1
|
Gatica JL, Aragón-Caqueo D, Aedo G, Fuenzalida H, Loubies R, Aedo S, Carrasco MF, Sabando V, Cunill C, Letelier MJ. Teledermatology Evaluation and Feedback Systems: A Tool for Improving Care. Healthcare (Basel) 2023; 11:healthcare11111626. [PMID: 37297766 DOI: 10.3390/healthcare11111626] [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: 05/11/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
Chile is a country where teledermatology has been growing exponentially since the implementation of a single national asynchronous teledermatology platform for the public system in December 2018. To ensure the quality of care in teledermatology systems, it is crucial to evaluate the fulfillment of basic specifiers such as ICD-Diagnosis, therapeutic suggestions, and diagnostic suggestions, among others. This article aims to evaluate the teledermatology system of the Chilean public health service by analyzing 243 randomly extracted consultations, representative of the 20,716 electronic consultations performed during 2020. Compliance with basic specifiers is evaluated. From these, fulfillment of core teledermatology functions, such as diagnostic and therapeutic suggestions, is observed in most consultations. There are statistically significant relationships between the patient's destination (primary health center [PHC] or face-to-face referral), pharmacological prescription, coverage of the drug prescribed by the public system, and the education received by the consulting physician. If the consultation is resolved in the PHC, there is a higher chance for pharmacological prescription, prescribing mostly drugs that are covered by the government. This is less likely to occur when patients are referred for face-to-face evaluation. A targeted evaluation of education, pharmacological prescriptions, and their applicability is key to improving the quality of teledermatology systems.
Collapse
Affiliation(s)
- José Luis Gatica
- Hospital Digital, Célula de Teledermatología, Ministerio de Salud de Chile, Santiago 8320218, Chile
| | | | - Gabriel Aedo
- Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago 8320000, Chile
| | - Héctor Fuenzalida
- Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago 8320000, Chile
| | - Rodrigo Loubies
- Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago 8320000, Chile
| | - Sócrates Aedo
- Escuela de Medicina, Facultad de Medicina, Universidad Finis Terrae, Santiago 7501015, Chile
| | - María Francisca Carrasco
- Hospital Digital, Célula de Teledermatología, Ministerio de Salud de Chile, Santiago 8320218, Chile
| | - Vezna Sabando
- Hospital Digital, Célula de Teledermatología, Ministerio de Salud de Chile, Santiago 8320218, Chile
| | - Carolina Cunill
- Hospital Digital, Célula de Teledermatología, Ministerio de Salud de Chile, Santiago 8320218, Chile
| | - María José Letelier
- Hospital Digital, Célula de Teledermatología, Ministerio de Salud de Chile, Santiago 8320218, Chile
| |
Collapse
|
2
|
Alkouri O, Khader Y, Al-Bashaireh A, Al Marzouqi A, Zyoud A, Jarrah M, Khassawneh B, Khamaiseh K, Schultz T. Development of a telemedicine group educational program for patients with heart failure: A delphi study. Heliyon 2023; 9:e14287. [PMID: 36950654 PMCID: PMC10025030 DOI: 10.1016/j.heliyon.2023.e14287] [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: 10/27/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/09/2023] Open
Abstract
Aims Evidence regarding the most effective and feasible videoconferencing group educational program for patients with heart failure is still equivocal. This study aimed to reach consensus about the structure, acceptability, and feasibility of videoconferencing for people with heart failure in Jordan that improves access to healthcare and clinical outcomes. Methods There were two Delphi survey studies of three rounds each. Delphi one survey involved 32 healthcare staff, experienced in heart failure clinical practice and telehealth, to obtain a consensus of opinion on a proposed group videoconferencing program for patients with heart failure. Delphi two involved seven staff of the information technology center, experienced in videoconferencing and using supporting applications, to obtain their consensus on the current capabilities of the healthcare system and patients about information technology. Descriptive statistics were used for each item to determine whether consensus was achieved or not. Items that received 80% disagreement or 80% agreement of participants were not presented for re-rating in the third round, while the items that scored varying degrees of agreement were presented for experts for re-rating. Results In Delphi one a group of items reached consensus regarding structure, factors influencing, and effectiveness of the videoconferencing program. In Delphi two, the findings indicated that videoconferencing modality is applicable and feasible in Jordan. Conclusion This is the first study that addresses the equivocal evidence for the design and implementation of heart failure videoconferencing programs. The framework of the current proposed program can be utilized as a guideline to test or develop a future videoconference program.
Collapse
Affiliation(s)
- Osama Alkouri
- Faculty of Nursing Yarmouk University, Irbid, P.O Box 566, 2116, Jordan
- Corresponding author.
| | - Yousef Khader
- Department of Public Health, Community Medicine, Jordan University of Science and Technology, P.O.Box: 3030, Irbid, 22110, Jordan
| | | | - Amina Al Marzouqi
- College of Health Sciences, Health Services Administration, University of Sharjah, P. O.Box 27272, Sharjah, United Arab Emirates
| | - Amr Zyoud
- Faculty of Nursing, Al-Ahliyya Amman University, Amman, 19328, Jordan
| | - Mohamad Jarrah
- Department of Internal Medicine, Jordan University of Science and Technology, P.O. Box: 3030, Irbid, 22110, Jordan
| | | | | | - Tim Schultz
- Flinders Health and Medical Research Institute, Flinders University, Sturt Road, Bedford Park South Australia 5042, GPO Box 2100, Adelaide, SA, 5001, Australia
| |
Collapse
|
3
|
Shouman S, Emara T, Saber HG, Allam MF. Awareness and attitude of primary healthcare patients towards telehealth in Cairo, Egypt. Curr Med Res Opin 2022; 38:993-998. [PMID: 35404179 DOI: 10.1080/03007995.2022.2065141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Telehealth is delivering health care services remotely from healthcare facilities using telecommunications and virtual technology. Egypt is aiming to reach Universal Health Coverage; this increases the demand for telehealth in routine health services. Telehealth helps in increasing access to areas with no available medical services as patients can be monitored remotely. OBJECTIVE To measure the awareness of telehealth among attendees of primary health care units and their acceptance of applying telehealth. METHODOLOGY This was a cross-sectional study among attendees of primary health units. Ethical issues were considered. RESULTS A sample size was calculated to be 162 and 170 valid Arabic interview questionnaires were filled by attendees. The awareness percentage of telehealth among attendees was 64.7% while the willingness to implement telehealth was 78%. Both awareness and willingness were significantly associated with age groups, residence, socioeconomic status, and presence of computer with internet access. Age, residence, and possession of a PC were the only adjusted predictive factors for knowledge about telehealth among patients in the multivariable analysis. CONCLUSION Large percentages of attendees to primary health care centers are aware of telehealth and are willing to implement it. The major cause of refusal to implement telehealth was ignorance of using telecommunication devices and the desire to be in close contact with the physicians.
Collapse
Affiliation(s)
- Sara Shouman
- Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tamer Emara
- Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba Gamal Saber
- Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Farouk Allam
- Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
4
|
Galavi Z, Montazeri M, Ahmadian L. Barriers and challenges of using health information technology in home care: A systematic review. Int J Health Plann Manage 2022; 37:2542-2568. [DOI: 10.1002/hpm.3492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 02/27/2022] [Accepted: 03/15/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Zahra Galavi
- Department of Health Information Sciences Faculty of Management and Medical Information Sciences Kerman University of Medical Sciences Kerman Iran
| | - Mahdieh Montazeri
- Department of Health Information Sciences Faculty of Management and Medical Information Sciences Kerman University of Medical Sciences Kerman Iran
- Medical Informatics Research Center Institute for Futures Studies in Health Kerman University of Medical Sciences Kerman Iran
| | - Leila Ahmadian
- Department of Health Information Sciences Faculty of Management and Medical Information Sciences Kerman University of Medical Sciences Kerman Iran
| |
Collapse
|
5
|
Molavynejad S, Miladinia M, Jahangiri M. A randomized trial of comparing video telecare education vs. in-person education on dietary regimen compliance in patients with type 2 diabetes mellitus: a support for clinical telehealth Providers. BMC Endocr Disord 2022; 22:116. [PMID: 35501846 PMCID: PMC9063130 DOI: 10.1186/s12902-022-01032-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Compliance to dietary recommendations by patients is the most difficult part of diabetes management. The nature of any educational method is to increase patients' awareness. But the question is, what is the effect of each method and for this purpose a comparative method should be considered. Therefore, this study was conducted to compare the effects of in-person education versus video tele-education on dietary regimen compliance in patients with T2DM. METHODS In this trial, 378 patients with type 2 diabetes mellitus (T2DM) were random allocated into video tele-education, in-person education and control groups. The patients' weight and biochemical parameters were measured before educational programs and three-month later. RESULTS The mean changes of patients' weight, glycemic parameters, and Lipid profiles decreased more in the two educational groups than the control group in a three-month period. There were no significant differences in the all study variables between the in-person and video education groups in post interventions except Total Cholesterol (TC). The pre- and post-intervention changes in the weight, TC, hemoglobin A1c, Triglyceride, and Very Low-density Lipoprotein Cholesterol were significant in both in-person group and video group. None of the educational programs had a significant impact on the Fasting blood sugar, Low-Density Lipoprotein Cholesterol, and High-Density Lipoprotein Cholesterol. DISCUSSION Video tele-education was just as effective as in-person educational method on dietary regimen compliance among patients with T2DM in a three-month period. Therefore, it is recommended to use video tele-education in combination with or as an alternative to the in-person education method. This study provides support for diabetes educator. TRIAL REGISTRATION This investigation was registered in the Iranian Registry of Clinical Trials Center ( IRCT20150302021307N4 ).
Collapse
Affiliation(s)
- Shahram Molavynejad
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojtaba Miladinia
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mina Jahangiri
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| |
Collapse
|
6
|
Shannon MM, Callum SM, Callisaya ML. Uncovering healthcare staff attitudes to the rapid deployment of telehealth in Victoria, 2020-2021: a 12-month telehealth experience. Intern Med J 2022. [PMID: 35289486 DOI: 10.1111/imj.15750] [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: 12/22/2021] [Revised: 03/05/2022] [Accepted: 03/09/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Telehealth was widely adopted in health services during the Covid-19 pandemic. It is unknown what the attitudes and ongoing needs of healthcare staff are after a rapid implementation of telehealth. AIMS To evaluate staff attitudes to telehealth utilisation after a rapid implementation. METHODS A health service-wide bespoke survey was sent to all clinicians, managers, and administration staff in June-July 2021. We evaluated attitudes to (i) telehealth application in the model of care and (ii) the barriers and enablers to use of telehealth. Descriptive statistics were used for quantitative data, and content analysis for the textual data. RESULTS A hundred and thirty-four respondents completed the survey (response rate = 22.5% of healthdirect users (71/315), and = 3.2% of total healthcare staff population). Most commonly, telehealth was identified as being important (78%) and safe (79%) by clinicians; important (100%) and encouraged (88%) by managers. In contrast, telehealth was identified as not the same as face-to-face (56%, 50%); but easy to add to usual work arrangements (43%, 44%) by clinicians and managers, respectively. The most common enablers of telehealth were: (i) having others use the same telehealth platform (74.3%, 100%), and (ii) completing training (68.9%, 72.7%) by clinicians and managers, respectively. The most common barriers were having (i) reliable internet connectivity (39.2%, 45.5%) by clinicians and managers respectively, (ii) the right equipment (clinician 37.8%), and (iii) a private area (managers 36.3%). CONCLUSIONS Despite training and having support from colleagues to implement telehealth, ongoing needs were identified that may promote uptake in specific health settings. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- M M Shannon
- Allied Health Research Translation Lead, Peninsula Health, Monash University
| | - S M Callum
- Telehealth Project Development Coordinator, Peninsula Health
| | - M L Callisaya
- Senior Research Fellow, Peninsula Clinical School, Central Clinical School Monash University
| |
Collapse
|
7
|
Banbury A, Pedell S, Parkinson L, Byrne L. Using the Double Diamond model to co-design a dementia caregivers telehealth peer support program. J Telemed Telecare 2021; 27:667-673. [PMID: 34726994 DOI: 10.1177/1357633x211048980] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aimed to develop a telehealth peer support program for isolated dementia caregivers. This paper reports the co-design process by telehealth and the impact and experiences of participants. The Double Diamond model guided the co-design process, which has four phases, with participants reflecting on their caregiving experiences. Group meetings were recorded, notes compiled with inductive thematic analysis undertaken for phases one to three. Each phase findings were presented to the group for verification and refinement. Semi-structured interviews with participants were completed at the end of the project. Six dementia caregivers were recruited from dispersed locations with diverse characteristics. The process identified eight key topics to be included in a program to be delivered by telehealth. Participants reported the technology did not detract from the co-design and at times aided it, despite some technical problems. All reported high levels of group connectedness, feeling supported and transfer of knowledge and skills. One participant would have liked more understanding of the process. The group continued to meet without professional input for 2.5 years following the completion of the project. Telehealth can be a mechanism to support diverse populations in participating in co-design projects.
Collapse
Affiliation(s)
- Annie Banbury
- Centre for Online Health, The University of Queensland, Australia.,Centre for Health Services Research, The University of Queensland, Australia.,School of Nursing, Midwifery & Social Sciences, 6939Central Queensland University, Australia
| | - Sonja Pedell
- Future Self and Design Living Lab, 3783Swinburne University of Technology, Australia
| | - Lynne Parkinson
- School of Nursing, Midwifery & Social Sciences, 6939Central Queensland University, Australia
| | - Louise Byrne
- School of Management, 5376RMIT University, Australia
| |
Collapse
|
8
|
Shi Y, Ma D, Zhang J, Chen B. In the digital age: a systematic literature review of the e-health literacy and influencing factors among Chinese older adults. JOURNAL OF PUBLIC HEALTH-HEIDELBERG 2021; 31:679-687. [PMID: 34104627 PMCID: PMC8175232 DOI: 10.1007/s10389-021-01604-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/18/2021] [Indexed: 01/25/2023]
Abstract
Aim This study aimed to explore the current status of e-health literacy among Chinese older adults, and to summarize and analyze the related influencing factors. Subject and methods Following the PRISMA Checklist, we searched MEDLINE, CINAHL Complete (EBSCO), PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, WanFang Data, and China Science and Technology Journal Database to identify the relevant literature published between January 2000 and December 2020. The Mixed Methods Assessment Tool (MMAT) was used to appraise the quality of the studies. Results Five articles were included for the systematic review. The results showed that the e-health literacy of Chinese older adults was low. Based on the social-ecological model, the influencing factors at the individual level included age, gender, educational attainment, socioeconomic status, physical and psychological conditions, frequency of internet use, and credibility perception of online health resources; at the interpersonal level, the influencing factors included marital status, being the family carer and being taught how to use internet to find health resources; at the social/community level, influencing factors included language barriers and cultural barriers. Conclusion Current e-health literacy among Chinese older adults is low, which is affected by a number of factors. Medical staff should provide detailed health information with guaranteed accuracy and reliability for elderly people. It is necessary to develop intervention programs tailored to varied educational needs of the elderly with different backgrounds (i.e., age, gender, educational attainment, and socioeconomic status) need to be developed in the near future. Family members are encouraged to teach older adults how to use e-health resource in appropriate ways.
Collapse
Affiliation(s)
- Yuxin Shi
- Wuhan University School of Health Sciences Faculty of Nursing, No. 115 Donghu Road, Wuchang District, Wuhan, Hubei Province 430071 People's Republic of China
| | - Denghui Ma
- Wuhan University School of Health Sciences Faculty of Nursing, No. 115 Donghu Road, Wuchang District, Wuhan, Hubei Province 430071 People's Republic of China
| | - Jun Zhang
- Wuhan University School of Health Sciences Faculty of Nursing, No. 115 Donghu Road, Wuchang District, Wuhan, Hubei Province 430071 People's Republic of China
| | - Bowen Chen
- Sun Yat-sen University School of Public Health, 74 Zhongshan Er Rd, Guangzhou, 510080 China
| |
Collapse
|
9
|
Charles C, Baudinet C, Cambon L, Imbert A, Pons M, Raynard B, Sauveplane D, Aromatario O, Dauchy S. Intervention par visioconférence et dynamique groupale. PSYCHO-ONCOLOGIE 2020. [DOI: 10.3166/pson-2020-0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Recourir à la visioconférence pour proposer des séances d’éducation, de soutien ou de psychothérapie en groupe est une des solutions pour faciliter l’accès aux soins de support. Très peu de données sont disponibles sur les spécificités interactionnelles que pourrait impliquer ce dispositif encore récent. L’article a pour objectif de rendre compte de la démarche de recherche exploratoire visant à construire une grille d’observation pour étudier cette question relationnelle à partir d’un dispositif d’ateliers thématiques collectifs mené en oncologie.
Collapse
|
10
|
Williams M, Barclay Y, Harper L, Marchant C, Seamark L, Hickson M. Feasibility, acceptability and cost efficiency of using webinars to deliver first‐line patient education for people with Irritable Bowel Syndrome as part of a dietetic‐led gastroenterology service in primary care. J Hum Nutr Diet 2020; 33:758-766. [DOI: 10.1111/jhn.12799] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/19/2020] [Accepted: 06/30/2020] [Indexed: 12/13/2022]
Affiliation(s)
- M. Williams
- Community Dietetics Service Somerset NHS Foundation Trust Taunton UK
| | - Y. Barclay
- Community Dietetics Service Somerset NHS Foundation Trust Taunton UK
| | - L. Harper
- Community Dietetics Service Somerset NHS Foundation Trust Taunton UK
| | - C. Marchant
- Community Dietetics Service Somerset NHS Foundation Trust Taunton UK
| | - L. Seamark
- Community Dietetics Service Somerset NHS Foundation Trust Taunton UK
| | - M. Hickson
- Institute of Health and Community University of Plymouth Plymouth UK
| |
Collapse
|
11
|
Banbury A, Parkinson L, Gordon S, Wood D. Implementing a peer-support programme by group videoconferencing for isolated carers of people with dementia. J Telemed Telecare 2020; 25:572-577. [PMID: 31631761 DOI: 10.1177/1357633x19873793] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Carers support programmes are commonly delivered in person, limiting attendance opportunities for rural carers and others who have access barriers. Studies using technology typically use text-based forums rather than real-time technology such as videoconferencing (VC). Delivering home-based carers support programmes by VC may mitigate barriers for accessing support. We report implementation findings for delivering a telehealth peer-support programme for isolated carers of people with dementia. METHODS Participants were recruited through aged care providers, peak bodies and media activities. Inclusion criteria were primary dementia caregiver with Internet access and being socially or geographically isolated. The study design was a staggered randomised waitlist design. Measures included the UCLA Loneliness Scale (ULS-6) and selected scales from the e-Health Literacy Questionnaire. Recruitment activities utilised digital processes. Participants completed a six-week programme delivered by VC. Qualitative data comprised logs detailing administration and IT procedures and difficulties. Post programme, 28 participants undertook semi-structured interviews. Data were analysed using descriptive statistics and thematic analysis. RESULTS There were 16 groups comprising 69 participants located throughout Australia, with 87% using their own devices. Technical issues were few but included connection problems, which were compounded by low digital literacy skills. Qualitative data themes included changing perceptions in using technology, differences in communicating by VC and technical support required. Recruitment activities were time-consuming and would benefit from IT tailored for group-based work. Eight groups continued to meet on a self-organised basis. DISCUSSION Providing peer-support groups using telehealth may have the potential to develop self-sustaining peer networks for isolated caregivers of people with dementia.
Collapse
Affiliation(s)
- Annie Banbury
- CQUniversity, Australia.,Prevention First, Australia.,Centre for Online Health, The University of Queensland, Australia
| | | | | | | |
Collapse
|
12
|
Banbury A, Nancarrow S, Dart J, Gray L, Dodson S, Osborne R, Parkinson L. Adding value to remote monitoring: Co-design of a health literacy intervention for older people with chronic disease delivered by telehealth - The telehealth literacy project. PATIENT EDUCATION AND COUNSELING 2020; 103:597-606. [PMID: 31744701 DOI: 10.1016/j.pec.2019.10.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 08/27/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To co-design, test and evaluate a health literacy, chronic disease self-management and social support intervention for older people delivered by group videoconferencing into the home. METHOD The Telehealth Literacy Project (THLP) was a mixed methods, quasi-experimental, non-randomised trial nested within a telehealth remote monitoring study. An intervention group (n = 52) participated in five, weekly videoconference group meetings lasting for 1.5 h and a control group (n = 60) received remote monitoring only. Outcomes were measured using the nine-scale Health Literacy Questionnaire (HLQ) and two scales of the Health Education Impact Questionnaire (heiQ). Semi-structured interviews and focus group data were thematically analysed. RESULT At 3 month follow-up, univariate analysis identified small effects in the intervention group only, with improved health literacy behaviours (five HLQ scales) and self-management skills (two heiQ scales). ANOVA of HLQ scales indicated no significant differences between the two groups over time indicating a contributing effect of the remote monitoring project. Intervention participants reported improved perception of companionship, emotional and informational support. CONCLUSION The THLP delivered with telemonitoring indicates potential to improve social support and some health literacy factors in older people. PRACTICE IMPLICATIONS Patient education can be delivered by group videoconferencing.
Collapse
Affiliation(s)
- Annie Banbury
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia; Centre for Online Health, The University of Queensland, Brisbane, Australia.
| | - Susan Nancarrow
- School of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
| | - Jared Dart
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Len Gray
- Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Richard Osborne
- Centre for Population Health Research, Deakin University, Melbourne, Australia
| | - Lynne Parkinson
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia; Faculty of Health and Medicine, University of Newcastle, Australia
| |
Collapse
|
13
|
Best P, McConnell T, Davidson G, Badham J, Neill RD. Group based video-conferencing for adults with depression: findings from a user-led qualitative data analysis using participatory theme elicitation. RESEARCH INVOLVEMENT AND ENGAGEMENT 2019; 5:40. [PMID: 31844555 PMCID: PMC6896757 DOI: 10.1186/s40900-019-0173-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/21/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Accessing support services for depression has been historically difficult given the societal stigma that exists regarding the condition. Recent advances in digital technologies continue to be postulated as a potential panacea yet the results from research trials have been mixed with a range of effect sizes. METHODS This article offers a different perspective by presenting a panel of end users (co-researchers) with qualitative interview data (n = 8) taken from a feasibility RCT of a group based video-conferencing service for depressed adults. The co-researcher panel were introduced to a new method of participatory data analysis known as Participatory Theme Elicitation (PTE). This method involves using network analysis techniques to create groupings and visual diagrams in order to support the generation of themes and minimise scientific researcher input/influence. RESULTS Co-researchers reported that while VC based interventions appeared convenient, accessible and relatively low cost - additional training and support should be offered to improve uptake and retention. In addition, co-researchers suggested that further exploration is needed regarding the level of self-awareness one feels in a group based VC environment and whether this facilitates disclosure (through disinhibition) or increases anxiety. CONCLUSION The findings presented here appear to support existing (researcher and academic-led) literature in the field as well as suggest new areas for investigation. By presenting data generated solely by co-researchers, this article also adds to the evidence surrounding participatory analysis methods - particularly the growing need for robust approaches that are accessible and less time-consuming than those currently available. TRIAL REGISTRATION NUMBER NCT03288506 (Clinicaltrials.gov) 20th Sept 2017 https://clinicaltrials.gov/ct2/show/NCT03288506.
Collapse
Affiliation(s)
- Paul Best
- School of Social Sciences Education and Social Work. 6 College Park, Queen’s University Belfast, Belfast, UK
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Royal Victoria Hospital, Queen’s University Belfast, Belfast, UK
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
| | - Tracey McConnell
- School of Social Sciences Education and Social Work. 6 College Park, Queen’s University Belfast, Belfast, UK
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
| | - Gavin Davidson
- School of Social Sciences Education and Social Work. 6 College Park, Queen’s University Belfast, Belfast, UK
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
| | - Jennifer Badham
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Royal Victoria Hospital, Queen’s University Belfast, Belfast, UK
| | - Ruth D. Neill
- School of Social Sciences Education and Social Work. 6 College Park, Queen’s University Belfast, Belfast, UK
- Centre for Evidence and Social Innovation, Queen’s University Belfast, Belfast, UK
| |
Collapse
|
14
|
Ignatowicz A, Atherton H, Bernstein CJ, Bryce C, Court R, Sturt J, Griffiths F. Internet videoconferencing for patient-clinician consultations in long-term conditions: A review of reviews and applications in line with guidelines and recommendations. Digit Health 2019; 5:2055207619845831. [PMID: 31069105 PMCID: PMC6495459 DOI: 10.1177/2055207619845831] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 03/28/2019] [Indexed: 12/18/2022] Open
Abstract
Background The use of internet videoconferencing in healthcare settings is widespread,
reflecting the normalisation of this mode of communication in society and
current healthcare policy. As the use of internet videoconferencing is
growing, increasing numbers of reviews of literature are published. Methods The authors conducted a review of the existing reviews of literature relating
to the use of internet videoconferencing for consultations between
healthcare professionals and patients with long-term conditions in their own
home. The review was followed with an assessment of United Kingdom National
Institute for Health and Clinical Excellence guidelines for patient care in
the context of common long-term illnesses to examine where videoconferencing
could be implemented in line with these recommendations. Results The review of reviews found no formal evidence in favour of or against the
use of internet videoconferencing. Patients were satisfied with the use of
videoconferencing but there was limited evidence that it led to a change in
health outcomes. Evidence of healthcare professional satisfaction when using
this mode of communication with patients was limited. The review of
guidelines suggested a number of opportunities for adoption and expansion of
internet videoconferencing. Implementing videoconferencing in line with
current evidence for patient care could offer support and provide
information on using a communication channel that suits individual patient
needs and circumstances. The evidence base for videoconferencing is growing,
but there is still a lack of data relating to cost, ethics and safety. Conclusions While the current evidence base for internet videoconferencing is equivocal,
it is likely to change as more research is undertaken and evidence
published. With more videoconferencing services added in more contexts,
research needs to explore how internet videoconferencing can be implemented
in ways that it is valued by patients and clinicians, and how it can fit
within organisational and technical infrastructure of the healthcare
services.
Collapse
Affiliation(s)
- Agnieszka Ignatowicz
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.,Warwick Medical School, The University of Warwick, Coventry, United Kingdom
| | - Helen Atherton
- Warwick Medical School, The University of Warwick, Coventry, United Kingdom
| | | | - Carol Bryce
- Warwick Medical School, The University of Warwick, Coventry, United Kingdom
| | - Rachel Court
- Warwick Medical School, The University of Warwick, Coventry, United Kingdom
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Frances Griffiths
- Warwick Medical School, The University of Warwick, Coventry, United Kingdom.,Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
15
|
Gentry MT, Lapid MI, Clark MM, Rummans TA. Evidence for telehealth group-based treatment: A systematic review. J Telemed Telecare 2018; 25:327-342. [DOI: 10.1177/1357633x18775855] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Interest in the use of telehealth interventions to increase access to healthcare services is growing. Group-based interventions have the potential to increase patient access to highly needed services. The aim of this study was to systematically review the available literature on group-based video teleconference services. Methods The English-language literature was searched using Ovid MEDLINE, PubMed, PsycINFO and CINAHL for terms related to telehealth, group therapy and support groups. Abstracts were reviewed for relevance based on inclusion criteria. Multiple study types were reviewed, including open-label, qualitative and randomised controlled trial study designs. Data were compiled regarding participants, study intervention and outcomes. Specific areas of interest were the feasibility of and satisfaction with telehealth technology, as well as the effect of video teleconference delivery on group dynamics, including therapeutic alliance. Results Forty published studies met the inclusion criteria and were included in the review. Six were randomised controlled trials. Among the studies, there was a broad range of study designs, participants, group interventions and outcome measures. Video teleconference groups were found to be feasible and resulted in similar treatment outcomes to in-person groups. However, few studies were designed to demonstrate noninferiority of video teleconference groups compared with in-person groups. Studies that examined group process factors showed small decreases in therapeutic alliance in the video teleconference participants. Conclusions Video teleconference groups are feasible and produce outcomes similar to in-person treatment, with high participant satisfaction despite technical challenges. Additional research is needed to identify optimal methods of video teleconference group delivery to maximise clinical benefit and treatment outcomes.
Collapse
Affiliation(s)
| | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, USA
| | | | | |
Collapse
|
16
|
Banbury A, Nancarrow S, Dart J, Gray L, Parkinson L. Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review. J Med Internet Res 2018; 20:e25. [PMID: 29396387 PMCID: PMC5816261 DOI: 10.2196/jmir.8090] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/10/2017] [Accepted: 11/02/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Group therapy and education and support sessions are used within health care across a range of disciplines such as chronic disease self-management and psychotherapy interventions. However, there are barriers that constrain group attendance, such as mobility, time, and distance. Using videoconferencing may overcome known barriers and improve the accessibility of group-based interventions. OBJECTIVE The aim of this study was to review the literature to determine the feasibility, acceptability, effectiveness, and implementation of health professional-led group videoconferencing to provide education or social support or both, into the home setting. METHODS Electronic databases were searched using predefined search terms for primary interventions for patient education and/or social support. The quality of studies was assessed using the Mixed Methods Appraisal Tool. We developed an analysis framework using hierarchical terms feasibility, acceptability, effectiveness, and implementation, which were informed by subheadings. RESULTS Of the 1634 records identified, 17 were included in this review. Home-based groups by videoconferencing are feasible even for those with limited digital literacy. Overall acceptability was high with access from the home highly valued and little concern of privacy issues. Some participants reported preferring face-to-face groups. Good information technology (IT) support and training is required for facilitators and participants. Communication can be adapted for the Web environment and would be enhanced by clear communication strategies and protocols. A range of improved outcomes were reported but because of the heterogeneity of studies, comparison of these across studies was not possible. There was a trend for improvement in mental health outcomes. Benefits highlighted in the qualitative data included engaging with others with similar problems; improved accessibility to groups; and development of health knowledge, insights, and skills. Videoconference groups were able to replicate group processes such as bonding and cohesiveness. Similar outcomes were reported for those comparing face-to-face groups and videoconference groups. CONCLUSIONS Groups delivered by videoconference are feasible and potentially can improve the accessibility of group interventions. This may be particularly useful for those who live in rural areas, have limited mobility, are socially isolated, or fear meeting new people. Outcomes are similar to in-person groups, but future research on facilitation process in videoconferencing-mediated groups and large-scale studies are required to develop the evidence base.
Collapse
Affiliation(s)
- Annie Banbury
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Australia
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
| | - Susan Nancarrow
- Office of the Deputy Vice Chancellor (Research), Southern Cross University, Lismore, Australia
| | - Jared Dart
- Faculty of Health Sciences, Bond University, Gold Coast, Australia
| | - Leonard Gray
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Lynne Parkinson
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Australia
- School of Medicine and Public Health, Newcastle University, Newcastle, Australia
| |
Collapse
|
17
|
Duan-Porter W, Van Houtven CH, Mahanna EP, Chapman JG, Stechuchak KM, Coffman CJ, Hastings SN. Internet Use and Technology-Related Attitudes of Veterans and Informal Caregivers of Veterans. Telemed J E Health 2017; 24:471-480. [PMID: 29252110 DOI: 10.1089/tmj.2017.0015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Healthcare systems are interested in technology-enhanced interventions to improve patient access and outcomes. However, there is uncertainty about feasibility and acceptability for groups who may benefit but are at risk for disparities in technology use. Thus, we sought to describe characteristics of Internet use and technology-related attitudes for two such groups: (1) Veterans with multi-morbidity and high acute care utilization and (2) informal caregivers of Veterans with substantial care needs at home. MATERIALS AND METHODS We used survey data from two ongoing trials, for 423 Veteran and 169 caregiver participants, respectively. Questions examined Internet use in the past year, willingness to communicate via videoconferencing, and comfort with new technology devices. RESULTS Most participants used Internet in the past year (81% of Veterans, 82% of caregivers); the majority of users (83% of Veterans, 92% of caregivers) accessed Internet at least a few times a week, and used a private laptop or computer (81% of Veterans, 89% of caregivers). Most were willing to use videoconferencing via private devices (77-83%). A majority of participants were comfortable attempting to use new devices with in-person assistance (80% of Veterans, 85% of caregivers), whereas lower proportions were comfortable "on your own" (58-59% for Veterans and caregivers). Internet use was associated with comfort with new technology devices (odds ratio 2.76, 95% confidence interval 1.70-4.53). CONCLUSIONS Findings suggest that technology-enhanced healthcare interventions are feasible and acceptable for Veterans with multi-morbidity and high healthcare utilization, and informal caregivers of Veterans. In-person assistance may be important for those with no recent Internet use.
Collapse
Affiliation(s)
- Wei Duan-Porter
- 1 Center for Chronic Disease Outcomes Research and Section of General Internal Medicine , Minneapolis VA Health Care System, Minneapolis, Minnesota.,2 Department of Medicine, University of Minnesota , Minneapolis, Minnesota
| | - Courtney H Van Houtven
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina.,4 Department of Medicine, Duke University School of Medicine , Durham, North Carolina.,5 Center for the Study of Aging and Human Development, Duke University , Durham, North Carolina
| | - Elizabeth P Mahanna
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina
| | - Jennifer G Chapman
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina
| | - Karen M Stechuchak
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina
| | - Cynthia J Coffman
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina.,6 Department of Biostatistics and Bioinformatics, Duke University Medical Center , Durham, North Carolina
| | - Susan Nicole Hastings
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina.,4 Department of Medicine, Duke University School of Medicine , Durham, North Carolina.,5 Center for the Study of Aging and Human Development, Duke University , Durham, North Carolina.,7 Geriatrics Research, Education and Clinical Center , Durham VA Health Care System, Durham, North Carolina
| |
Collapse
|