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Chen HC, Chang CY, Tsai CH, Hsu WL, Sung WF, Wu YX. Healthcare Outcomes of Patients and Antecedents via Teleophthalmology in Eastern Taiwan during COVID-19. Healthcare (Basel) 2024; 12:1672. [PMID: 39201230 PMCID: PMC11353605 DOI: 10.3390/healthcare12161672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 08/18/2024] [Accepted: 08/19/2024] [Indexed: 09/02/2024] Open
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has caused significant transformations in healthcare. Many countries began the rapid development and adoption of telemedicine to avoid the spread of the pandemic and created an innovative model for healthcare delivery. This study identified the critical antecedents that affected the considered healthcare outcomes via teleophthalmology in Eastern Taiwan during the COVID-19 pandemic. METHODS This study's participants included residents of five towns in Taitung County who had experience with teleophthalmology. This study analyzed the structured questionnaires completed by the participants to validate the proposed research framework. Statistical methods were used to verify the research models, including descriptive statistical analysis, confirmatory factor analysis, and structural equation modeling. The date of this study was from 1 October 2020 to 31 July 2023. RESULTS The results of this study reveal that the average monthly use of teleophthalmology by individuals in rural areas increased annually. Females tended to utilize teleophthalmology services more than males. There were no significant differences across any of the constructs with respect to age or educational level. Additionally, the patients' awareness of healthcare accessibility via and the communication quality of teleophthalmology simultaneously affected teleophthalmology's adoption and service quality, which in turn jointly affected health outcomes. Both healthcare accessibility and communication quality were the antecedents of the healthcare outcomes. The health outcomes refer to the impact of teleophthalmology on the quality of the patients' health and well-being. Additionally, teleophthalmology's adoption and service quality acted as mediators. CONCLUSIONS This study's findings are expected to increase attention to the healthcare outcomes and antecedents of teleophthalmology to promote better telemedicine practices and services for rural residents.
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Affiliation(s)
- Hsing-Chu Chen
- Head Office, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan;
- Department of Public Health, Tzu Chi University, Hualien 970, Taiwan
| | - Ching-Yu Chang
- Medical Affairs Office, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan; (C.-Y.C.); (W.-F.S.); (Y.-X.W.)
| | - Chung-Hung Tsai
- Department of Information Technology and Management, Tzu Chi University, Hualien 970, Taiwan;
| | - Wei-Lin Hsu
- Department of Information Technology and Management, Tzu Chi University, Hualien 970, Taiwan;
| | - Wen-Fang Sung
- Medical Affairs Office, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan; (C.-Y.C.); (W.-F.S.); (Y.-X.W.)
| | - Yu-Xuan Wu
- Medical Affairs Office, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan; (C.-Y.C.); (W.-F.S.); (Y.-X.W.)
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Patra M, Hamiduzzaman M, McLaren H, Siddiquee NA. A Scoping Review of Changes to Patient-Doctor Communication During COVID-19. HEALTH COMMUNICATION 2024; 39:25-48. [PMID: 36522301 DOI: 10.1080/10410236.2022.2152225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Effective communication between patients and doctors is fundamental to high-quality healthcare, patient safety, and overall satisfaction. However, the onset of COVID-19 has prompted significant shifts in communication from in-room and face-to-face interactions to virtual consults. The impact of this pandemic-related change on patient-doctor communication goals, processes, attributes, and environment remains unclear. We undertook a scoping review involving the systematic search of seven academic databases for relevant articles published up to and including June 2021. In total, 47 articles were identified that met the inclusion criteria. We applied the patient-doctor communication framework to guide our deductive thematic analysis of articles included, sorting results from reported studies and position papers into themes and sub-themes. The theme of communication goals highlighted sub-themes related to patient safety, convenience, affordability, and satisfaction; preparation included sub-themes on technology interventions, workforce training, and digital literacy; participant attributes included compassion for doctors and rebuilding trust among patients; and communication process included issues related to telemedicine or video conferencing, challenges with diminished patient privacy, and distractions in the patient's home setting. Finally, the environment theme included insights into doctors' workload, isolation, and anxiety and how changes requiring increases in virtual consults iteratively altered confidence in care provision and communication with patients. Results of the scoping review provide important insights for strengthening virtual patient-doctor interactions, including target areas for training and professional development during and beyond the current pandemic.
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Affiliation(s)
- Mahua Patra
- Department of Sociology, Maulana Azad College, University of Calcutta
| | | | - Helen McLaren
- College of Education, Psychology & Social Work, Flinders University
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Hamlin M, Holmén J, Wentz E, Aiff H, Ali L, Steingrimsson S. Patient Experience of Digitalized Follow-up of Antidepressant Treatment in Psychiatric Outpatient Care: Qualitative Analysis. JMIR Ment Health 2023; 10:e48843. [PMID: 37819697 PMCID: PMC10600645 DOI: 10.2196/48843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Nonadherence to pharmaceutical antidepressant treatment is common among patients with depression. Digitalized follow-up (ie, self-monitoring systems through mobile apps) has been suggested as an effective adjunct to conventional antidepressant treatment to increase medical adherence, improve symptoms of depression, and reduce health care resource use. OBJECTIVE The aim of this study was to determine patients' experience of digitalized follow-up using a mobile app as an adjunct to treatment concurrent with a new prescription, a change of antidepressant, or a dose increase. METHODS This was a qualitative, descriptive study. Patients at 2 psychiatric outpatient clinics were recruited at the time of changing antidepressant medication. After using a mobile app (either a commercial app or a public app) for 4-6 weeks with daily registrations of active data, such as medical intake and questions concerning general mental health status, individual semistructured interviews were conducted. Recorded data were transcribed and then analyzed using content analysis. RESULTS In total, 13 patients completed the study. The mean age was 35 (range 20-67) years, 8 (61.5%) were female, and all reported high digital literacy. Overall, the emerging themes indicated that the patients found the digital app to be a valuable adjunct to antidepressant treatment but with potential for improvement. Both user adherence and medical adherence were positively affected by a daily reminder and the app's ease of use. User adherence was negatively affected by the severity of depression. The positive experience of visually presented data as graphs was a key finding, which was beneficial for self-awareness, the patient-physician relationship, and user adherence. Finally, the patients had mixed reactions to the app's content and requested tailored content. CONCLUSIONS The patients identified several factors addressing both medical adherence and user adherence to a digital app when using it for digitalized follow-up concurrent with the critical time related to changes in antidepressant medication. The findings highlight the need for rigorous evidence-based empirical studies to generate sustainable research results.
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Affiliation(s)
- Matilda Hamlin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Joacim Holmén
- Department of Psychiatry, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Elisabet Wentz
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Harald Aiff
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Lilas Ali
- Department of Psychiatry, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Steinn Steingrimsson
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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Majid U, Wasim A, Truong J, Bakshi S. Public trust in governments, health care providers, and the media during pandemics: A systematic review. JOURNAL OF TRUST RESEARCH 2022. [DOI: 10.1080/21515581.2022.2029742] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Umair Majid
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Aghna Wasim
- Psychology Program, University of Toronto, Toronto, Canada
| | - Judy Truong
- Research & Development, MaRS Discovery Distrust, Toronto, Canada
| | - Simran Bakshi
- Science Program, University of Western Ontario, London, Canada
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O'Reilly-Jacob M, Perloff J, Sherafat-Kazemzadeh R, Flanagan J. Nurse practitioners' perception of temporary full practice authority during a COVID-19 surge: A qualitative study. Int J Nurs Stud 2022; 126:104141. [PMID: 34923317 PMCID: PMC8609748 DOI: 10.1016/j.ijnurstu.2021.104141] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND At the beginning of the COVID-19 pandemic in the United States, 22 state governors temporarily waived physician supervision of nurse practitioners to expand access to health care during the state of emergency. OBJECTIVE We examined the nurse practitioner perception of the simultaneous scope of practice changes and the exigent pandemic demands during the initial COVID-19 surge in Massachusetts. METHODS Qualitative descriptive design using content analysis of open-ended responses to a web-based survey of Massachusetts nurse practitioners conducted in May & June 2020. RESULTS Survey response rate was 40.6 percent (N = 389). Content analysis identified four themes including: 1) State waivers enabled more control over practice and more expedited care, 2) State waiver did not change practice either because of pre-established independence or employers not changing policy, 3) Perception of nurse practitioner role as both versatile and disposable and 4) Telehealth increased access to care and created an autonomous setting. CONCLUSIONS Although findings suggest fewer barriers in some areas, the temporary removal of state-level restrictions alone is not sufficient to achieve immediate full scope of practice for nurse practitioners. There is a need for regulatory frameworks that optimize the capacity of the advanced practice nursing workforce to respond to global health emergencies. US-based policymakers and healthcare organizations should revise outdated scope of practice policies and capitalize on telehealth technology to utilize the full extent of nurse practitioners. Likewise, nursing leaders should be a voice for nurse practitioners to more effectively and safely maximize the nurse practitioner contribution during emergency responses. In countries where the role is under development, regulators can leverage these findings to establish modernized nurse practitioner scope of practice policies from the outset.
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Affiliation(s)
- Monica O'Reilly-Jacob
- Boston College, Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA,Corresponding author
| | - Jennifer Perloff
- Brandeis University, The Heller School for Social Policy and Management, 415 South Street, Waltham, MA, 02454, USA
| | - Roya Sherafat-Kazemzadeh
- Brandeis University, The Heller School for Social Policy and Management, 415 South Street, Waltham, MA, 02454, USA
| | - Jane Flanagan
- Boston College, Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA
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Hamlin M, Ymerson T, Carlsen HK, Dellepiane M, Falk Ö, Ioannou M, Steingrimsson S. Changes in Psychiatric Inpatient Service Utilization During the First and Second Waves of the COVID-19 Pandemic. Front Psychiatry 2022; 13:829374. [PMID: 35250673 PMCID: PMC8891754 DOI: 10.3389/fpsyt.2022.829374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has caused societal restrictions and public fear which may have impacted the pattern of seeking psychiatric care. There has generally been a decrease in the numbers seeking acute psychiatric care. It is important to investigate which groups seeking psychiatric treatment have decreased in number. The aim of our investigation was to identify which groups have a changed pattern in acute psychiatric service utilization during the first two waves of the COVID-19 pandemic. The study investigated changes in the rate and pattern of visits and hospital admissions for psychiatric disorders at a large Swedish hospital. A register-based study was conducted using administrative data on adult psychiatric emergency department visits (PEVs) and hospital admission rates. Data during the first two COVID-19 waves were compared to corresponding control periods in 2018-2019. Furthermore, a survey was performed among patients visiting the Psychiatric Emergency Department on their views of COVID-19 and acute psychiatric care. During the COVID-19 periods, PEVs were reduced overall by 16 and 15% during the first and second wave, respectively (p < 0.001 in both cases), while the rate of admissions remained unaltered. PEVs were significantly reduced for most psychiatric diagnosis subgroups except for patients with schizophrenia and other related psychotic disorders as well as for those who required ongoing outpatient care. Most of the survey respondents disagreed that the pandemic affected their visit and about a quarter thought a video call with a doctor could have replaced their visit. In conclusion, there was a significant reduction in overall PEVs during both COVID-19 waves but this did not affect the numbers requiring admission for psychiatric inpatient care.
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Affiliation(s)
- Matilda Hamlin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thérèse Ymerson
- Region Västra Götaland, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanne Krage Carlsen
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marzia Dellepiane
- Region Västra Götaland, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Örjan Falk
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Michael Ioannou
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Steinn Steingrimsson
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
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Castner J, Bell SA, Hetland B, Der-Martirosian C, Castner M, Joshi AU. National Estimates of Workplace Telehealth Use Among Emergency Nurses and All Registered Nurses in the United States. J Emerg Nurs 2022; 48:45-56. [PMID: 34656361 PMCID: PMC9881547 DOI: 10.1016/j.jen.2021.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/06/2021] [Accepted: 07/06/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The goal of this research was to quantify the baseline status of prepandemic workplace emergency nursing telehealth as a key consideration for ongoing telehealth growth and sustainable emergency nursing care model planning. The purpose of this research was to: (1) generate national estimates of prepandemic workplace telehealth use among emergency and other inpatient hospital nurses and (2) map the geographic distribution of prepandemic workplace emergency nurse telehealth use by state of nurse residence. METHODS We generated national estimates using data from the 2018 National Sample Survey of Registered Nurses. Data were analyzed using jack-knife estimation procedures coherent with the complex sampling design selected as representative of the population and requiring analysis with survey weights. RESULTS Weighted estimates of the 161 865 emergency nurses, compared with 1 191 287 other inpatient nurses revealed more reported telehealth in the workplace setting (49% vs 34%) and individual clinical practice telehealth use (36% vs 15%) among emergency nurses. The geographic distribution of individual clinical practice emergency nurse telehealth use indicates greatest adoption per 10 000 state residents in Maine, Alaska, and Missouri with more states in the Midwest demonstrating emergency nurse adoption of telehealth into clinical practice per population than other regions in the United States. DISCUSSION By quantifying prepandemic national telehealth use, the results provide corroborating evidence to the potential long-term adoptability and sustainability of telenursing in the emergency nursing specialty. The results also implicate the need to proactively define emergency nursing telehealth care model standards of practice, nurse competencies, and reimbursement.
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Staccini P, Lau AYS. Consumer Informatics and COVID-19 Pandemics: Challenges and Opportunities for Research. Yearb Med Inform 2021; 30:210-218. [PMID: 34479392 PMCID: PMC8416219 DOI: 10.1055/s-0041-1726532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Objective:
To summarise the state of the art during the year 2020 in consumer health informatics and education, with a special emphasis on “Managing Pandemics with Health Informatics - Successes and Challenges”.
Methods:
We conducted a systematic search of articles published in PubMed using a predefined set of queries, which identified 147 potential articles for review. These articles were screened according to topic relevance and 15 were selected for consideration of best paper candidates, which were then presented to a panel of international experts for full paper review and scoring. The top five papers were discussed in a consensus meeting. Three papers received the highest score from the expert panel, and these papers were selected to be representative papers on consumer informatics for managing pandemics in the year 2020.
Results:
Bibliometrics analysis conducted on words found in abstracts of the candidate papers revealed 4 clusters of articles, where the clustering outcomes explained 77.04% of the dispersion. The first cluster composed of articles related to the use of mobile apps for video consultation and telehealth during the pandemic. The second revealed studies reporting the lived experience of healthcare workers and patients during COVID-19. The third focused on ways people used the internet to seek for health information during the pandemic and the dissemination of fake news. The last cluster composed of articles reporting the use of social listening methods (e.g., via tweet hashtags) to explore the spread of the virus around the world.
Conclusions:
The pandemic outbreak of the novel coronavirus disease (COVID-19) constitutes a grave risk to the global community and sparks a significant increase in public interest and media coverage, especially on social media. Consumers are facing a new set of challenges that were not considered before COVID-19, often finding themselves in a world that is constantly changing—blended with facts and fake information—and unable to decide what to do next. Despite most people understanding the good will behind public health policies, one must not forget it is individuals we are supporting and that their personal circumstances may affect how they perceive and comply with these policies. Consumers more than ever need help to make sense of the uncertainty and their situation and we need to help them navigate the best option in a world that is constantly evolving.
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Affiliation(s)
- Pascal Staccini
- Département IRIS, URE RETINES, Faculté de Médecine, Université Côte d'Azur, France
| | - Annie Y S Lau
- Center for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Australia
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