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Subramanya V, Spychalski J, Coats S, Gottstein E, Chancellor J, Kulshreshtha A. Empathetic Communication in Telemedicine: A Pilot Study. PRIMER (LEAWOOD, KAN.) 2024; 8:36. [PMID: 38946757 PMCID: PMC11212695 DOI: 10.22454/primer.2024.644242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Background and Objectives In health care, empathy is a clinician's ability to understand a patient's emotional state and convey that understanding in their care; and being culturally sensitive is communicating and respecting cultural differences. Providing health care on digital platforms introduces a new challenge of conveying empathy and cultural sensitivity. This study aimed to evaluate whether patients who were seen in-person had different perceptions of clinicians' empathy and cultural sensitivity compared to those who were seen via telemedicine. Methods In this cross-sectional pilot study, we recruited primary care clinicians (N=8) and their telemedicine (N=14) and in-person patients (N=20) from two clinics at Emory University in Atlanta, Georgia. We evaluated clinicians' empathy and cultural sensitivity by self-report and from patients' standpoints. Results Patient perception of clinician empathy scores were similar (P value=.31) for in-person appointments (mean=33.8) and telemedicine appointments (mean=31.3). Patient perception of culturally sensitive communication varied in the sensitivity domain and was consistently low for the domain of discrimination (suggesting low discrimination among the clinicians) regardless of the modality of the visit. Conclusions This novel pilot study demonstrated comparable empathy and culturally sensitive communication scores in telemedicine and in-person visits, highlighting the potential for continued use of telemedicine in outpatient primary care. Delivery of care via telemedicine can enable an expansion of high-quality care to underserved communities. Future studies are needed to confirm our findings to enhance the experience of telemedicine visits for patients and clinicians.
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Affiliation(s)
- Vinita Subramanya
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Julia Spychalski
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Sarah Coats
- Emory School of Medicine, Emory University, Atlanta, GA
| | | | | | - Ambar Kulshreshtha
- Department of Family and Preventive Medicine Emory University School of Medicine, Atlanta, GA | Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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Pérula-Jiménez C, Romero-Rodríguez E, Fernández-Solana J, Fernández-García JÁ, Parras-Rejano JM, Pérula-de Torres LÁ, González-de la Rubia A, González-Santos J. Primary Care Professionals' Empathy and Its Relationship to Approaching Patients with Risky Alcohol Consumption. Healthcare (Basel) 2024; 12:262. [PMID: 38275543 PMCID: PMC10815215 DOI: 10.3390/healthcare12020262] [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: 12/04/2023] [Revised: 01/05/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
The aim of this study was to estimate the level of empathy among primary care (PC) health professionals and its relationship with their approach to patients at risk due to alcohol consumption. This is an observational, descriptive, and multicenter study that included 80 PHC professionals. The professionals completed a questionnaire comprising socio-occupational questions and inquiries regarding their actions when dealing with patients suspected of risky alcohol consumption. The Jefferson Scale of Empathy was used to measure their level of empathy and was completed by 80 professionals, of whom 57.5% were family physicians, 10% were nurses, and 32.5% were family- and community-medicine residents. The mean age was 39.5 ± 13.1 (SD) (range of 24-65 years) and 71.3% were females. The mean empathy level score was 112.9 ± 11.1 (95% CI: 110.4-115.4; range: 81-132 points). Actions that stood out for their frequency were providing health advice in the general population, offering advice to pregnant women, and recommending abstinence to users of hazardous machinery or motor vehicles. The level of empathy was associated with age (p = 0.029), the health center's scope (p = 0.044), systematic alcohol exploration (p = 0.034), and follow-ups for patients diagnosed with risky consumption (p = 0.037). The mean score obtained indicated a high level of empathy among professionals. Professionals with greater empathy more frequently conducted systematic screening for risky alcohol consumption.
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Affiliation(s)
- Celia Pérula-Jiménez
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14011 Cordoba, Spain; (C.P.-J.); (E.R.-R.); (J.Á.F.-G.)
- Montoro Health Center, Andalusian Health Service, 14600 Cordoba, Spain
| | - Esperanza Romero-Rodríguez
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14011 Cordoba, Spain; (C.P.-J.); (E.R.-R.); (J.Á.F.-G.)
- Cordoba and Guadalquivir Health District, 14001 Cordoba, Spain;
| | | | - José Ángel Fernández-García
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14011 Cordoba, Spain; (C.P.-J.); (E.R.-R.); (J.Á.F.-G.)
- Villarrubia Center, 14005 Cordoba, Spain
| | - Juan Manuel Parras-Rejano
- Cordoba and Guadalquivir Health District, 14001 Cordoba, Spain;
- Huerta de la Reina Health Center, Andalusian Health Service, 14600 Cordoba, Spain
| | - Luis Ángel Pérula-de Torres
- Research Network on Chronicity, Primary Care and Prevention and Health Promotion (RICAPS-ISCIII), 08007 Zaragoza, Spain;
- Program of Preventive Activities and Health Promotion (PAPPS-semFYC), 08009 Barcelona, Spain
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Jilani AQ, Khan A, Saloni S, Kumar S, Singh J, Varma K, Siddiqui MA, Sinha R. Level of patient satisfaction with online psychiatric outdoor services. CONSORTIUM PSYCHIATRICUM 2023; 4:23-32. [PMID: 38249530 PMCID: PMC10795947 DOI: 10.17816/cp5597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/08/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND The COVID-19 global pandemic exposed gaps in the treatment of common physical and mental disorders that had to do with things like lockdowns, poor convenience, fear of contracting COVID, and economic constraints. Hence, to address these treatment gaps while also limiting exposure to the COVID-19 infection, telemedicine in the form of telephone and internet consultations has increasingly become the recourse around the world. Our center adopted this trend and also launched a telepsychiatry initiative in order to better cater to the needs of patients with pre-existing mental health disorders and to ensure regular follow-ups and compliance with prescription regiments. AIM The present study aimed to assess the level of patient satisfaction with the online psychiatric services/telepsychiatry. METHODS The sample consisted of 100 patients with pre-existing mental health disorders. This was a cross-sectional study lasting 6 months. The DigiDoc app by Hospital Information Software (HIS) software, which is used to manage a patients appointment schedule, relevant clinical and lab details, along with follow-up prescriptions, was used to follow the selected patients for the purpose of this study. This software also provides a digital platform for video calls for online consultation. The Client Satisfaction Questionnaires-8 (CSQ-8) was employed to collect patient data for analysis. RESULTS The mean total CSQ-8 score of the study sample was 21.015.80 (832), which corresponds to a low-to-moderate level of satisfaction with online psychiatric services/telepsychiatry. Most patients (45%) reported low satisfaction levels, followed by 37% who reported moderate levels of satisfaction. Only 18% of patients reported higher satisfaction with telepsychiatry. CONCLUSION Despite the psychiatrists ability to provide adequate professional advice and psychoeducation through online psychiatric services, patients level of satisfaction proved moderate-to-low. This suggests a need to design standard protocols and guidelines in the search and provision of consultation services on online psychiatric service platforms that could help enhance patients levels of satisfaction.
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Affiliation(s)
| | - Arish Khan
- Era’s Lucknow Medical College & Hospital
| | | | | | - Jai Singh
- Era’s Lucknow Medical College & Hospital
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Werkmeister B, Haase AM, Fleming T, Officer TN. Global Implications From the Rise and Recession of Telehealth in Aotearoa New Zealand Mental Health Services During the COVID-19 Pandemic: Mixed Methods Study. JMIR Form Res 2023; 7:e50486. [PMID: 37738075 PMCID: PMC10519279 DOI: 10.2196/50486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/19/2023] [Accepted: 08/20/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic accelerated the adoption of telehealth services for remote mental health care provision. Although studies indicate that telehealth can enhance the efficiency of service delivery and might be favored or even preferred by certain clients, its use varied after the pandemic. Once the pandemic-related restrictions eased, some regions curtailed their telehealth offerings, whereas others sustained them. Understanding the factors that influenced these decisions can offer valuable insights for evidence-based decision-making concerning the future of telehealth in mental health services. OBJECTIVE This study explored the factors associated with the uptake of and retreat from telehealth across a multiregional outpatient mental health service in Aotearoa New Zealand. We aimed to contribute to the understanding of the factors influencing clinicians' use of telehealth services to inform policy and practice. METHODS Applying an interpretive description methodology, this sequential mixed methods study involved semistructured interviews with 33 mental health clinicians, followed by a time-series analysis of population-level quantitative data on clinician appointment activities before and throughout the COVID-19 pandemic. The interviews were thematically analyzed, and select themes were reframed for quantitative testing. The time-series analysis was conducted using administrative data to explore the extent to which these data supported the themes. In total, 4,117,035 observations were analyzed between October 1, 2019, and August 1, 2022. The findings were then synthesized through the rereview of qualitative themes. RESULTS The rise and recession of telehealth in the study regions were related to 3 overarching themes: clinician preparedness and role suitability, population determinants, and service capability. Participants spoke about the importance of familiarity and training but noted differences between specialist roles. Quantitative data further suggested differences based on the form of telehealth services offered (eg, audiovisual or telephone). In addition, differences were noted based on age, gender, and ethnicity; however, clinicians recognized that effective telehealth use enabled clinicians' flexibility and client choice. In turn, clinicians spoke about system factors such as telehealth usability and digital exclusion that underpinned the daily functionality of telehealth. CONCLUSIONS For telehealth services to thrive when they are not required by circumstances such as pandemic, investment is needed in telehealth training for clinicians, digital infrastructure, and resources for mental health teams. The strength of this study lies in its use of population-level data and consideration of a telehealth service operating across a range of teams. In turn, these findings reflect the voice of a variety of mental health clinicians, including teams operating from within specific cultural perspectives.
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Affiliation(s)
- Benjamin Werkmeister
- School of Health, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
- Department of Psychological Medicine, University of Otago (Wellington), Wellington, New Zealand
- Te Whatu Ora, Wellington, New Zealand
| | - Anne M Haase
- School of Health, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Theresa Fleming
- School of Health, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| | - Tara N Officer
- School of Nursing, Midwifery, and Health Practice, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
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Ghosh A, Mahintamani T, Aswathy PV, Basu D, Mattoo SK, Subodh BN, Pillai RR, Kaur M. Service users' perception and attitude toward telemedicine-based treatment for substance use disorders: A qualitative study from India. Indian J Psychiatry 2023; 65:774-784. [PMID: 37645352 PMCID: PMC10461579 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_167_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/14/2023] [Accepted: 06/28/2023] [Indexed: 08/31/2023] Open
Abstract
Aim We aimed to assess the service user's acceptability, feasibility, and attitude toward telemedicine practice and compare it with in-person consultation in substance use disorder (SUD). Materials and Methods We recruited 15 adult patients with SUD who accessed both telemedicine and in-person care. We conducted in-depth interviews on awareness and access, facilitators and barriers, treatment satisfaction, and therapeutic relationship in the telemedicine context. We performed a conventional content analysis of the interview excerpts and used inductive and deductive coding. We assumed that social, personal, and logistic contexts influence patients' perceptions and experiences with telemedicine-based addiction care (TAC). Results Most participants were middle-aged men (40.5 years, 86.7%), dependent on two or more substances (86.7%), and had a history of chronic, heavy substance use (use ~16 years, dependence ~11.5 years). Patients' perspectives on TAC could broadly be divided into three phases: pre-consultation, consultation, and post-consultation. Patients felt that TAC improved treatment access with adequate autonomy and control; however, there were technical challenges. Patients expressed privacy concerns and feared experiencing stigma during teleconsultation. They reported missing the elaborate inquiry, physical examination, and ritual of visiting their doctors in person. Additionally, personal comfort and technical difficulties determine the satisfaction level with TAC. Overall perception and suitability of TAC and the decision to continue it developed in the post-consultation phase. Conclusion Our study provides an in-depth insight into the barriers and facilitators of telemedicine-based SUD treatment access, use, and retention; it also helps to understand better the choices and preferences for telehealth care vis-à-vis standard in-person care for SUDs.
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Affiliation(s)
- Abhishek Ghosh
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tathagata Mahintamani
- Department of Addiction Medicine,Psychiatry, Lokopriya Gopinath Bordoloi Regional Institute of Mental Health, Tezpur, Assam, India
| | - P. V. Aswathy
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Debasish Basu
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - B. N. Subodh
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Renjith R. Pillai
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manpreet Kaur
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Kister K, Laskowski J, Dybała E, Makarewicz A. Are we ready for Telepsychiatry? Benefits and challenges of digital
psychotherapy. CURRENT PROBLEMS OF PSYCHIATRY 2023. [DOI: 10.12923/2353-8627/2023-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Background: Telemedicine is one of the most modern and fastest-growing branches of medicine. The most common form is video consultation. We distinguish between synchronous and asynchronous telepsychiatry. This study aims to show the benefits of using telepsychiatry services, the challenges it poses to users, and to evaluate its use against traditional therapy.
Materials and methods: A review of literature from 1956-2023 in EMBASE, OpenKnowledge and PubMed databases was conducted. Keywords used were: telepsychiatry, teletherapy, and digital psychiatry. Ninety-eight articles were included.
Discussion: Telepsychiatry is an opportunity for regions affected by medical staff shortages. It bypasses cultural barriers, the problem of traveling and reduces the cost of medical point-of-service. Telepsychiatry is an opportunity for patients who do not use psychiatrists due to discrimination in a conservative society. Groups that may find it challenging include the elderly, the blind, and the deaf. Creating a healthy therapeutic alliance through a screen can be impossible, making it difficult to achieve successful therapy. A barrier to developing telepsychiatry is the need for more guidelines for dealing with medical errors.
Conclusions: Telemedicine can help in accessing specialized care regardless of location. Telepsychiatry provides a safe and anonymous environment for patients reluctant to receive inpatient therapy. The effectiveness of online therapy is primarily debated. Telepsychiatry should be limited to follow-up consultations and well-known patients - it is a form of complementing the diagnosis and treatment process. The authors point to the need for developing specific guidelines for conducting teletherapy with particular attention to the problem of suicide.
Keywords: telepsychiatry, teletherapy, digital psychiatry.
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Affiliation(s)
- Klaudia Kister
- I Departmentof Psychiatry, Psychoterapy and Early Intervention of Medical University in Lublin, Poland - Students Research Group
| | - Jakub Laskowski
- Department of Paediatrician Oncology, Transplantology and Haematology Medical University of Lublin, Poland - Students Research Group
| | | | - Agata Makarewicz
- I Department of Psychiatry, Psychoterapy and Early Intervention, Medical University of Lublin, Poland
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