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Nguyen L, Jack SM, Davis H, Bellefeuille S, Arafeh D, Di Rezze B, Ketelaar M, Gorter JW. "Filling in the gap": A qualitative case study about identity construction of siblings of youth with a neurodisability. J Adolesc 2024; 96:1354-1367. [PMID: 38797961 DOI: 10.1002/jad.12353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION In families of children with a neurodisability, siblings have unique experiences that can shape their identity. There is limited information about the developmental process of how siblings form their identity. This study aims to understand the identity construction of young siblings who have a sibling with a neurodisability. METHODS As part of a patient-oriented research program, we engaged with our Sibling Youth Advisory Council in Canada. In this qualitative case study, data from semi-structured interviews augmented by photo elicitation and graphic elicitation of relational maps were analyzed using reflexive thematic analysis. RESULTS Nineteen sibling participants (median age = 19 years, range = 14-33 years) reflected on the uniqueness of their role during childhood. During adolescence and emerging adulthood, they became closer with their sibling with a neurodisability and increased communication with their parents about how to care for their sibling with a neurodisability. These experiences influenced how they explored and began to reconcile their sibling identity with their professional and social identities. CONCLUSION Siblings of youth with a neurodisability discover their unique identity and require support in this developmental process. Future interventions could evaluate how supports for siblings can have an impact on the positive development of their identity.
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Affiliation(s)
- Linda Nguyen
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Susan M Jack
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - Hanae Davis
- Sibling Youth Advisory Council, Hamilton, Ontario, Canada
| | | | - Dana Arafeh
- Sibling Youth Advisory Council, Hamilton, Ontario, Canada
| | - Briano Di Rezze
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Marjolijn Ketelaar
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Jan Willem Gorter
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Pediatrics, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada
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2
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Eridani-Ball B, Brimble MJ. Care of an infant born with a cleft palate: a case study. Nurs Child Young People 2024:e1514. [PMID: 38495018 DOI: 10.7748/ncyp.2024.e1514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 03/19/2024]
Abstract
Orofacial clefts are the most common facial congenital abnormalities in humans. Their management is complex due to a range of immediate and ongoing challenges. These include breathing, feeding, speech, hearing and dental issues. This article uses a case study approach to outline these challenges for a patient who was born with a cleft palate. The case is followed by a discussion of contemporary evidence-based care. The article focuses on family-centred care and multidisciplinary teamwork, and the author also details the central role of the children's nurse.
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3
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Berger U, Lebowitz E. Parent training for dependent, yet abled, young adults. Bull Menninger Clin 2022; 86:249-281. [PMID: 36047938 DOI: 10.1521/bumc.2022.86.3.249] [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] [Indexed: 11/20/2022]
Abstract
The term Failure to launch (FTL) has been used to describe abled adults who do not work, do not attend school, and live with- and at the expense of-their parents. FTL can be beneficially addressed through parent training, a treatment method that is rarely used with adults (i.e., individuals past the age of majority). The authors first review the goals of parent training programs offered to parents of adults. The review demonstrates that these goals dovetail with key aspects of FTL. The authors then describe a new parent training approach for parents of individuals with FTL, based on SPACE (Supportive Parenting for Anxious Childhood Emotions). They highlight five key components of SPACE-FTL: Psychoeducation, Reducing Parental Accommodation, Increasing Parental Support, De-Escalation, and Engaging Supporters. The authors conclude by discussing SPACE-FTL in relation and comparison to other parent training programs and their components.
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Affiliation(s)
- Uri Berger
- Anxiety and Mood Disorders Program, Child Study Center, Yale University, New Haven, Connecticut
| | - Eli Lebowitz
- Anxiety and Mood Disorders Program, Child Study Center, Yale University, New Haven, Connecticut
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4
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Sturgiss EA, Peart A, Richard L, Ball L, Hunik L, Chai TL, Lau S, Vadasz D, Russell G, Stewart M. Who is at the centre of what? A scoping review of the conceptualisation of 'centredness' in healthcare. BMJ Open 2022; 12:e059400. [PMID: 35501096 PMCID: PMC9062794 DOI: 10.1136/bmjopen-2021-059400] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES We aimed to identify the core elements of centredness in healthcare literature. Our overall research question is: How has centredness been represented within the health literature published between 1990 and 2019? METHODS A scoping review across five databases (Medline (Ovid), PsycINFO, CINAHL, Embase (Ovid) and Scopus; August 2019) to identify all peer-reviewed literature published since 1990 that focused on the concept of centredness in any healthcare discipline or setting. Screening occurred in duplicate by a multidisciplinary, multinational team. The team met regularly to iteratively develop and refine a coding template that was used in analysis and discuss the interpretations of centredness reported in the literature. RESULTS A total of 23 006 title and abstracts, and 499 full-text articles were screened. A total of 159 articles were included in the review. Most articles were from the USA, and nursing was the disciplinary perspective most represented. We identified nine elements of centredness: Sharing power; Sharing responsibility; Therapeutic relationship/bond/alliance; Patient as a person; Biopsychosocial; Provider as a person; Co-ordinated care; Access; Continuity of care. There was little variation in the concept of centredness no matter the preceding word (eg, patient-/person-/client-), healthcare setting or disciplinary lens. Improving health outcomes was the most common justification for pursuing centredness as a concept, and respect was the predominant driving value of the research efforts. The patient perspective was rarely included in the papers (15% of papers). CONCLUSIONS Centredness is consistently conceptualised, regardless of the preceding word, disciplinary lens or nation of origin. Further research should focus on centring the patient perspective and prioritise research that considers more diverse cultural perspectives.
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Affiliation(s)
- Elizabeth Ann Sturgiss
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Annette Peart
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Lauralie Richard
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
| | - Lauren Ball
- Menzies Health Institute Queensland, Griffith University,School of Public Health, Southport, Queensland, Australia
| | - Liesbeth Hunik
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tze Lin Chai
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia
| | - Steven Lau
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
| | - Danny Vadasz
- Health Issues Centre, Melbourne, Victoria, Australia
| | - Grant Russell
- Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Moira Stewart
- Department of Family Medicine, Centre for Studies in Family Medicine, Western University, London, Ontario, Canada
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5
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Bradshaw J, Siddiqui N, Greenfield D, Sharma A. Kindness, Listening, and Connection: Patient and Clinician Key Requirements for Emotional Support in Chronic and Complex Care. J Patient Exp 2022; 9:23743735221092627. [PMID: 35434291 PMCID: PMC9008851 DOI: 10.1177/23743735221092627] [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] [Indexed: 11/16/2022] Open
Abstract
Emotional support for patients is critical for achieving person-centered care. However,
the literature evidences an ongoing challenge in embedding emotional support within
current health services. This study aimed to investigate the strategies to embed emotional
support from the perspectives of patients and clinicians. This is an exploratory
qualitative study that collected data through focus group discussions (FGDs) and
interviews from 11 patients, 2 carers, and 7 clinicians in the multi-disciplinary care
teams in an outpatient complex and chronic care setting in New South Wales, Australia. The
FGDs and interviews were recorded, transcribed, and thematically analyzed. Three main
themes emerged from the experience of both the patients and clinicians: (1) warmth and
kindness, (2) deep listening, and (3) social connection in the process of treatment.
Clinicians’ and patients’ shared experience of these themes was key to embed emotional
support in care. Practical strategies including promoting shared understanding of
emotional support, enhancing provider's capability to deliver emotional support, and
building patient's networking opportunities in treatment processes were discussed to
facilitate emotional support in patient care and health services.
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Affiliation(s)
- Jane Bradshaw
- University of Tasmania, Health Service Management School of Business & Economics, Sydney, Australia
- Be Pain Smart Service, Royal Rehab, Ryde, Australia
| | - Nazlee Siddiqui
- University of Tasmania, Health Service Management School of Business & Economics, Sydney, Australia
| | - David Greenfield
- UNSW Simpson Centre for Health Services Research, Sydney, Australia
- University of New South Wales Southwestern Sydney Clinical School, Liverpool, Australia
| | - Anita Sharma
- Nepean Blue Mountains Local Health District, Western Sydney, Australia
- Nepean Clinical School, University of Sydney, Sydney, Australia
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6
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Feldthusen C, Forsgren E, Wallström S, Andersson V, Löfqvist N, Sawatzky R, Öhlén J, J Ung E. Centredness in health care: A systematic overview of reviews. Health Expect 2022; 25:885-901. [PMID: 35261138 PMCID: PMC9122448 DOI: 10.1111/hex.13461] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction The introduction of effective, evidence‐based approaches to centredness in health care is hindered by the fact that research results are not easily accessible. This is partly due to the large volume of publications available and because the field is closely linked to and in some ways encompasses adjoining fields of research, for example, shared decision making and narrative medicine. In an attempt to survey the field of centredness in health care, a systematic overview of reviews was conducted with the purpose of illuminating how centredness in health care is presented in current reviews. Methods Searches for relevant reviews were conducted in the databases PubMed, Scopus, Cinahl, PsychINFO, Web of Science and EMBASE using terms connected to centredness in health care. Filters specific to review studies of all types and for inclusion of only English language results as well as a time frame of January 2017–December 2018, were applied. Results The search strategy identified 3697 unique reviews, of which 31 were included in the study. The synthesis of the results from the 31 reviews identified three interrelated main themes: Attributes of centredness (what centredness is), Translation from theory into practice (how centredness is done) and Evaluation of effects (possible ways of measuring effects of centredness). Three main attributes of centeredness found were: being unique, being heard and shared responsibility. Aspects involved in translating theory into practice were sufficient prerequisites, strategies for action and tools used in safeguarding practice. Further, a variety and breadth of measures of effects were found in the included reviews. Conclusions Our synthesis demonstrates that current synthesized research literature on centredness in health care is broad, as it focuses both on explorations of the conceptual basis and the practice, as well as measures of effects. This study provides an understanding of the commonalities identified in the reviews on centredness in healthcare overall, ranging from theory to practice and from practice to evaluation. Patient or Public Contribution Patient representatives were involved during the initiation of the project and in decisions about its focus, although no patient or public representatives made direct contributions to the review process.
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Affiliation(s)
- Caroline Feldthusen
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Emma Forsgren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Sara Wallström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Viktor Andersson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Noah Löfqvist
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Richard Sawatzky
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,School of Nursing, Trinity Western University, Langley, British Columbia, Canada.,Centre for Health Evaluation and Outcome Sciences, Providence Health Care, Vancouver, British Columbia, Canada
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Eva J Ung
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
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7
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Thunberg G, Johnson E, Bornman J, Öhlén J, Nilsson S. Being heard - Supporting person-centred communication in paediatric care using augmentative and alternative communication as universal design: A position paper. Nurs Inq 2021; 29:e12426. [PMID: 34076320 DOI: 10.1111/nin.12426] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/28/2021] [Accepted: 05/01/2021] [Indexed: 12/30/2022]
Abstract
Person-centred care, with its central focus on the patient in partnership with healthcare practitioners, is considered to be the contemporary gold standard of care. This type of care implies effective communication from and by both the patient and the healthcare practitioner. This is often problematic in the case of the paediatric population, because of the many communicative challenges that may arise due to the child's developmental level, illness and distress, linguistic competency and disabilities. The principle of universal design put forth in conventions and legislation means that the design of products and services should be usable by all people, to the greatest extent possible. Augmentative and alternative communication encompasses strategies, for example pictures and apps, that are typically used with people with communication disability. In this position paper, we argue for the universal use of augmentative and alternative communication to support person-centred communication and care for children, regardless of age or potential disability. Clinical examples are shared from three different paediatric care settings where pictorial supports were applied universally. Interviews were conducted with children and adolescents (with and without disabilities), parents and healthcare practitioners, and the principles of universal design were used as a framework to demonstrate how person-centred communication is supported in paediatric care.
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Affiliation(s)
- Gunilla Thunberg
- Dart Centre for Augmentative and Alternative Communication and Assistive Technology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Speech and Language Pathology Unit, Institute of Neuroscience and Physiology at Sahlgrenska Academy, Gothenburg, Sweden.,Gothenburg Centre for Person-centred Care, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Ensa Johnson
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | - Juan Bornman
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| | - Joakim Öhlén
- Gothenburg Centre for Person-centred Care, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Palliative Centre, Sahlgrenska University Hospital Region Västra Götaland, Gothenburg, Sweden
| | - Stefan Nilsson
- Gothenburg Centre for Person-centred Care, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
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8
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Schlüer AB. Die Essenz der Pädiatrischen Pflege. Pflege 2020; 33:335-336. [PMID: 33236696 DOI: 10.1024/1012-5302/a000772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Anna-Barbara Schlüer
- Pflegeentwicklung & Forschungszentrum für das Kind, Universitäts-Kinderspital Zürich
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9
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Power K, McCrea Z, White M, Breen A, Dunleavy B, O'Donoghue S, Jacquemard T, Lambert V, El-Naggar H, Delanty N, Doherty C, Fitzsimons M. The development of an epilepsy electronic patient portal: Facilitating both patient empowerment and remote clinician-patient interaction in a post-COVID-19 world. Epilepsia 2020; 61:1894-1905. [PMID: 32668026 PMCID: PMC7404863 DOI: 10.1111/epi.16627] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/15/2020] [Accepted: 07/02/2020] [Indexed: 12/13/2022]
Abstract
Objectives The current coronavirus disease 2019 (COVID‐19) pandemic stresses an urgency to accelerate much‐needed health service reform. Rapid and courageous changes being made to address the immediate impact of the pandemic are demonstrating that the means and technology to enable new models of health care exist. For example, innovations such as electronic patient portals (ePortal) can facilitate (a) radical reform of outpatient care; (b) cost containment in the economically constrained aftermath of the pandemic; (c) environmental sustainability by reduction of unnecessary journeys/transport. Herein, the development of Providing Individualised Services and Care in Epilepsy (PiSCES), an ePortal to the Irish National Epilepsy Electronic Patient Record, is demonstrated. This project, which pre‐dates the COVID‐19 crisis, aims to facilitate better patient‐ and family‐centered epilepsy care. Methods A combination of ethnographic research, document analysis, and joint application design sessions was used to elicit PiSCES requirements. From these, a specification of desired modules of functionality was established and guided the software development. Results PiSCES functional features include “My Epilepsy Care Summary,” “My Epilepsy Care Goals,” “My Epilepsy Clinic Letters,” “Help Us Measure Your Progress,” “Prepare For Your Clinic Visit,” “Information for Your Healthcare Provider.” The system provides people with epilepsy access to, and engages them as co‐authors of, their own medical record. It can promote improved patient‐clinician partnerships and facilitate patient self‐management. Significance In the aftermath of COVID‐19, it is highly unlikely that the healthcare sector will return to a “business as usual” way of delivering services. The pandemic is expected to accelerate adoption of innovations like PiSCES. It is therefore a catalyst for change that will deliver care that is more responsive to individual patient needs and preferences.
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Affiliation(s)
- Kevin Power
- Future Neuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Zita McCrea
- Future Neuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Maire White
- Future Neuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Annette Breen
- Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | | | | | - Tim Jacquemard
- Future Neuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Veronica Lambert
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Hany El-Naggar
- Future Neuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Neurology, Beaumont Hospital, Dublin, Ireland.,School of Pharmacy and Biomolecular Sciences (PBS), The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Norman Delanty
- Future Neuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Neurology, Beaumont Hospital, Dublin, Ireland.,School of Pharmacy and Biomolecular Sciences (PBS), The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Colin Doherty
- Future Neuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Neurology, St. James's Hospital, Dublin, Ireland
| | - Mary Fitzsimons
- Future Neuro SFI Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.,School of Pharmacy and Biomolecular Sciences (PBS), The Royal College of Surgeons in Ireland, Dublin, Ireland
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10
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Campbell J, Theodoros D, Hartley N, Russell T, Gillespie N. Implementation factors are neglected in research investigating telehealth delivery of allied health services to rural children: A scoping review. J Telemed Telecare 2019; 26:590-606. [PMID: 31216211 DOI: 10.1177/1357633x19856472] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Rural children are likely to benefit from the telehealth delivery of multidisciplinary allied healthcare. This study aimed to (a) identify the scope of literature describing the telehealth delivery of allied health services to children living in rural areas and (b) understand the extent to which implementation - that is, specific activities designed to put telehealth into practice - has been investigated in such literature. METHODS Systematic scoping review methodology was used to locate studies in which telehealth delivered allied health services to children aged 0-12 who lived rurally (January 1998-January 2018). Two reviewers screened the studies, extracted data and appraised quality with Critical Skills Appraisal Programme checklists. Databases searched were PubMed, MEDLINE, CINAHL, PsycINFO, ERIC and Cochrane Library. RESULTS Data were extracted from 23 papers (two randomised controlled trials, one pseudorandomised controlled trial, one non-randomised experimental trial, two interrupted time series without parallel control groups, 10 case series and seven studies of diagnostic yield). Most were level III (n = 4) or IV (n = 17) when classified according to National Health and Medical Research Council guidelines. One study met all Critical Skills Appraisal Programme quality criteria. Allied healthcare interventions were aimed at improving functioning in communication (n = 10), behaviour and socio-emotional domains (n = 8) and identifying hearing concerns (n = 5). Many studies (n = 12) identified implementation facilitators, largely training and equipment. Only one study referred to an explicit framework for telehealth implementation (user-centred design). DISCUSSION Future research should target occupational therapy, physiotherapy, dietetics and social work, and determine the implementation factors and models likely to create successful telehealth services for this population.
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Affiliation(s)
- Jessica Campbell
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia.,Centre of Research Excellence in Telehealth, Faculty of Medicine, The University of Queensland, Australia
| | - Deborah Theodoros
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia.,Centre of Research Excellence in Telehealth, Faculty of Medicine, The University of Queensland, Australia
| | - Nicole Hartley
- Centre of Research Excellence in Telehealth, Faculty of Medicine, The University of Queensland, Australia.,UQ Business School, The University of Queensland, Australia
| | - Trevor Russell
- School of Health and Rehabilitation Sciences, The University of Queensland, Australia.,Centre of Research Excellence in Telehealth, Faculty of Medicine, The University of Queensland, Australia
| | - Nicole Gillespie
- Centre of Research Excellence in Telehealth, Faculty of Medicine, The University of Queensland, Australia.,UQ Business School, The University of Queensland, Australia
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11
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Meskó B, Radó N, Győrffy Z. Opinion leader empowered patients about the era of digital health: a qualitative study. BMJ Open 2019; 9:e025267. [PMID: 30898816 PMCID: PMC6475254 DOI: 10.1136/bmjopen-2018-025267] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/14/2019] [Accepted: 02/11/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES We aimed to explore the opinion leader empowered patients' relationship with their medical professionals, their experiences and beliefs about technologies, and how they see the future. We also attempted to determine whether technologies, the access to it or patient empowerment are the main driving forces behind these changes. DESIGN A qualitative interview study analysed with interpretative phenomenological analysis. SETTING All interviews were conducted and recorded individually with the same trained interviewer via a Skype call. PARTICIPANTS The study is based on qualitative, semistructured interviews with 11 opinion leader empowered patients from six countries including UK, USA, Australia, Sweden, South Africa and Ireland. RESULTS We identified four superordinate themes emerging from e-patients' experiences: (1) impact of technology, (2) the meaning of empowerment, (3) the changing physician-patient relationship and (4) expectations for the future. The relationship e-patients have with their physicians is based on efficient communication, proactivity, the desire for asking questions and the use of technologies. The interviews have shown that the rapid development of technology has fundamentally changed the lives of these e-patients, and technology eventually is transforming the physician-patient relationship into a partnership. Regarding the future of the physician-patient partnership, e-patients emphasised that change will rather be cultural than technological. CONCLUSIONS The interviews have shown that cooperation between technology and healthcare is not enough on its own: the most decisive factor is the return of the human touch and reciprocal communication. All of these suggest that technology is an important ally in the 'renaissance of medicine' that starts to treat patients as it should have always had.
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Affiliation(s)
- Bertalan Meskó
- The Medical Futurist Institute, Budapest, Hungary
- Institute of Behavioural Sciences, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Nóra Radó
- The Medical Futurist Institute, Budapest, Hungary
| | - Zsuzsa Győrffy
- The Medical Futurist Institute, Budapest, Hungary
- Institute of Behavioural Sciences, Semmelweis University, Faculty of Medicine, Budapest, Hungary
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