physicians & Surgeons, Columbia University, New York, New York
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Moore CD, Cook KM. Promoting and measuring family caregiver self-efficacy in caregiver-physician interactions. SOCIAL WORK IN HEALTH CARE 2011; 50:801-814. [PMID: 22136346 DOI: 10.1080/00981389.2011.580835] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This article describes the development of a 5-item scale that assesses family caregivers' self-efficacy in communicating with physicians about ill family members (Perceived Efficacy in Caregiver-Physician Interactions-PECPI) in the context of an evaluation study of an online training in health care communication skills for caregivers. A national sample of 197 self-identified family caregivers participated in an online webinar and completed a brief evaluation instrument before and immediately after the training. Results indicated that the webinar was effective in increasing perceived self-efficacy and self-reported knowledge about and level of preparation for medical visits. Principal component analysis indicates that the PECPI is unidimensional with a Cronbach's alpha of .91.
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Affiliation(s)
- Crystal Dea Moore
- Department of Sociology, Anthropology, and Social Work, Skidmore College, Saratoga Springs, New York, USA.
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35
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Koenig KN, Steiner V, Pierce LL. Information needs of family caregivers of persons with cognitive versus physical deficits. GERONTOLOGY & GERIATRICS EDUCATION 2011; 32:396-413. [PMID: 22087784 DOI: 10.1080/02701960.2011.611713] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study compared information needs of caregivers of persons with dementia with caregivers of those who received rehabilitation treatment. Caregivers were provided a 48-item survey and asked to choose their top ten information needs. Dementia caregivers' (n = 33) top needs were dealing with forgetfulness/confusion (91%) and repeating questions/actions (61%) in care recipients. Rehabilitation caregivers' (n = 40) top needs were handling care recipients' mobility problems (75%) and dealing with their own stress (65%). Dementia caregivers focused on care recipients' needs related to behavioral symptoms, whereas rehabilitation caregivers focused on needs related to physical care of care recipients and their own needs.
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Affiliation(s)
- Kelly N Koenig
- College of Medicine, The University of Toledo, Toledo, Ohio 43614, USA.
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Olden M, Cukor J, Rizzo AS, Rothbaum B, Difede J. House calls revisited: leveraging technology to overcome obstacles to veteran psychiatric care and improve treatment outcomes. Ann N Y Acad Sci 2010; 1208:133-41. [PMID: 20955335 PMCID: PMC4018828 DOI: 10.1111/j.1749-6632.2010.05756.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Despite an increasing number of military service members in need of mental health treatment following deployment to Iraq and Afghanistan, numerous psychological and practical barriers limit access to care. Perceived stigma about admitting psychological difficulties as well as frequent long distances to treatment facilities reduce many veterans' willingness and ability to receive care. Telemedicine and virtual human technologies offer a unique potential to expand services to those in greatest need. Telemedicine-based treatment has been used to address multiple psychiatric disorders, including posttraumatic stress disorder, depression, and substance use, as well as to provide suicide risk assessment and intervention. Clinician education and training has also been enhanced and expanded through the use of distance technologies, with trainees practicing clinical skills with virtual patients and supervisors connecting with clinicians via videoconferencing. The use of these innovative and creative vehicles offers a significant and as yet unfulfilled promise to expand delivery of high-quality psychological therapies, regardless of clinician and patient location.
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Affiliation(s)
- Megan Olden
- Department of Psychiatry, Weill Cornell Medical College of Cornell University, New York, New York 10065, USA.
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37
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Ramkumar NA, Elliott TR. Family caregiving of persons following neurotrauma: issues in research, service and policy. NeuroRehabilitation 2010; 27:105-12. [PMID: 20634605 PMCID: PMC3395726 DOI: 10.3233/nre-2010-0585] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Family caregivers of persons following neurotrauma function as de facto extensions of our health care system. Their challenges may result in negative consequences for their physical and mental health, which directly impacts the well-being of their care-recipient. In this paper, we survey current practices in providing caregiver support, outline considerations for developing collaborative interventions, and make recommendations for assessing intervention effectiveness consistent with the nature of the adjustment processes among caregivers and care recipients.
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