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Maruthurkkara S. Cochlear Implant Remote Assist: Clinical and Real-World Evaluation. Int J Audiol 2024:1-11. [PMID: 38696614 DOI: 10.1080/14992027.2024.2337075] [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: 03/23/2023] [Accepted: 03/20/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVES To develop and evaluate Cochlear™ Remote Assist (RA), a smartphone-based cochlear implant (CI) teleaudiology solution. The development phase aimed to identify the minimum features needed to remotely address most issues typically experienced by CI recipients. The clinical evaluation phase assessed ease of use, call clarity, system latency, and CI recipient feedback. DESIGN The development phase involved mixed methods research with experienced CI clinicians. The clinical evaluation phase involved a prospective single-site clinical study and real-world use across 16 clinics. STUDY SAMPLE CI clinicians (N = 23), CI recipients in a clinical study (N = 15 adults) and real-world data (N = 57 CI recipients). RESULTS The minimum feature set required for remote programming in RA, combined with sending replacements by post, should enable the clinician to address 80% of the issues typically seen in CI follow-up sessions. Most recipients completed the RA primary tasks without prior training and gave positive ratings for usefulness, ease of use, effectiveness, reliability, and satisfaction on the Telehealth Usability Questionnaire. System latency was reported to be acceptable. CONCLUSION RA is designed to help clinicians address a significant proportion of issues typically encountered by CI recipients. Clinical study and real-world evaluation confirm RA's ease of use, call quality, and responsiveness.
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Affiliation(s)
- Saji Maruthurkkara
- Cochlear Limited, 1 University Ave Macquarie University, Sydney, Australia
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Poh JXY, Chan KH, Tan SSL, Xu T. Occupational therapists' perceptions of the feasibility of using tele-assessment for remote prescription of assistive devices in Singapore: A qualitative study. Work 2024; 77:1153-1163. [PMID: 38007633 DOI: 10.3233/wor-230168] [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: 11/27/2023] Open
Abstract
BACKGROUND Occupational therapists (OT) assess and prescribe assistive devices to older adults with limitations in performing daily living activities. Timely prescription of assistive devices to accommodate the rising demand has been affected by the COVID-19 pandemic. Tele-assessment allows for continuity of care, but its success depends on therapists' acceptance. OBJECTIVE This study examined OTs' perceptions of the feasibility of conducting tele-assessment and developing a clinical practice guideline for remote prescription of assistive devices for older adults in Singapore. METHODS Eligible OTs were recruited from purposive sampling. Semi-structured interviews were conducted via a virtual platform (Zoom). Audio recordings were transcribed verbatim. Inductive thematic analysis using a line-by-line coding method was used to identify common trends. RESULTS Interviews with 10 participants revealed three main themes: (1) therapists' perceptions of the feasibility of tele-assessment, (2) criteria for safe and appropriate prescription of assistive devices via tele-assessment, and (3) practical considerations for the implementation of tele-assessment. Participants felt that tele-assessment increases efficiency with more older adults being more receptive towards technology. They also raised suggestions to address OTs' concerns regarding the safety and accuracy prescription of assistive devices following tele-assessment. This included establishing the client's suitability for assistive device prescription, characteristics of assistive devices, resources required, and considering the preferences of stakeholders involved. CONCLUSION Tele-assessment for assistive device prescription by OTs appears feasible in Singapore. OTs should consider collaborating with other stakeholders to develop a tele-assessment clinical practice guideline for assistive device prescription. Further studies testing its clinical effectiveness during and/or post-pandemic are warranted.
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Affiliation(s)
- Jess Xiu Yi Poh
- Rehabilitation Department, National University Hospital, Singapore
| | - Kuang Hong Chan
- Department of Occupational Therapy, Institute of Mental Health, Singapore
| | - Samantha Si Li Tan
- Department of Occupational Therapy, Singapore General Hospital, Singapore
| | - Tianma Xu
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
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Ju HH, Momin R, Cron S, Jularbal J, Alford J, Johnson C. A Nurse-Led Telehealth Program for Diabetes Foot Care: Feasibility and Usability Study. JMIR Nurs 2023; 6:e40000. [PMID: 37279046 DOI: 10.2196/40000] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/14/2023] [Accepted: 04/30/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Diabetes mellitus can lead to severe and debilitating foot complications, such as infections, ulcerations, and amputations. Despite substantial progress in diabetes care, foot disease remains a major challenge in managing this chronic condition that causes serious health complications worldwide. OBJECTIVE The primary aim of this study was to examine the feasibility and usability of a telehealth program focused on preventive diabetes foot care. A secondary aim was to descriptively measure self-reported changes in diabetes knowledge, self-care, and foot care behaviors before and after participating in the program. METHODS The study used a single-arm, pre-post design in 2 large family medical practice clinics in Texas. Participants met individually with the nurse practitioner once a month for 3 months using synchronous telehealth videoconferencing. Each participant received diabetes foot education guided by the Integrated Theory of Health Behavior Change. Feasibility was measured with rates of enrollment and program and assessment completion. Usability was measured with the Telehealth Usability Questionnaire. Diabetes knowledge, self-care, and foot care behaviors were measured with validated survey instruments at baseline, 1.5 months, and 3 months. RESULTS Of 50 eligible individuals, 39 (78%) enrolled; 34 of 39 (87%) completed the first videoconference and 29 of 39 (74%) completed the second and third videoconferences. Of the 39 who consented, 37 (95%) completed the baseline assessment; 50% (17/34) of those who attended the first videoconference completed the assessment at 1.5 months, and 100% (29/29) of those who attended the subsequent videoconferences completed the final assessment. Overall, participants reported a positive attitude toward the use of telehealth, with a mean Telehealth Usability Questionnaire score of 6.24 (SD 0.98) on a 7-point scale. Diabetes knowledge increased by a mean of 15.82 (SD 16.69) points of 100 (P<.001) from baseline to 3 months. The values for the Summary of Diabetes Self-Care Activities measure demonstrated better self-care, with participants performing foot care on average 1.74 (SD 2.04) more days per week (P<.001), adhering to healthy eating habits on average 1.57 (SD 2.12) more days per week (P<.001), and being physically active on average 1.24 (SD 2.21) more days per week (P=.005). Participants also reported an improvement in the frequency of foot self-examinations and general foot care behaviors. The mean scores for foot care increased by a mean of 7.65 (SD 7.04) points (scale of 7 to 35) from baseline to 3 months postintervention (P<.001). CONCLUSIONS This study demonstrates that a nurse-led telehealth educational program centered on diabetes foot care is feasible, acceptable, and has the potential to improve diabetes knowledge and self-care, which are precursors to preventing debilitating foot complications.
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Affiliation(s)
- Hsiao-Hui Ju
- The University of Texas Health Science Center at Houston Cizik School of Nursing, Houston, TX, United States
| | - Rashmi Momin
- The University of Texas Health Science Center at Houston Cizik School of Nursing, Houston, TX, United States
| | - Stanley Cron
- The University of Texas Health Science Center at Houston Cizik School of Nursing, Houston, TX, United States
| | - Jed Jularbal
- Affiliates of Family Medicine, Spring, TX, United States
| | - Jeffery Alford
- Sweetwater Medical Associates, Sugar Land, TX, United States
| | - Constance Johnson
- The University of Texas Health Science Center at Houston Cizik School of Nursing, Houston, TX, United States
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Boos K, Murphy K, George TS, Brandes J, Hopp J. The impact of a didactic and experiential learning model on health profession students' knowledge, perceptions, and confidence in the use of telehealth. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:232. [PMID: 36177412 PMCID: PMC9514251 DOI: 10.4103/jehp.jehp_1553_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/21/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Training of health profession students in telehealth is important to ensure proper implementation for healthcare delivery. This prospective study aimed to analyze the effects of didactic and experiential learning on knowledge, confidence, and attitudes of telehealth among health profession students (Survey 1). The perceptions of a mixed model telehealth platform were also considered among these students and community clients (Survey 2). MATERIALS AND METHODS A quasi-experimental repeated-measure study was conducted on 153 university health profession students in physician assistant, physical therapy, occupational therapy, and nursing (NR) across the 2020-2021 academic year. Survey 1 was administered to students pre/postdidactic telehealth training and at two sequential points within two semesters of telehealth experiential learning. Survey 2 was distributed among students and a pool of 19 community clients at 4 time points across the experience. Survey data were analyzed using R software. RESULTS There was a significant improvement in telehealth knowledge, confidence, and attitudes among all student disciplines after the didactic module with marginal means ranging 3.313/5-4.318/5 for pretest to posttest 1. Improvement continued through experiential learning with marginal means ranging 4.170/5-4.369/5 in posttest 3. There was also a significant student and client approval of the telehealth platform with a student mean high of 3.962/5 ± 0.527 and client mean high of 4.727/5 ± 0.238. CONCLUSION A didactic training module combined with experiential learning is effective for health profession students' improvement in perception, knowledge, and attitudes toward telehealth. Health profession students and community clients approve a mixed model telehealth platform.
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Affiliation(s)
- Karene Boos
- College of Health Sciences, Carroll University, Waukesha, Wisconsin, USA
| | - Kerri Murphy
- College of Health Sciences, Carroll University, Waukesha, Wisconsin, USA
| | - Thomas St. George
- College of Health Sciences, Carroll University, Waukesha, Wisconsin, USA
| | - James Brandes
- College of Health Sciences, Carroll University, Waukesha, Wisconsin, USA
| | - Jane Hopp
- College of Health Sciences, Carroll University, Waukesha, Wisconsin, USA
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Hofmann G, Hampanda K, Harrison MS, Fasano M, Nacht A, Yeoman M. Virtual Prenatal and Postpartum Care Acceptability Among Maternity Care Providers. Matern Child Health J 2022; 26:1401-1408. [PMID: 35292887 PMCID: PMC8923334 DOI: 10.1007/s10995-022-03412-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 11/29/2022]
Abstract
Introduction The Covid-19 pandemic and statewide stay-at-home orders abruptly impacted clinic operations necessitating the incorporation of telehealth. Uptake of telehealth is multifaceted. Clinician acceptance is critical for success. The aim of this study is to understand maternity care providers’ acceptance of and barriers to providing virtual maternity care. Methods Providers completed a baseline and 3-month follow up survey incorporating the validated implementation outcome measures, feasibility of intervention measure (FIM), intervention appropriateness measure (IAM), and acceptability of intervention measure (AIM).Statistical analyses evaluated differences between groups in this small convenience sample to understand trends in perceptions and barriers to telehealth. While not intended to be a qualitative study, a code tree was used to evaluate open-ended responses. Results Baseline response rate 50.4% (n = 56). Follow-up retention/response-rate 68% (n = 38). Most reported no prior telehealth experience. 94% agreed with the FIM, decreasing to 92% at follow-up. 80% (prenatal) and 84% (postpartum) agreed with the IAM. Agreement with the AIM increased to 83%.Differences in the FIM and AIM found by division (p < 0.01) and years in practice (p < 0.01). Identified barriers included patient lack of essential tools, inadequate clinic support, and patients prefer in person visits. Themes that emerged included barriers, needs, and areas of success. Discussion Telehealth was found to be feasible, appropriate, and acceptable across provider types and divisions. Improving patient/provider access to quality equipment is imperative. Future research must address how and when to incorporate telehealth.
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Affiliation(s)
- Genevieve Hofmann
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 East 17th Avenue, AO1, Room 4213, Mailstop B-198-2, Aurora, CO, 80045, USA.
| | - Karen Hampanda
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 East 17th Avenue, AO1, Room 4213, Mailstop B-198-2, Aurora, CO, 80045, USA
| | - Margo S Harrison
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 East 17th Avenue, AO1, Room 4213, Mailstop B-198-2, Aurora, CO, 80045, USA
| | - Marcella Fasano
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 East 17th Avenue, AO1, Room 4213, Mailstop B-198-2, Aurora, CO, 80045, USA
| | - Amy Nacht
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 East 17th Avenue, AO1, Room 4213, Mailstop B-198-2, Aurora, CO, 80045, USA
| | - Molly Yeoman
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, 12631 East 17th Avenue, AO1, Room 4213, Mailstop B-198-2, Aurora, CO, 80045, USA
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Beit Yosef A, Maeir T, Khalailh F, Gilboa Y. Perceived feasibility of an occupation-based telerehabilitation intervention for older adults with chronic health conditions in Israel. Hong Kong J Occup Ther 2022; 35:62-70. [PMID: 35847184 PMCID: PMC9279877 DOI: 10.1177/15691861221080311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 01/28/2022] [Indexed: 11/16/2022] Open
Abstract
Aims Our study explored the perceived feasibility of using a home-based telerehabilitation
service for older adults with chronic health conditions in Israel. Method This mixed-methods study included two focus groups of registered occupational
therapists (n = 10) working in rehabilitation wards in Israel.
Participants completed an open-ended questionnaire and Likert scale items so that data
could be gathered on their perspectives regarding using an in-home telerehabilitation
service for older adults after discharge from rehabilitation units. Thematic analysis
with an a priori coding approach was applied to the data. Results Perceived advantages included transfer to the natural environment and the overcoming of
geographical distance. Caregiver support and patient motivation were recognized as
enabling factors. Perceived barriers included lack of hands-on contact and the concern
that safety could be impeded by technological challenges and the patients’ cognitive
status. Conclusions Findings from this study can potentially contribute to facilitating the implementation
of a home-based telerehabilitation service as a practical alternative for elderly
patients after discharge from rehabilitation units in Israel.
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Affiliation(s)
- Aviva Beit Yosef
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Talia Maeir
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Fatena Khalailh
- The Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Jerusalem, Israel
| | - Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Almog T, Gilboa Y. Remote Delivery of Service: A Survey of Occupational Therapists’ Perceptions. Rehabil Process Outcome 2022; 11:11795727221117503. [PMID: 36091866 PMCID: PMC9452793 DOI: 10.1177/11795727221117503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/17/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Telehealth has been declared an accepted method of occupational therapy (OT) service delivery and has been shown to be effective. However, studies done before the outbreak of coronavirus disease (COVID-19) show that most occupational therapists didn’t use it. Aim: The aim of this exploratory study was to examine the perceptions of occupational therapists regarding remote delivery of service following the COVID-19 outbreak. Material and methods: An online survey, including 11-item five-point Likert scale, and 2 open-ended questions were distributed to occupational therapists. Results: Responses were received from 245 Israeli occupational therapists. The majority of the participants (60%) strongly agreed that remote delivery allows an ecological and effective intervention, while 76% strongly agreed that an ideal treatment is one that would combine telehealth with in-person intervention. Qualitative findings indicated that the most significant advantage was providing care in the natural environment and improving accessibility to the service. The most salient barriers were limitations of the therapeutic relationship and threats on clinical reasoning. Conclusion: The study results highlight the complexity of telehealth. Findings indicate that overall occupational therapists perceive remote care as an effective and legitimate service delivery method that cannot be used as an alternative to in-person treatment. These findings can help in developing intervention programs for remote treatment, and their implementation.
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Affiliation(s)
- Tehila Almog
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
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Ragheb JW, Kountanis JA, Shilling BA, Cassidy R, McKinney AM, Pancaro C. Retrospective study evaluating telehealth antenatal anesthesia consults for high-risk obstetric patients. J Matern Fetal Neonatal Med 2021; 35:8836-8843. [PMID: 34806512 DOI: 10.1080/14767058.2021.2005566] [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: 10/19/2022]
Abstract
BACKGROUND Telehealth has gained popularity, particularly in the COVID-19 era. The use of telehealth is now being applied to preoperative evaluation clinics in an effort to overcome barriers to antenatal anesthesia assessment of high-risk obstetrical patients. OBJECTIVES The objective of this study is to determine if the quality of antenatal anesthesia telehealth consults of high-risk obstetric patients is comparable to in-person encounters. This is determined by assessing if telehealth consults are feasible and meet the standards of care, as well as the level of patient satisfaction and ease of use as reported by providers. STUDY DESIGN This retrospective study assessed patients prior to delivery who completed a video-telehealth anesthesia consultation (51 cases) from November 1st, 2019 to November 30th, 2020 and all of those for patients receiving an in-person anesthesia consultation (171 controls) from November 2017 through October 2019. Our primary hypothesis was that telehealth and in-person consultations would not result in different standards of care. The primary outcome was an indicator of meeting the standard of care, and the difference in proportions between the telehealth and in-person consultation was tested by Fisher's exact test. Our secondary hypotheses were that patients reported high levels of satisfaction and could use telehealth easily and providers could use the platform easily. Secondary outcomes were assessed by using the Consultation and Relational Empathy (CARE) and the Telehealth Usability Questionnaire (TUQ) surveys, respectively. RESULTS For the primary outcome, 94.1% (48/51) of telehealth and 89.5% (153/171) of in-person visits met the standard of care, indicating no significant difference between groups (p-value = .4204). The CARE score was 46 [41,50] {median [interquartile range]}, (p-value < .0001), indicating patient satisfaction with telehealth. The use-average scores on the TUQ for the patient and provider were 6.67 [6.33, 7] and 6 [5.33, 7] respectively, indicating great system usability. CONCLUSION This study demonstrates no significant difference in the standard of care between in-person and telehealth visits. Furthermore, telehealth consultation was feasible and associated with high patient satisfaction and platform usability. Preoperative consultation of high-risk obstetric patients using telehealth visits should be routinely considered in clinical practice.Condensation: There is no significant difference in the standard of care between in-person and telehealth antenatal anesthesia consultations, and patients report high satisfaction and platform usability.Telehealth is gaining popularity, but its role in antenatal anesthesia consultation of high risk obstetrical patients has not yet been defined with respect to standard of care, patient satisfaction, and platform usability.There was no significant difference in standard of care between in-person and telehealth antenatal anesthesia consultations, and patients reported high satisfaction and platform usability.Telehealth should be considered as an alternative to in-person antenatal anesthesia consultation of high risk obstetrical patients. It is a particularly attractive alternative to in-person consultation due to cost-savings, increased patient accessibility, and ease of use.
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Affiliation(s)
| | - Joanna A Kountanis
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | | | - Ruth Cassidy
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Amy M McKinney
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Carlo Pancaro
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
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Serwe KM, Walmsley ALE. The effectiveness of telehealth for a caregiver wellness program. J Telemed Telecare 2021:1357633X21994009. [PMID: 34233538 DOI: 10.1177/1357633x21994009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study compared outcomes of a telehealth and in-person delivered caregiver wellness program called Powerful Tools for Caregivers (PTC). METHODS A total of 11 pairs of PTC class leaders delivered in-person and telehealth PTC classes. Caregiver participants completed a health-related questionnaire one week before, one week after, and six months after completing the program. A split-plot, mixed-design analysis of variance (ANOVA) and t tests were used to examine attendance and health-related outcome measures: depression as measured by the Center for Epidemiological Studies Depression Scale-Revised (CESD-R), caregiver experience as measured by the Bakas Caregiving Outcomes scale (BCOS), caregiver self-efficacy, and number of negative self-care behaviors. RESULTS A total of 72 caregivers attended PTC in-person and 42 attended via telehealth.Mean attendance was 4.97 ± 1.21 for the in-person group and 5.21 ± 0.071 for the telehealth group, with no significant difference between delivery formats t(112) = 1.074, p = 0.285; 23 caregivers completed all three assessment periods for ANOVA. Interaction of group and time was non-significant for all outcome measures and the main effect of group was only significant for CESD-R scores at pre-PTC assessment, indicating that there were no differences between the two delivery formats for outcomes at post test or six months. The effect of time was significant for all outcome measures, indicating both in-person and telehealth participants improved on health-related outcomes over time. DISCUSSION Telehealth is an effective delivery format for PTC - a traditionally in-person caregiver wellness program. This trial was registered [ClinicalTrials.gov identifier: NCT03800238].
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Affiliation(s)
- Katrina M Serwe
- Occupational Therapy, Concordia University Wisconsin, Mequon, WI, USA
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Weaver MS, Lukowski J, Wichman B, Navaneethan H, Fisher AL, Neumann ML. Human Connection and Technology Connectivity: A Systematic Review of Available Telehealth Survey Instruments. J Pain Symptom Manage 2021; 61:1042-1051.e2. [PMID: 33068709 PMCID: PMC7556265 DOI: 10.1016/j.jpainsymman.2020.10.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/03/2020] [Accepted: 10/09/2020] [Indexed: 12/20/2022]
Abstract
CONTEXT The current upsurge in telehealth use in palliative and hospice care warrants consideration of patient, family caregiver, and interdisciplinary palliative perspectives on telehealth modality and communication experiences. Currently, telehealth experiences and encounters are being described but not yet extensively evaluated by palliative care teams. OBJECTIVES To locate survey instruments available to assess telehealth interactions, to determine the content and constructs covered by the available instruments, and to describe the patient populations previously surveyed by the existing instruments. METHODS This study and its reporting followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with the protocol registered in The International Prospective Register of Systematic Reviews. Three databases were searched with over 3100 articles analyzed for use of a telehealth survey instrument. RESULTS Twelve telehealth communication assessment instruments were identified with a mean length of 20 questions, primarily Likert-scale responses with one inclusive of free text and one qualitative inquiry survey. Three inquired only into modality, four queried communication, and five studied both modality and communication experience. Existing telehealth survey instruments are unidirectional in exploring patient or family experience, with two inclusive of provider perspectives. Participant demographics are notably underreported in telehealth experience studies with a frank lack of diversity in ethnic/racial, geographic, age, educational, and income representativeness in current telehealth survey instrument respondents. CONCLUSION Palliative care teams may consider familiarity with telehealth survey instrument as an essential component to progress from description of telehealth use to evaluation of telehealth encounters. Current survey instrument outcome reports do not represent inclusivity or diversity, although telehealth is now being clinically applied across settings.
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Affiliation(s)
- Meaghann S Weaver
- Division of Pediatric Palliative Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, Nebraska, USA.
| | - Joe Lukowski
- Division of Pediatric Palliative Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, Nebraska, USA
| | - Brittany Wichman
- Division of Pediatric Palliative Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, Nebraska, USA
| | - Hema Navaneethan
- Division of Pediatric Palliative Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, Nebraska, USA
| | - Alfred L Fisher
- Division of Geriatrics, Gerontology, and Palliative Care, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Marie L Neumann
- Division of Pediatric Palliative Care, Department of Pediatrics, Children's Hospital and Medical Center, Omaha, Nebraska, USA
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Perspectives of Registered Dietitian Nutritionists on Adoption of Telehealth for Nutrition Care during the COVID-19 Pandemic. Healthcare (Basel) 2021; 9:healthcare9020235. [PMID: 33672179 PMCID: PMC7926532 DOI: 10.3390/healthcare9020235] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 02/08/2023] Open
Abstract
Widespread transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has resulted in a global coronavirus disease 2019 (COVID-19) pandemic that is straining medical resources worldwide. In the United States (US), hospitals and clinics are challenged to accommodate surging patient populations and care needs while preventing further infection spread. Under such conditions, meeting with patients via telehealth technology is a practical way to help maintain meaningful contact while mitigating SARS-CoV-2 transmission. The application of telehealth to nutrition care can, in turn, contribute to better outcomes and lower burdens on healthcare resources. To identify trends in telehealth nutrition care before and during the pandemic, we emailed a 20-question, qualitative, structured survey to approximately 200 registered dietitian nutritionists (RDNs) from hospitals and clinics that have participated in the Malnutrition Quality Improvement Initiative (MQii). RDN respondents reported increased use of telehealth-based care for nutritionally at-risk patients during the pandemic. They suggested that use of such telehealth nutrition programs supported positive patient outcomes, and some of their sites planned to continue the telehealth-based nutrition visits in post-pandemic care. Nutrition care by telehealth technology has the potential to improve care provided by practicing RDNs, such as by reducing no-show rates and increasing retention as well as improving health outcomes for patients. Therefore, we call on healthcare professionals and legislative leaders to implement policy and funding changes that will support improved access to nutrition care via telehealth.
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Hajesmaeel-Gohari S, Bahaadinbeigy K. The most used questionnaires for evaluating telemedicine services. BMC Med Inform Decis Mak 2021; 21:36. [PMID: 33531013 PMCID: PMC7852181 DOI: 10.1186/s12911-021-01407-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/25/2021] [Indexed: 12/13/2022] Open
Abstract
Background Questionnaires are commonly used tools in telemedicine services that can help to evaluate different aspects. Selecting the ideal questionnaire for this purpose may be challenging for researchers. This study aims to review which questionnaires are used to evaluate telemedicine services in the studies, which are most common, and what aspects of telemedicine evaluation do they capture. Methods The PubMed database was searched in August 2020 to retrieve articles. Data extracted from the final list of articles included author/year of publication, journal of publication, type of evaluation, and evaluation questionnaire. Data were analyzed using descriptive statistics. Results Fifty-three articles were included in this study. The questionnaire was used for evaluating the satisfaction (49%), usability (34%), acceptance (11.5%), and implementation (2%) of telemedicine services. Among telemedicine specific questionnaires, Telehealth Usability Questionnaire (TUQ) (19%), Telemedicine Satisfaction Questionnaire (TSQ) (13%), and Service User Technology Acceptability Questionnaire (SUTAQ) (5.5%), were respectively most frequently used in the collected articles. Other most used questionnaires generally used for evaluating the users’ satisfaction, usability, and acceptance of technology were Client Satisfaction Questionnaire (CSQ) (5.5%), Questionnaire for User Interaction Satisfaction (QUIS) (5.5%), System Usability Scale (SUS) (5.5%), Patient Satisfaction Questionnaire (PSQ) (5.5%), and Technology Acceptance Model (TAM) (3.5%) respectively. Conclusion Employing specifically designed questionnaires or designing a new questionnaire with fewer questions and more comprehensiveness in terms of the issues studied provides a better evaluation. Attention to user needs, end-user acceptance, and implementation processes, along with users' satisfaction and usability evaluation, may optimize telemedicine efforts in the future.
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Affiliation(s)
- Sadrieh Hajesmaeel-Gohari
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Kambiz Bahaadinbeigy
- Gastroenterology and Hepatology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
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Dubin JM, Wyant WA, Balaji NC, Ong WL, Kettache RH, Haffaf M, Zouari S, Santillan D, Autrán Gómez AM, Sadeghi-Nejad H, Loeb S, Borin JF, Gomez Rivas J, Grummet J, Ramasamy R, Teoh JYC. Telemedicine Usage Among Urologists During the COVID-19 Pandemic: Cross-Sectional Study. J Med Internet Res 2020; 22:e21875. [PMID: 33031047 PMCID: PMC7647472 DOI: 10.2196/21875] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/06/2020] [Accepted: 09/24/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Prior to the COVID-19 pandemic, urology was one of the specialties with the lowest rates of telemedicine and videoconferencing use. Common barriers to the implementation of telemedicine included a lack of technological literacy, concerns with reimbursement, and resistance to changes in the workplace. In response to the COVID-19 pandemic declared in March 2020, the delivery of urological services globally has quickly shifted to telemedicine to account for the mass clinical, procedural, and operative cancellations, inadequate personal protective equipment, and shortage of personnel. OBJECTIVE The aim of this study was to investigate current telemedicine usage by urologists, urologists' perceptions on the necessity of in-person clinic appointments, the usability of telemedicine, and the current barriers to its implementation. METHODS We conducted a global, cross-sectional, web-based survey to investigate the use of telemedicine before and after the COVID-19 pandemic. Urologists' perceived usability of telemedicine was assessed using a modified Delphi approach to create questions based on a modified version of the validated Telehealth Usability Questionnaire (TUQ). For the purposes of this study, telemedicine was defined as video calls only. RESULTS A total of 620 urologists from 58 different countries and 6 continents participated in the survey. Prior to COVID-19, 15.8% (n=98) of urologists surveyed were using telemedicine in their clinical practices; during the pandemic, that proportion increased to 46.1% (n=283). Of the urologists without telemedicine experience, interest in telemedicine usage increased from 43.7% (n=139) to 80.8% (n=257) during the COVID-19 pandemic. Among urologists that used telemedicine during the pandemic, 80.9% (n=244) were interested in continuing to use it in their practice. The three most commonly used platforms were Zoom, Doxy.me, and Epic, and the top three barriers to implementing telemedicine were patients' lack of technological comprehension, patients' lack of access to the required technology, and reimbursement concerns. CONCLUSIONS This is the first study to quantify the use, usability, and pervading interest in telemedicine among urologists during the COVID-19 pandemic. In the face of this pandemic, urologists' usage of telemedicine nearly tripled, demonstrating their ability to adopt and adapt telemedicine into their practices, but barriers involving the technology itself are still preventing many from utilizing it despite increasing interest.
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Affiliation(s)
- Justin M Dubin
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - W Austin Wyant
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Navin C Balaji
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - William Lk Ong
- Department of Urology, Penang General Hospital, Penang, Malaysia
| | - Reda H Kettache
- Department of Urology, Bachir Bennacer - Biskra Hospital, Biskra, Algeria
| | - Malik Haffaf
- Department of Urology, EHU 1er Novembre, Oran, Algeria
| | - Skander Zouari
- Urology Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Diego Santillan
- Department of Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Ana Maria Autrán Gómez
- Department of Urology, Hospital Universitario Fundación Jiménez Diaz, Madrid, Spain
- Research Office of Confederacion Americana de Urologia, Buenos Aires, Argentina
| | - Hossein Sadeghi-Nejad
- Department of Urology, Rutgers New Jersey Medical School, Newark, NJ, United States
- Department of Urology, Hackensack Meridian Health, Hackensack, NJ, United States
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs Medical Center, New York City, NY, United States
| | - James F Borin
- Department of Urology, New York University, New York City, NY, United States
| | - Juan Gomez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain
- Department of Urology, Autonomous University of Madrid, Madrid, Spain
| | - Jeremy Grummet
- Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia
| | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Jeremy Y C Teoh
- SH Ho Urology Centre, Prince of Wales Hospital, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
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Knotowicz H, Haas A, Coe S, Furuta GT, Mehta P. Opportunities for Innovation and Improved Care Using Telehealth for Nutritional Interventions. Gastroenterology 2019; 157:594-597. [PMID: 31376397 DOI: 10.1053/j.gastro.2019.04.052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 01/22/2023]
Affiliation(s)
- Holly Knotowicz
- Department of Audiology, Speech-Language Pathology, and Learning Services, Children's Hospital Colorado, Aurora, Colorado
| | - Angela Haas
- Department of Audiology, Speech-Language Pathology, and Learning Services, Children's Hospital Colorado, Aurora, Colorado
| | - Stephanie Coe
- Department of Audiology, Speech-Language Pathology, and Learning Services, Children's Hospital Colorado, Aurora, Colorado
| | - Glenn T Furuta
- Department of Pediatrics, University of Colorado, Children's Hospital Colorado, Digestive Health Institute, Aurora, Colorado
| | - Pooja Mehta
- Department of Pediatrics, University of Colorado, Children's Hospital Colorado, Digestive Health Institute, Aurora, Colorado.
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