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Dostie R, Dunn H, Marks WN, Camden C, Lovo S. Use of telehealth for paediatric rehabilitation needs of Indigenous children - a scoping review. Int J Circumpolar Health 2024; 83:2308944. [PMID: 38320112 PMCID: PMC10848996 DOI: 10.1080/22423982.2024.2308944] [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: 12/04/2023] [Accepted: 01/18/2024] [Indexed: 02/08/2024] Open
Abstract
Telerehabilitation is proposed as a promising avenue to enhance service accessibility for Indigenous communities, yet its application for Indigenous children remains relatively unexplored. This scoping review followed the PRISMA-ScR framework to explore current knowledge on the use of telerehabilitation for Indigenous children. Ten scholarly databases, seven grey literature databases, reference searches, and expert consultations were utilised to identify relevant studies. Included articles discussed the use of telerehabilitation provided by rehabilitation professionals (e.g. occupational therapist (OT), physical therapist (PT), speech and language pathologist (SLP) to Indigenous children and/or caregivers. Seven studies were included. Telerehabilitation was explored in different ways, the most common being real-time videoconferencing by SLPs. While some studies explicitly acknowledged cultural responsiveness within both the research process and the intervention, most were not designed for Indigenous children and their caregivers; rather, these participants were included with non-Indigenous participants. Successful implementation and sustainability of telerehabilitation services requires addressing technological limitations, understanding, and respecting diverse worldviews, and co-developing services to meet the unique needs of Indigenous families. Telerehabilitation has been rarely used with Indigenous children and when it was, little attention was given to cultural considerations. These findings emphasise that future telerehabilitation interventions should be truly community-led to ensure cultural relevance.
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Affiliation(s)
- Rosalie Dostie
- School of rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Qc, Canada
| | - Hailey Dunn
- School of rehabilitation sciences, College of Medicine, Saskatchewan University, Saskatoon, SK, Canada
| | | | - Chantal Camden
- School of rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Qc, Canada
| | - Stacey Lovo
- School of rehabilitation sciences, College of Medicine, Saskatchewan University, Saskatoon, SK, Canada
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Beltrán V, Muñoz-Sepúlveda F, Acevedo C, Navarro P, Venegas B, Salgado C, Uribe P, Engelke W. A rural teledentistry care experience: a geriatric approach to assessing oral health status and treatment needs in older adults from a Mapuche community in Chile. Front Public Health 2024; 12:1356622. [PMID: 38903581 PMCID: PMC11188396 DOI: 10.3389/fpubh.2024.1356622] [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: 12/20/2023] [Accepted: 05/08/2024] [Indexed: 06/22/2024] Open
Abstract
Background Limited attention has been given to oral health challenges faced by older Indigenous populations, especially in rural settings, where disparities exist. This study aims to assess oral health in a rural Mapuche community in southern Chile, utilizing geriatric technology support, and exploring the connection between geriatric health and oral well-being to fill a gap in this context. Methods A cross-sectional study was conducted involving 76 independent older adults from a rural Mapuche community who required dental care. Assessments were in a remote care setting gathering extensive data including comprehensive geriatric assessments, medical and dental conditions using a geriatric teledentistry platform (TEGO®). Statistical analysis involved descriptive analysis, logistic regression, and both multiple correspondence analysis and k-means cluster analysis. Results The sample comprised individuals with limited formal education and a high degree of vulnerability. Geriatric assessments unveiled cognitive deterioration, frailty, depression risk, and multimorbidity. A distribution of the DMFT index, number of remaining teeth, number of occluding pairs, number of teeth with restorative needs and other relevant clinical findings was conducted based on sociodemographic, and medical-geriatric-dental characteristics, and additionally, a Multinomial Logistic Regression Analysis of Dentition Variables in Relation to Geriatric Assessments was performed. The dental burden was substantial, with an average DMFT index of 25.96 (SD 4.38), high prevalence of non-functional dentition (89.3%), periodontal disease (83%), xerostomia (63.2%) and oral mucosal lesions (31.5%). Age, lower education, depression, daily medication number and sugary consumption frequency were associated with a decreased average number of teeth (p < 0.05). Multiple correspondence analysis and k-means cluster analysis identified 4 clusters, with the edentulous and functional dentition groups being the most distinct. Conclusion This study uncovers a substantial dental burden and intricate medical-geriatric conditions interlinked among Indigenous older adults in a rural Chilean Mapuche community. The implementation of a geriatric technological ecosystem in the community enabled the resolution of less complex oral health issues and facilitated remote consultations with specialists, reducing the necessity for travel to health centers. This underscores the need for innovative dental public health initiatives to address health disparities and improve the overall well-being of older Indigenous adults.
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Affiliation(s)
- Víctor Beltrán
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco, Chile
- Interuniversity Center for Healthy Aging (CIES), Santiago, Chile
| | - Fernanda Muñoz-Sepúlveda
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco, Chile
- Interuniversity Center for Healthy Aging (CIES), Santiago, Chile
- Program of Master in Dental Science, Dental School, Universidad de La Frontera, Temuco, Chile
| | - Claudia Acevedo
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco, Chile
| | - Pablo Navarro
- Research Center for Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile
- Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile
| | - Bernardo Venegas
- Stomatology Department, Faculty of Dentistry, Universidad de Talca, Talca, Chile
| | | | - Pablo Uribe
- Dental School, Universidad de La Frontera, Temuco, Chile
| | - Wilfried Engelke
- Faculty of Medicine, Georg-August University of Göttingen, Göttingen, Germany
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O'Neil LM, O'Neill M, Whelan F, Leahy T, Wormald R, Hinton-Bayre AD, Ghandour J, Kuthubutheen J. Novel ENT live telehealth and live video-otoscopy clinics in remote Australia: outcomes and comparisons to traditional clinic models. J Laryngol Otol 2024; 138:253-257. [PMID: 37698117 DOI: 10.1017/s0022215123001561] [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] [Indexed: 09/13/2023]
Abstract
BACKGROUND Coronavirus disease 2019 challenged the delivery of healthcare in Australia, disproportionately impacting vulnerable patients, including Aboriginal and/or Torres Strait Islander peoples and those living in remote regions. The otolaryngology service provided to remote Western Australia adapted to these barriers by altering clinical consultations to a digital model. METHODS A review was undertaken of patients in regional Western Australia. Demographics and clinical outcomes from 20 live telehealth clinics were retrospectively reviewed and compared to 16 face-to-face clinics. RESULTS The demographics of patients reviewed in both live telehealth and face-to-face clinics were similar, except for a larger proportion of Aboriginal and/or Torres Strait Islander patients utilising telehealth. The outcomes of patients reviewed through each model of care were comparable. Live video-otoscopy provided diagnostic quality images in 92 per cent of cases. CONCLUSION The findings of our review suggest that, despite its limitations, a large proportion of ENT patients may be safely assessed through a live telehealth model.
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Affiliation(s)
- Luke M O'Neil
- Western Australian Country Health Service, Perth, Australia
- Division of Surgery, Medical School, University of Western Australia, Perth, Australia
| | - Margie O'Neill
- Western Australian Country Health Service, Perth, Australia
| | - Fiona Whelan
- Western Australian Country Health Service, Perth, Australia
| | - Travis Leahy
- Western Australian Country Health Service, Perth, Australia
- Division of Otolaryngology, Medical School, The University of Notre Dame, Perth, Australia
| | - Robert Wormald
- Western Australian Country Health Service, Perth, Australia
| | - Anton D Hinton-Bayre
- Western Australian Country Health Service, Perth, Australia
- Division of Surgery, Medical School, University of Western Australia, Perth, Australia
| | | | - Jafri Kuthubutheen
- Western Australian Country Health Service, Perth, Australia
- Division of Surgery, Medical School, University of Western Australia, Perth, Australia
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Choi W, Lim Y, Heo T, Lee S, Kim W, Kim SC, Kim Y, Kim J, Kim H, Kim H, Lee T, Kim C. Characteristics and Effectiveness of Mobile- and Web-Based Tele-Emergency Consultation System between Rural and Urban Hospitals in South Korea: A National-Wide Observation Study. J Clin Med 2023; 12:6252. [PMID: 37834896 PMCID: PMC10573876 DOI: 10.3390/jcm12196252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: The government of South Korea has established a nationwide web- and mobile-based emergency teleconsultation network by designating urban and rural hospitals. The purpose of this study is to analyze the characteristics and effectiveness of the tele-emergency system in South Korea. (2) Methods: Tele-emergency consultation cases from May 2015 to December 2018 were analyzed in the present study. The definition of a tele-emergency in the present study is an emergency consultation between doctors in rural and urban hospitals via a web- and mobile-based remote emergency consultation system (RECS). Consultations through an RECS are grouped into three categories: medical procedure or treatment guidance, image interpretation, and transportation requests. The present study analyzed the characteristics of the tele-emergency system and the reduction in unnecessary transportation (RUT). (3) Results: A total of 2604 cases were analyzed in the present study from 2985 tele-emergency consultation cases. A total of 381 cases were excluded for missing data. Consultations for image interpretation were the most common in trauma cases (71.3%), while transfer requests were the most common in non-trauma cases (50.3%). Trauma patients were more frequently admitted to rural hospitals or discharged and followed up with at rural hospitals (20.3% vs. 40.5%) after consultations. In terms of disease severity, non-severe cases were statistically higher in trauma cases (80.6% vs. 59.4%; p < 0.001). The RUT was statistically highly associated with trauma cases (60.8% vs. 42.8%; p < 0.001). In an analysis that categorized cases by region, a statistically higher proportion of transportation was used in island regions (69.9% vs. 49.5%; p < 0.003). More RUT was associated with non-island regions (30.1% vs. 50.5%; p = 0.001). (4) Conclusions: The tele-emergency system had a great role in reducing unnecessary patient transportation in non-severe trauma cases and non-island rural area emergency cases. Further research is needed for a cost/benefit analysis and clinical outcomes.
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Affiliation(s)
- WooSung Choi
- Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea;
| | - YongSu Lim
- Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea;
- Department of Emergency Medicine, Gachon University College of Medicine, Incheon 21565, Republic of Korea
| | - Tag Heo
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea; (T.H.); (S.L.)
| | - SungMin Lee
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea; (T.H.); (S.L.)
| | - Won Kim
- Department of Emergency Medicine, Cheju Halla General Hospital, Jeju 63127, Republic of Korea;
| | - Sang-Chul Kim
- Department of Emergency Medicine, Chungbuk National University College of Medicine, Cheongju 28644, Republic of Korea;
| | - YeonWoo Kim
- Department of Emergency Medicine, Andong Medical Center, Andong 36743, Republic of Korea;
| | - JaeHyuk Kim
- Department of Emergency Medicine, Mokpo Hangook Hospital, Mokpo 58643, Republic of Korea;
| | - Hyun Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea;
| | - HyungIl Kim
- Department of Emergency Medicine, Dankook University College of Medicine, Cheonan 31116, Republic of Korea;
| | - TaeHun Lee
- Department of Emergency Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Republic of Korea;
| | - Chol Kim
- Department of Emergency Medicine, Saint Carollo General Hospital, Suncheon 57931, Republic of Korea;
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Usher K, Jackson D, Peng W, Amarasena S, McCowan D, Miller J, Cashman B, Sibbritt D. Mental health and use of Medicare Benefits Schedule follow-up mental health services by Indigenous people in Australia during the COVID-19 pandemic. Front Public Health 2023; 11:1190484. [PMID: 37670830 PMCID: PMC10475934 DOI: 10.3389/fpubh.2023.1190484] [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: 03/21/2023] [Accepted: 07/28/2023] [Indexed: 09/07/2023] Open
Abstract
Background Mental health care has declined during the COVID-19 pandemic as has attendance for preventive mental health health services. This study aimed to investigate trends in all types of mental health service claims identified in an Indigenous-specific health assessment for Indigenous people before and during COVID-19. Methods We conducted an analysis of Medicare Benefits Scheme (MBS) mental health service items (Items 81,325 and 81,355), to investigate the trends in all types of mental health service claims specifically intended for Indigenous people of Australia. Data were analysed using descriptive statistics, including the total annual numbers of Indigenous peoples' mental health service claims cross-tabulated by age groups and gender, between the calendar years 2017-2021. Multivariable Poisson regression modelling was used to determine associations that were statistically significant. Results Our results indicate an overall rise in MBS claims for mental health follow-up services during 2019-2020 followed by a decline in 2020-2021. In addition, there was an overall decline in claims for follow-up psychology services across the time period 2019-2021. Conclusion We found a significant decline in MBS items specific to follow-up mental health services (MBS Items 81,325 and 81,355) for Indigenous people in Australia suggesting a decline in attendance for mental health service follow-up which in turn may indicate a deficit in mental health care during the COVID-19 pandemic, an issue that may lead to poorer mental health outcomes in the future. Further research is needed to understand whether these changes were due to the impact of the COVID-19 pandemic or other factors.
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Affiliation(s)
- Kim Usher
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Debra Jackson
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Wenbo Peng
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | | | - Debbie McCowan
- Armajun Health Service Aboriginal Corporation, Inverell, NSW, Australia
| | - Joe Miller
- School of Health, Faculty of Medicine and Health, University of New England, Armidale, NSW, Australia
| | - Belinda Cashman
- Aboriginal Maternal & Infant Health Service, Western Sydney Local Health District, Mount Druitt, NSW, Australia
| | - David Sibbritt
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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