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D'souza B, Glover A, Bavor C, Brown B, Dodd RH, Lee JC, Millar J, Miller JA, Zalcberg JR, Serpell J, Ioannou LJ, Nickel B. The impact of delayed diagnosis and treatment due to COVID-19 on Australian thyroid cancer patients: a qualitative interview study. BMJ Open 2024; 14:e069236. [PMID: 38626980 PMCID: PMC11029499 DOI: 10.1136/bmjopen-2022-069236] [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] [Received: 10/23/2022] [Accepted: 03/26/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVES The study aims to investigate the perceptions of patients with thyroid cancer on the potential impact of diagnosis and treatment delays during the COVID-19 pandemic. DESIGN This study involved qualitative semi-structured telephone interviews. The interviews were transcribed verbatim, analysed using the thematic framework analysis method and reported using the Consolidated Criteria for Reporting Qualitative Research. SETTING Participants in the study were treated and/or managed at hospital sites across New South Wales and Victoria, Australia. PARTICIPANTS 17 patients with thyroid cancer were interviewed and included in the analysis (14 females and 3 males). RESULTS The delays experienced by patients ranged from <3 months to >12 months. The patients reported about delays to diagnostic tests, delays to surgery and radioactive iodine treatment, perceived disease progression and, for some, the financial burden of choosing to go through private treatment to minimise the delay. Most patients also reported not wanting to experience delays any longer than they did, due to unease and anxiety. CONCLUSIONS This study highlights an increased psychological burden in patients with thyroid cancer who experienced delayed diagnosis and/or treatment during COVID-19. The impacts experienced by patients during this time may be similar in the case of other unexpected delays and highlight the need for regular clinical review during delays to diagnosis or treatment.
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Affiliation(s)
- Bianka D'souza
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Anthony Glover
- The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- University of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia
- Australian and New Zealand Endocrine Surgeons, St Leonards, New South Wales, Australia
| | - Claire Bavor
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Benjamin Brown
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Rachael H Dodd
- The University of Sydney School of Public Health, Sydney, New South Wales, Australia
- The Daffodil Centre, Kings Cross, New South Wales, Australia
| | - James C Lee
- Department of Surgery, Monash University, Clayton, Victoria, Australia
- Monash University Endocrine Unit, The Alfred Hospital & Monash Health, Melbourne, Victoria, Australia
| | - Jeremy Millar
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
- Radiation Oncology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Julie A Miller
- Endocrine Surgery Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia
- Epworth Hospital Network, Melbourne, Victoria, Australia
| | - John R Zalcberg
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Jonathan Serpell
- Department of Surgery, Monash University, Clayton, Victoria, Australia
- Surgery, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Liane J Ioannou
- Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Brooke Nickel
- The University of Sydney School of Public Health, Sydney, New South Wales, Australia
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Gahungu N, Lan NSR, Gamalath S, Phan J, Bhat V, Spencer R, Hitchen SA, Rankin JM, Dwivedi G, Ihdayhid AR. Telehealth during COVID-19 restrictions in patients with cardiovascular disease: impact on medication prescriptions and patient satisfaction. Intern Med J 2024. [PMID: 38506546 DOI: 10.1111/imj.16378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 03/05/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND AND AIMS Telehealth plays an integral part in healthcare delivery. The impact of telehealth and the COVID-19 pandemic on medication prescribing and patient satisfaction with telehealth in cardiology clinics remains unknown. METHODS A retrospective study of cardiology clinic patients at an Australian tertiary hospital was conducted; 630 patients seen before the COVID-19 pandemic (0.6% telehealth) and 678 during the pandemic (91.2% telehealth) were included. Medication changes, new prescriptions and time to obtaining prescriptions after clinic were compared. To evaluate patients' experiences, cardiology clinic patients reviewed during the pandemic were prospectively invited to participate in an electronic survey sent to their mobile phones. RESULTS The overall rates of medication changes made in the clinic between the prepandemic and the pandemic periods did not differ significantly (26.9% vs 25.8%). Compared with prepandemic, new cardiac medication prescriptions during clinic were significantly less (9.3% vs 2.5%; P < 0.0001) and recommendations to general practitioners (GP) to initiate cardiac medications were significantly more (2.6% vs 9.1%; P < 0.0001). Time to obtaining new prescriptions was significantly longer in the pandemic cohort (median 0 days (range: 0-32) vs 10.5 days (range: 0-231); P < 0.0001). Two hundred forty-three (32.7%) patients participated in the survey; 50% reported that telehealth was at least as good as face-to-face consultations. Most patients (61.5%) were satisfied with telehealth and most (62.9%) wished to see telehealth continued postpandemic. CONCLUSION Telehealth during the COVID-19 pandemic was associated with greater reliance on GP to prescribe cardiac medications and delays in obtaining prescriptions among cardiology clinic patients. Although most patients were satisfied with telehealth services, nearly half of the cardiac patients expressed preference towards traditional face-to-face consultations.
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Affiliation(s)
- Nestor Gahungu
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Nick S R Lan
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Sameera Gamalath
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Jane Phan
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Vikas Bhat
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Rhys Spencer
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Sarah A Hitchen
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - James M Rankin
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Girish Dwivedi
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
- Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia
| | - Abdul Rahman Ihdayhid
- Department of Cardiology, Fiona Stanley Hospital, Perth, Western Australia, Australia
- Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia
- Medical School, Curtin University, Perth, Western Australia, Australia
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Dillon MP, Bishop K, Ridgewell E, Clarke L, Kumar S. Describe the population receiving orthotic/prosthetic services using telehealth in Australia, and their experience and satisfaction: a quantitative and qualitative investigation. Disabil Rehabil 2024; 46:1188-1203. [PMID: 37070568 DOI: 10.1080/09638288.2023.2196094] [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] [Received: 10/25/2022] [Accepted: 03/22/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE Telehealth may help meet the growing demand for orthotic/prosthetic services. Despite the resurgence of telehealth due to COVID-19, there is limited evidence to inform policy and funding decisions, nor guide practitioners. METHODS Participants were adult orthosis/prosthesis users or parents/guardians of child orthosis/prosthesis users. Participants were convenience sampled following an orthotic/prosthetic telehealth service. An online survey included: demographics, Telehealth Usability Questionnaire, and the Orthotic Prosthetic Users Survey - Client Satisfaction with Services. A subsample of participants took part in a semi-structured interview. RESULTS Most participants were tertiary educated, middle-aged, female, and lived in metropolitan or regional centres. Most telehealth services were for routine reviews. Most participants chose to use telehealth given the distance to the orthotic/prosthetic service, irrespective of whether they lived in metropolitan cities or regional areas. Participants were highly satisfied with the telehealth mode and the clinical service they received via telehealth. While orthosis/prosthesis users were highly satisfied with the clinical service received, and the telehealth mode, technical issues affected reliability and detracted from the user experience. Interviews highlighted the importance of high-quality interpersonal communication, agency and control over the decision to use telehealth, and a degree of health literacy from a lived experience of using an orthosis/prosthesis.
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Affiliation(s)
- Michael P Dillon
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, La Trobe University, Bundoora, Australia
| | - Katie Bishop
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, La Trobe University, Bundoora, Australia
| | - Emily Ridgewell
- Australian Orthotic Prosthetic Association, Camberwell, Australia
| | - Leigh Clarke
- Australian Orthotic Prosthetic Association, Camberwell, Australia
| | - Saravana Kumar
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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Emezue CN, Karnik NS, Sabri B, Anakwe A, Bishop-Royse JC, Dan-Irabor D, Froilan AP, Dunlap A, Li Q, Julion W. Mental Telehealth Utilization Patterns Among High School Students from Racial and Ethnic Minority Backgrounds Affected by Violence and Substance Use. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01936-y. [PMID: 38366279 DOI: 10.1007/s40615-024-01936-y] [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: 10/15/2023] [Revised: 01/18/2024] [Accepted: 01/31/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Recent data show high school students from racial and ethnic minority (REM) backgrounds in the United States confront a twofold challenge, marked by the highest rates of firearm-related homicides since 1994 and increased youth substance use. The pandemic increased online and telehealth usage opportunities for at-risk REM youth. Therefore, this study investigated (1) the frequency and prevalence of co-occurring youth violence and substance use among REM adolescents, (2) racial/ethnic, age, and natal sex (as gender data was not collected) differences in patterns and trends in co-occurring youth violence and substance use among REM adolescents, and (3) the relationship between these syndemic issues and REM adolescent mental telehealth use during the pandemic. METHODS Data was sourced from a nationally representative sample of U.S. 9th-12th students (n = 3241) who completed the CDC's 2021 Adolescent and Behavioral Experiences Survey (ABES). Using univariate (frequency distribution), bivariate (Pearson's chi-squared test), and multivariate logistic regression models, we examined seven violence victimization outcomes, four violence perpetration outcomes, two family violence outcomes, and six substance use outcomes and their associations with telehealth use for mental health (dependent variable) among REM adolescents. RESULTS This sample was primarily female (50.7%), Black or African American (48.3%), Hispanic or Latinx (20.6%), and identified as straight or heterosexual (69.5%). The study found significant sex-based differences in violence perpetration/victimization, substance use, and telehealth use for mental health. In general, mental telehealth use was significantly associated with substance use among REM adolescents (cigarette smoking, vaping, alcohol, marijuana, prescription meds, and illicit drug use) (p-value = .001). Mental telehealth use was also significantly associated with all peer and family violence outcomes (p < 0.001). Controlling for covariates, gun carrying was associated with 4.8 times higher odds of using mental telehealth. Students in a physical fight or carrying a weapon (gun, knife, or club) on school property had 2.45 times and 8.09 times the odds of utilizing mental telehealth. Bullied students were 2.5 times more likely to use mental telehealth (p-value < 0.05). Illicit drug use (cocaine, heroin, methamphetamines, and ecstasy) was associated with a higher likelihood of mental telehealth use (AOR = 1.3, p-value = .05). CONCLUSION Our results suggest crucial insights for shaping violence and substance use prevention strategies, with implications for the future of online and telehealth behavioral services. Mental telehealth help-seeking emerges as a crucial avenue for supporting adolescents affected by violence and substance use, especially when they face obstacles to accessing traditional services. It can work in tandem with in-person services to address these challenges.
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Affiliation(s)
- Chuka N Emezue
- Department of Women, Children, and Family Nursing, College of Nursing, Rush University Medical Center, Chicago, USA.
| | - Niranjan S Karnik
- Department of Psychiatry, Institute for Juvenile Research (IJR), University of Illinois Chicago, Chicago, USA
| | - Bushra Sabri
- Johns Hopkins University, School of Nursing, Baltimore, USA
| | - Adaobi Anakwe
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | - Dale Dan-Irabor
- School of Humanities and Social Sciences, University of Missouri Kansas City - Volker Campus, Kansas City, USA
| | - Andrew Paul Froilan
- Faculty Practice and Department of Women, Children, and Family Nursing, Rush University Medical Center, Chicago, USA
| | - Aaron Dunlap
- Department of Women, Children, and Family Nursing, College of Nursing, Rush University Medical Center, Chicago, USA
| | - Qing Li
- University of Mississippi Medical Center, School of Nursing, Jackson, USA
| | - Wrenetha Julion
- Department of Women, Children, and Family Nursing, College of Nursing, Rush University Medical Center, Chicago, USA
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O'Donnell N, Waller J, Marlow L, Anderson NC, McBride E. "Knowing that I had HPV, I literally just shut down": A qualitative exploration of the psychosocial impact of human papillomavirus (HPV) in women living with mental health conditions. Br J Health Psychol 2024; 29:80-94. [PMID: 37658582 DOI: 10.1111/bjhp.12688] [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: 07/22/2022] [Accepted: 08/09/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE Psychological distress after testing positive for human papillomavirus (HPV) at cervical cancer screening is well documented in the general population. However, little is known about the impact of an HPV-positive result on those with pre-existing mental health conditions, who may be at higher risk of experiencing clinically significant distress. This study explored the psychosocial impact of HPV in women with co-morbid mental health conditions, as well as their experience of cervical screening during the COVID-19 pandemic. METHODS Semi-structured telephone interviews were conducted with 22 women aged 27-54 who had tested positive for HPV at routine cervical screening in England, and who reported having at least one mental health condition. Data were analysed using thematic analysis. RESULTS Being informed of an HPV-positive result increased distress and heightened pre-existing psychological challenges. Psychosocial response and duration of HPV-related distress appeared to be influenced by the ability to regulate emotions, number of consecutive HPV-positive results, interactions with health care professionals, and other life stressors. The experience added further complexity to many women's perceptions of self and self-esteem. Women who had received psychological treatment for their mental health condition were best able to self-manage HPV-related distress by applying learned coping skills. CONCLUSIONS Receiving an HPV-positive result at cervical screening appears to be a distressing experience for women with co-morbid mental health conditions. Future hypothesis-driven research is needed to confirm findings and develop effective interventions to reduce psychosocial burden.
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Affiliation(s)
| | - Jo Waller
- School of Cancer and Pharmaceutical Sciences, King's College London (KCL), London, UK
| | - Laura Marlow
- School of Cancer and Pharmaceutical Sciences, King's College London (KCL), London, UK
| | | | - Emily McBride
- Institute of Psychology, Psychiatry and Neuroscience (IoPPN), King's College London (KCL), London, UK
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Liang F, Yang X, Peng W, Zhen S, Cao W, Li Q, Xiao Z, Gong M, Wang Y, Gu D. Applications of digital health approaches for cardiometabolic diseases prevention and management in the Western Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:100817. [PMID: 38456090 PMCID: PMC10920052 DOI: 10.1016/j.lanwpc.2023.100817] [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: 03/12/2023] [Revised: 05/04/2023] [Accepted: 05/23/2023] [Indexed: 03/09/2024]
Abstract
Cardiometabolic diseases (CMDs) are the major types of non-communicable diseases, contributing to huge disease burdens in the Western Pacific region (WPR). The use of digital health (dHealth) technologies, such as wearable gadgets, mobile apps, and artificial intelligence (AI), facilitates interventions for CMDs prevention and treatment. Currently, most studies on dHealth and CMDs in WPR were conducted in a few high- and middle-income countries like Australia, China, Japan, the Republic of Korea, and New Zealand. Evidence indicated that dHealth services promoted early prevention by behavior interventions, and AI-based innovation brought automated diagnosis and clinical decision-support. dHealth brought facilitators for the doctor-patient interplay in the effectiveness, experience, and communication skills during healthcare services, with rapidly development during the pandemic of coronavirus disease 2019. In the future, the improvement of dHealth services in WPR needs to gain more policy support, enhance technology innovation and privacy protection, and perform cost-effectiveness research.
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Affiliation(s)
- Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Xueli Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, 22 Qixiangtai Rd, Tianjin 300070, People's Republic of China
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, 22 Qixiangtai Rd, Tianjin 300070, People's Republic of China
| | - Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, 251 Ningda Road, Xining City 810016, People's Republic of China
- Qinghai Provincial Key Laboratory of Prevention and Control of Glucolipid Metabolic Diseases with Traditional Chinese Medicine, Xining 810008, People's Republic of China
| | - Shihan Zhen
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Wenzhe Cao
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Qian Li
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Zhiyi Xiao
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Mengchun Gong
- Institute of Health Management, Southern Medical University, No. 1023-1063, Shatai South Road, Guangzhou 510515, People's Republic of China
| | - Youfa Wang
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, International Obesity and Metabolic Disease Research Center, Xi'an Jiaotong University, Xi'an 710061, People's Republic of China
| | - Dongfeng Gu
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
- School of Medicine, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
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In de Braekt A, Coolen CM, Maaskant JM, de Man-van Ginkel JM, Eskes AM, Jongerden IP. Views of family members on using video calls during the hospital admission of a patient: A qualitative study. J Adv Nurs 2024. [PMID: 38243625 DOI: 10.1111/jan.16060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 12/11/2023] [Accepted: 01/07/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Utilization of video calls on hospital wards to facilitate involvement of and communication with family members is still limited. A deeper understanding of the needs and expectations of family members regarding video calls on hospital wards is necessary, to identify potential barriers and facilitate video calls in practice. AIM The aim of this study was to explore the views, expectations and needs of a patient's family members regarding the use of video calls between family members, patients and healthcare professionals, during the patient's hospital admission. METHODS A qualitative study was carried out. Semi-structured interviews with family members of patients admitted to two hospitals were conducted between February and May 2022. Family members of patients admitted to the surgical, internal medicine and gynaecological wards were recruited. RESULTS Twelve family members of patients participated. Family members stated that they perceive video calls as a supplemental option and prefer live visits during hospital admission. They expected video calls to initiate additional moments of contact with healthcare professionals, e.g. to join in medical rounds. When deploying video calls, family members mentioned that adequate instruction and technical support by nurses should be available. CONCLUSION Family members considered video calls valuable when visiting is not possible or to participate in medical rounds or other contacts with healthcare professionals outside of visiting hours. IMPLICATIONS Family members need to be supported in options and use of video calls on hospital wards. Additional knowledge about actual participation in care through video calls is needed as well as the effect on patient, family and healthcare professional outcomes. IMPACT Using video calls on hospital wards can provide family members with flexible alternatives for contact and promote family involvement. REPORTING METHOD COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION Family members of patients admitted to hospital have contributed by sharing their perspectives in interviews. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Family members perceive additional value from the use of video calls on hospital wards. For family, use of video calls needs to be facilitated with clear instruction materials and support. TRIAL AND PROTOCOL REGISTRATION Amsterdam UMC Medical Ethics Review Committee (ref number W21_508 # 21.560).
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Affiliation(s)
- Anna In de Braekt
- Nursing Science, Program in Clinical Health Sciences, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Surgery, Spaarne Gasthuis, Haarlem, The Netherlands
| | - Celeste M Coolen
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Jolanda M Maaskant
- Department of Pediatrics, University Medical Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Janneke M de Man-van Ginkel
- Nursing Science, Program in Clinical Health Sciences, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Nursing Science, Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Anne M Eskes
- Department of Surgery, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Digital Health, Amsterdam, The Netherlands
- Menzies Health Institute Queensland and School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
| | - Irene P Jongerden
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health research institute, Quality and Organization of Care, Amsterdam, The Netherlands
- Expertise Center for Palliative Care, Amsterdam, The Netherlands
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Zwickl S, Ruggles T, Wong AFQ, Ginger A, Angus LM, Eshin K, Cook T, Cheung AS. Disruption of gender-affirming health care, and COVID-19 illness, testing, and vaccination among trans Australians during the pandemic: a cross-sectional survey. Med J Aust 2024; 220:23-28. [PMID: 37994182 PMCID: PMC10952718 DOI: 10.5694/mja2.52169] [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: 05/16/2023] [Accepted: 08/23/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVES To assess rates of disruption of gender-affirming health care, of coronavirus disease 2019 (COVID-19) illness, testing, and vaccination, and of discrimination in health care among Australian trans people during the COVID-19 pandemic. DESIGN, SETTING Online cross-sectional survey (1-31 May 2022); respondents were participants recruited by snowball sampling for TRANSform, an Australian longitudinal survey-based trans health study, 1 May - 30 June 2020. PARTICIPANTS People aged 16 years or older, currently living in Australia, and with a gender different to their sex recorded at birth. MAIN OUTCOME MEASURES Proportions of respondents who reported disruptions to gender-affirming health care, COVID-19 illness, testing, and vaccination, and positive and negative experiences during health care. RESULTS Of 875 people invited, 516 provided valid survey responses (59%). Their median age was 33 years (interquartile range, 26-45 years); 193 identified as women or trans women (37%), 185 as men or trans men (36%), and 138 as non-binary (27%). Of 448 respondents receiving gender-affirming hormone therapy, 230 (49%) reported disruptions to treatment during the pandemic; booked gender-affirming surgery had been cancelled or postponed for 37 of 85 respondents (44%). Trans-related discrimination during health care was reported by a larger proportion of participants than in a pre-pandemic survey (56% v 26%). COVID-19 was reported by 132 respondents (26%), of whom 49 reported health consequences three months or more after the acute illness (37%; estimated Australian rate: 5-10%). Three or more COVID-19 vaccine doses were reported by 448 participants (87%; Australian adult rate: 70%). CONCLUSIONS High rates of COVID-19 vaccination among the trans people we surveyed may reflect the effectiveness of LGBTIQA+ community-controlled organisation vaccination programs and targeted health promotion. Training health care professionals in inclusive services for trans people could improve access to appropriate health care and reduce discrimination.
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Affiliation(s)
| | | | | | | | - Lachlan M Angus
- The University of MelbourneMelbourneVIC
- Austin HealthMelbourneVIC
| | | | | | - Ada S Cheung
- The University of MelbourneMelbourneVIC
- Austin HealthMelbourneVIC
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Flight I, Harrison NJ, Symonds EL, Young G, Wilson C. Validation of the Consumer Health Activation Index (CHAI) in general population samples of older Australians. PEC INNOVATION 2023; 3:100224. [PMID: 37965059 PMCID: PMC10641242 DOI: 10.1016/j.pecinn.2023.100224] [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: 05/21/2023] [Revised: 09/12/2023] [Accepted: 09/30/2023] [Indexed: 11/16/2023]
Abstract
Objective To validate the 10-item Consumer Health Activation Index (CHAI), developed in the United States, as an activation measure for interventions targeted at the Australian older general population. Methods The study was a cross sectional design. Exploratory factor analysis (EFA) was conducted on survey data from a community sample of participants (n = 250), aged 55-75 years. Confirmatory factor analysis (CFA) was used to evaluate dimensionality among a second sample of participants randomly sampled from the electoral roll (n = 571), aged 50-75 years. Associations between the CHAI and self-reported health behaviours were examined. Results EFA revealed a 7-item, two-factor structure ('Health self-management' and 'Patient-provider engagement'). CFA indicated optimum model fit was obtained with this structure. Subscale reliability and validity were confirmed, with significant correlation to age, functional health literacy and health screening. Conclusion In contrast to the original structure, optimum model fit was obtained with a two-factor solution and retention of seven items. The subscales have utility as a measure of health activation for tailoring of information in this group. Innovation A freely-available, unidimensional health activation measure has demonstrated an underlying two-scale structure that will enable tailored approaches toward the enhancement and maintenance of self- and externally-managed health behaviours in an Australian population.
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Affiliation(s)
- Ingrid Flight
- Cancer Research, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Nathan J. Harrison
- Cancer Research, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
- National Centre for Education and Training on Addiction, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Erin L. Symonds
- Cancer Research, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
- Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Graeme Young
- Cancer Research, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Carlene Wilson
- Cancer Research, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
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Banbury A, Taylor ML, Gray LC, Reid N, Smith AC. Sustaining and expanding telehealth activity: Training requirements for Australian residential aged care front-line staff. PEC INNOVATION 2023; 2:100109. [PMID: 37214526 PMCID: PMC10194154 DOI: 10.1016/j.pecinn.2022.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/30/2022] [Accepted: 11/26/2022] [Indexed: 05/24/2023]
Abstract
Objective To identify the training needs of front-line aged care staff as perceived by senior clinicians and managers at selected residential aged care facilities (RACFs). Methods A qualitative explorative designed study using semi-structured interviews with a convenience sample of RACF senior managers and nurses. A hybrid analysis approach using a framework deductive analysis followed by inductive analysis for sub-themes. Results Four sub-themes emerged to sustain increased telehealth activity: technology knowledge and digital literacy skills, including understanding telehealth ecosystems and technical skills; evidence-based reviews and clinical frameworks for telehealth consultations to identify appropriate consultations and successful use cases; telehealth best practice guidelines and workflows including telehealth consultations protocols, communicating by videoconferencing, how to support families in attending telehealth consultations and optimal training models; and telehealth policy and legal guidance. Conclusion Staff require comprehensive training to sustain and expand telehealth use in RACFs. Training should focus on knowledge, skills and competencies in using telehealth as well as the broad factors of policies and understanding ICT systems to support staffs' abilities and confidence. Innovation This study provides innovative findings that identify key components and associated activities and resources for training RACF staff to ensure they have sufficient knowledge, competency, skills and confidence to integrate telehealth into care provision.
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Affiliation(s)
- Annie Banbury
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Ground Floor, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
- Centre for Health Services Research, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
| | - Monica L. Taylor
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Ground Floor, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
- Centre for Health Services Research, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
| | - Leonard C. Gray
- Centre for Health Services Research, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
| | - Natasha Reid
- Centre for Health Services Research, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
| | - Anthony C. Smith
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Ground Floor, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
- Centre for Health Services Research, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102, Australia
- Centre for Innovative Medical Technology, University of Southern Denmark, Odense University Hospital, Kløvervænget 8C, entrance 101, 3. Floor, DK-5000 Odense C, Denmark
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Koo FEC, Chan MCE, King SK, Trajanovska M. The early years: hirschsprung disease and health-related quality of life. Qual Life Res 2023; 32:3327-3337. [PMID: 37474849 DOI: 10.1007/s11136-023-03482-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE Chronic diseases are notorious in the way that they interfere with many aspects of a child's development, and this holds true for children with Hirschsprung disease (HD). The present research aims to (1) determine whether the health-related quality of life (HRQoL) of HD children differs from healthy paediatric populations; and (2) explore the relationship between HD children's HRQoL and psychosocial outcomes of parents. METHODS Using a cross-sectional survey study design, children's HRQoL was assessed using the Pediatric Quality of Life Inventory (PedsQL), while parental psychosocial outcomes were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and depression short-forms, Family Management Measure (FaMM), and Parent Experience of Child Illness. Surveys were administered over telephone to parents of 48 Australian children treated for HD (87.5% male, median age 4.5 years) during the period May to November 2021. RESULTS While postoperative HRQoL of HD children was comparable to that of healthy age-matched controls, psychosocial quality of life of HD children was significantly poorer (mean difference = 3.40, CI [0.05, 6.76]). All parental outcome measures were significantly correlated with the PedsQL (r = - 0.77-0.67, p < 0.05) in expected directions, with FaMM subscales (except parent mutuality) demonstrating the most variation (R2 = 0.41-0.59). Of note, 31.3% of parents reported moderate to severe symptoms of anxiety on the PROMIS. CONCLUSION Despite overall positive results for children, parents reported elevated symptoms of anxiety. This study highlights the importance of long-term follow-up care for HD patients and their families.
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Affiliation(s)
- Fern Ee Caryn Koo
- Melbourne Graduate School of Education, The University of Melbourne, Parkville, VIC, Australia
- Clinical Sciences, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, Australia
| | - Man Ching Esther Chan
- Melbourne Graduate School of Education, The University of Melbourne, Parkville, VIC, Australia
| | - Sebastian K King
- Clinical Sciences, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia
- Department of Paediatric Surgery, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Misel Trajanovska
- Clinical Sciences, Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, Australia.
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.
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12
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Bright AM, Doody O. Mental health service users' experiences of telehealth interventions facilitated during the COVID-19 pandemic and their relevance to nursing: An integrative review. J Psychiatr Ment Health Nurs 2023; 30:1114-1129. [PMID: 37278201 DOI: 10.1111/jpm.12943] [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] [Received: 10/21/2022] [Revised: 05/03/2023] [Accepted: 05/21/2023] [Indexed: 06/07/2023]
Abstract
WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Service users report telehealth interventions to be useful in terms of access and convenience however, a preference for face-to-face interventions remains. Nurses are using telehealth interventions in clinical practice however, further research is necessary in this area as the evidence of their involvement is limited. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This paper highlights the use of telehealth interventions should augment rather than replace face-to-face care provision. ABSTRACT INTRODUCTION: The Covid-19 pandemic saw the swift implementation of physical and social distancing that impacted the way in which mental health services were facilitated. Consequently, telehealth/e-health interventions are increasing in use. AIM This integrative review aims to explore existing literature regarding mental health service users' experiences of telehealth interventions facilitated through the COVID-19 pandemic, to determine the visibility of nursing involvement in the facilitation of telehealth interventions and to use these experiences to inform nursing practice. METHOD A methodical search of eight (n = 8) academic databases was undertaken using CINAHL, SCOPUS, EMBASE, PsycINFO, Web of Science, Cochrane, MEDLINE and Academic Search Complete between January 2020 and January 2022. RESULTS A total of 5133 papers were screened by title and abstract of which (n = 77) progressed for full-text screening. Five (n = 5) papers met the inclusion criteria for this review and results were mapped onto the four meta-paradigms of nursing: person; where the findings discuss the acceptability of telehealth interventions; environment; where the findings highlight barriers and facilitators to the use of telehealth interventions; health; where the findings discuss staff time and logistical issues relating to telehealth interventions and nursing; where the findings centre around the therapeutic relationship. DISCUSSION This review highlights there is a paucity of direct evidence relating to nursing involvement in the facilitation of telehealth interventions. However, there are benefits to the use of telehealth interventions that include increased access to services, less perceived stigma and increased engagement which are relevant to nursing practice. A lack of individual contact and concerns relating to infrastructure indicates a fondness for face-to-face interventions remains high. IMPLICATIONS FOR PRACTICE There is a need for further research on the role of the nurse in the facilitation of telehealth interventions, specific interventions used and outcomes of such interventions.
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Affiliation(s)
- Ann-Marie Bright
- Department of Nursing & Midwifery, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Owen Doody
- Department of Nursing & Midwifery, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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13
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Sazon H, Catapan SDC, Rahimi A, Canfell OJ, Kelly J. How do Twitter users feel about telehealth? A mixed-methods analysis of experiences, perceptions and expectations. Health Expect 2023; 27:e13927. [PMID: 38038231 PMCID: PMC10726278 DOI: 10.1111/hex.13927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/26/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Telehealth use has increased considerably in the last years and evidence suggests an overall positive sentiment towards telehealth. Twitter has a wide userbase and can enrich our understanding of telehealth use by users expressing their personal opinions in an unprompted way. This study aimed to explore Twitter users' experiences, perceptions and expectations about telehealth over the last 5 years. METHODS Mixed-methods study with sequential complementary quantitative and qualitative phases was used for analysis stages comprising (1) a quantitative semiautomated analysis and (2) a qualitative research-led thematic analysis. A machine learning model was used to establish the data set with relevant English language tweets from 1 September 2017 to 1 September 2022 relating to telehealth using predefined search words. Results were integrated at the end. RESULTS From the initial 237,671 downloaded tweets, 6469 had a relevancy score above 0.8 and were input into Leximancer and 595 were manually analysed. Experiences, perceptions and expectations were categorised into three domains: experience with telehealth consultation, telehealth changes over time and the purpose of the appointment. The most tweeted experience was expectations for telehealth consultation in comparison to in-person consultations. Users mostly mentioned the hope that waiting times for the consultations to start to be less than in-person, more telehealth appointments to be available and telehealth to be cheaper. Perceptions around the use of telehealth in relation to healthcare delivery changes brought about by the COVID-19 pandemic were also expressed. General practitioners were mentioned six times more than other healthcare professionals. CONCLUSION/IMPLICATIONS This study found that Twitter users expect telehealth services to be better, more affordable and more available than in-person consultations. Users acknowledged the convenience of not having to travel for appointments and the challenges to adapt to telehealth. PATIENT OR PUBLIC CONTRIBUTION An open data set with 237,671 tweets expressing users' opinions in an unprompted way was used as a source for telehealth service users, caregivers and members of the public experiences, perceptions and expectations of telehealth.
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Affiliation(s)
- Hannah Sazon
- School of Public HealthThe University of QueenslandBrisbaneQueenslandAustralia
| | - Soraia de Camargo Catapan
- Centre for Online HealthThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Health Services ResearchThe University of QueenslandBrisbaneQueenslandAustralia
| | | | - Oliver J. Canfell
- Queensland Digital Health Centre, Centre for Health Services Research, Faculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
- Digital Health Cooperative Research CentreAustralian GovernmentSydneyNew South WalesAustralia
- UQ Business School, Faculty of Business, Economics and LawThe University of QueenslandBrisbaneQueenslandAustralia
| | - Jaimon Kelly
- Centre for Online HealthThe University of QueenslandBrisbaneQueenslandAustralia
- Centre for Health Services ResearchThe University of QueenslandBrisbaneQueenslandAustralia
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14
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Hill NTM, Bouras H, Too LS, Perry Y, Lin A, Weiss D. Association between mental health workforce supply and clusters of high and low rates of youth suicide: An Australian study using suicide mortality data from 2016 to 2020. Aust N Z J Psychiatry 2023; 57:1465-1474. [PMID: 37608497 PMCID: PMC10619187 DOI: 10.1177/00048674231192764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
OBJECTIVE To examine the association between mental health workforce supply and spatial clusters of high versus low incidence of youth suicide. METHODS A cross-sectional analysis of spatial suicide clusters in young Australians (aged 10-25) from 2016 to 2020 was conducted using the scan statistic and suicide data from the National Coronial Information System. Mental health workforce was extracted from the 2020 National Health Workforce Dataset by local government areas. The Geographic Index of Relative Supply was used to estimate low and moderate-to-high mental health workforce supply for clusters characterised by a high and low incidence of suicide (termed suicide hotspots and coldspots, respectively). Univariate and multivariate logistic regression was used to determine the association between suicide clusters and a range of sociodemographic characteristics including mental health workforce supply. RESULTS Eight suicide hotspots and two suicide coldspots were identified. The multivariate analysis showed low mental health workforce supply was associated with increased odds of being involved in a suicide hotspot (adjusted odds ratio = 8.29; 95% confidence interval = 5.20-13.60), followed by residential remoteness (adjusted odds ratio = 2.85; 95% confidence interval = 1.68-4.89), and illicit drug consumption (adjusted odds ratio = 1.97; 1.24-3.11). Both coldspot clusters occurred in areas with moderate-to-high mental health workforce supply. CONCLUSION Findings highlight the potential risk and protective roles that mental health workforce supply may play in the spatial distributions of youth suicide clusters. These findings have important implications for the provision of postvention and the prevention of suicide clusters.
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Affiliation(s)
- NTM Hill
- Telethon Kids Institute, Nedlands, WA, Australia
- Centre for Child Health Research, The University of Western Australia, Crawley, WA, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - H Bouras
- Telethon Kids Institute, Nedlands, WA, Australia
| | - LS Too
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Y Perry
- Telethon Kids Institute, Nedlands, WA, Australia
- Centre for Child Health Research, The University of Western Australia, Crawley, WA, Australia
| | - A Lin
- Telethon Kids Institute, Nedlands, WA, Australia
- Centre for Child Health Research, The University of Western Australia, Crawley, WA, Australia
| | - D Weiss
- Telethon Kids Institute, Nedlands, WA, Australia
- Curtin School of Population Health, Curtin University, Bentley, WA, Australia
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15
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Jörgensen E, Wood L, Lynch MA, Spencer N, Gunnlaugsson G. Child Rights during the COVID-19 Pandemic: Learning from Child Health-and-Rights Professionals across the World. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1670. [PMID: 37892333 PMCID: PMC10605735 DOI: 10.3390/children10101670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/25/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023]
Abstract
The COVID-19 pandemic underscores the importance of a child rights-based approach to policymaking and crisis management. Anchored in the United Nations Convention on the Rights of the Child, the 3P framework-provision, protection, and participation-forms the foundation for health professionals advocating for children's rights. Expanding it with two additional domains-preparation and power-into a 5P framework has the potential to enhance child rights-based policies in times of crisis and future pandemics. The study aimed to (1) gather perspectives from child health-and-rights specialists on how children's rights were highlighted during the early phase of the pandemic in their respective settings; and (2) evaluate the usefulness of the 5P framework in assessing children's visibility and rights. A qualitative survey was distributed among child health-and-rights professionals; a total of 68 responses were analysed in Atlas.ti 9 from a multi-disciplinary group of policymakers and front-line professionals in eight world regions. As framed by the 5Ps, children's rights were generally not safeguarded in the initial pandemic response and negatively impacted children's health and wellbeing. Further, children lacked meaningful opportunities to raise their concerns to policymakers. The 5P framework holds the potential to shape an ethical child rights-based decision-making framework for future crises, both nationally and globally.
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Affiliation(s)
- Eva Jörgensen
- Faculty of Sociology, Anthropology and Folkloristics, School of Social Sciences, University of Iceland, Sæmundargata 2-6, 102 Reykjavík, Iceland;
| | - Laura Wood
- Department of Sociology, Lancaster University, Bailrigg, Lancaster LA1 4YU, UK;
| | - Margaret A. Lynch
- Department of Paediatrics, King’s College, Strand, London WC2R 2LS, UK;
| | - Nicholas Spencer
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry CV4 9JD, UK;
| | - Geir Gunnlaugsson
- Faculty of Sociology, Anthropology and Folkloristics, School of Social Sciences, University of Iceland, Sæmundargata 2-6, 102 Reykjavík, Iceland;
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Ward K, Vagholkar S, Lane J, Raghuraman S, Lau AYS. Are chronic condition management visits translatable to telehealth? Analysis of in-person consultations in primary care. Int J Med Inform 2023; 178:105197. [PMID: 37619394 DOI: 10.1016/j.ijmedinf.2023.105197] [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] [Received: 05/26/2023] [Revised: 07/24/2023] [Accepted: 08/13/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Telehealth was rapidly adopted in primary care during COVID-19. However, there is a lack of research assessing how translatable in-person consultations are to telehealth. OBJECTIVE To examine insights from in-person GP-Patient consultations for patients with chronic conditions, including 1/frequency, duration, conditions of physical examinations, and when they occur during consultations, 2/types of physical artefacts used, 3/clinical tasks performed, and 4/translatability of clinical tasks to telehealth. METHODS Eligible consultations were extracted from a dataset archive named HaRI, which contains 281 in-person GP consultations in de-identified transcript and video format. 38 consultations were included for analysis meeting eligibility criteria in this study. A multi-method approach (using content analysis, visualisation, video and time analysis) was applied to eligible consultations, extracting clinical tasks that involve physical interactions. Finally, an evidence-based scoring system was used on each clinical task, determining the likelihood of whether each task could be translated into telehealth. RESULTS Nine chronic conditions were observed across 38 GP-Patient consultations, predominately diabetes (39 %, 15/38). Out of these 38 consultations, 76 % (29/38) featured physical examinations, where 68 % (26/38) were initiated by GPs (e.g., auscultation), and 26 % (10/38) were initiated by patients (e.g., self-palpation). The average percentage of time spent on physical examination(s) during consultations is low (13.6 %, SD = 9.4 %). A total of 24 clinical tasks were observed across these 38 consultations. Out of these 24 tasks, 92 % (22/24) were supported by physical artefacts. The average score of a task being translatable to Telehealth is 7/10 (where Score 1 = Not amenable to being replicated over telehealth at this stage, scoring 10 = Easily translatable over telehealth with almost no additional equipment being required). CONCLUSION All tasks observed across chronic condition management visits were deemed translatable/potentially translatable to telehealth. However, physical interactions between GPs and patients are still essential. Future research in telehealth should focus on examining ways to support physical examination, reduce uncertainty, promote safety netting, and facilitate patients' safety at home with effective technology and support.
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Affiliation(s)
- Kanesha Ward
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
| | - Sanjyot Vagholkar
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Jared Lane
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Sunayana Raghuraman
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Annie Y S Lau
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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17
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Snoswell CL, Stringer H, Taylor ML, Caffery LJ, Smith AC. An overview of the effect of telehealth on mortality: A systematic review of meta-analyses. J Telemed Telecare 2023; 29:659-668. [PMID: 34184578 DOI: 10.1177/1357633x211023700] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Telehealth is recognised as a viable way of providing health care over distance, and an effective way to increase access for individuals with transport difficulties or those living in rural and remote areas. While telehealth has many positives for patients, clinicians and the health system, it is important that changes in the delivery of health care (e.g. in-person to telehealth) do not result in inferior or unsafe care. In this review, we collate existing meta-analyses of mortality rates to provide a holistic view of the current evidence regarding telehealth safety. METHODS In November 2020, a search of Pretty Darn Quick Evidence portal was conducted in order to locate systematic reviews published between 2010 and 2019, examining and meta-analysing the effect of telehealth interventions on mortality compared to usual care. RESULTS This review summarises evidence from 24 meta-analyses. Five overarching medical disciplines were represented (cardiovascular, neurology, pulmonary, obstetrics and intensive care). Overall, telehealth did not increase mortality rates. DISCUSSION The evidence from this review can be used by decision makers, in conjunction with other disease-specific and health economic evidences, to support and guide telehealth implementation plans.
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Affiliation(s)
- Centaine L Snoswell
- Centre for Online Health, The University of Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Australia
- Pharmacy Department, Princess Alexandra Hospital, Australia
| | - Hannah Stringer
- Centre for Online Health, The University of Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Australia
| | - Monica L Taylor
- Centre for Online Health, The University of Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Australia
| | - Liam J Caffery
- Centre for Online Health, The University of Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Australia
| | - Anthony C Smith
- Centre for Online Health, The University of Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Australia
- Centre for Innovative Medical Technology, University of Southern Denmark, Denmark
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18
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Panisset MG, Galea MP. The effect of COVID-19 lockdowns on exercise and the role of online exercise in Australians with multiple sclerosis. Mult Scler Relat Disord 2023; 78:104901. [PMID: 37536213 DOI: 10.1016/j.msard.2023.104901] [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: 03/04/2023] [Revised: 06/26/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION Regular exercise is beneficial for people with Multiple Sclerosis (MS), regardless of disability level. The previously reported differential effect of COVID-19-related lockdowns on exercise levels in this population remains unexplained. We examined effects of lockdowns on exercise in Australians with MS according to disability levels, lockdown severity and health technology use. METHODS A cross-sectional survey of people with MS in Australia (22 April-23 September 2021) collected demographic and clinical information as well as exercise patterns before and during lockdowns. Mann-Whitney was used to compare ordinal data and Likelihood Ratio to compare dichotomous data. RESULTS 151 people completed the survey. 72.2% had mild disability and 25.2% moderate disability. Extended lockdowns were associated with significantly decreased sedentary behaviour (31.5% to 25.9%) but also with decreased exercise frequency in frequent exercisers (≥3 times/week; 53.7% to 22.2%). The latter occurred significantly more in those with mild disability (-22.7%) than with moderate disability (-3.5%). More people with mild disability walked for exercise pre-pandemic (LR 8.6, p=.004) and during lockdowns (LR 6.6, p=.010). Walking during lockdowns was positively associated with working from home. People with moderate disability were more likely to engage in home exercise both pre-pandemic (LR 5.5, p=.019) and during lockdown (LR 5.2, p=.023). Engagement in home exercise rose for both groups during lockdowns and was facilitated by on-line exercise classes. CONCLUSION Lockdowns differentially affected exercise patterns according to disability level. The proportion of people achieving exercise recommendations decreased more in those with mild but not moderate disability. Incidental physical activity was disproportionately impacted in people with moderate disability.
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Affiliation(s)
- M G Panisset
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC 3050, Australia.
| | - M P Galea
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC 3050, Australia; Australian Rehabilitation Research Centre, Parkville, Australia
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Thomas E, Lee CMY, Norman R, Wells L, Shaw T, Nesbitt J, Frean I, Baxby L, Bennett S, Robinson S. Patient Use, Experience, and Satisfaction With Telehealth in an Australian Population (Reimagining Health Care): Web-Based Survey Study. J Med Internet Res 2023; 25:e45016. [PMID: 37590037 PMCID: PMC10472164 DOI: 10.2196/45016] [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] [Received: 12/13/2022] [Revised: 03/27/2023] [Accepted: 04/28/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic triggered a rapid scale-up of telehealth services in Australia as a means to provide continued care through periods of physical restrictions. The factors that influence engagement in telehealth remain unclear. OBJECTIVE The purpose of this study is to understand the experience of Australian people who engaged in a telehealth consultation during the pandemic period (2020-2021) and the demographic factors that influence engagement. METHODS A web-based survey was distributed to Australians aged over 18 years that included 4 questions on frequency and type of clinical consultation, including with a general practitioner (GP), specialist, allied health, or nurse; 1 question on the experience of telehealth; and 2 questions on the quality of and satisfaction with telehealth. Statistical analysis included proportion of responses (of positive responses where a Likert scale was used) and regression analyses to determine the effect of demographic variables. RESULTS Of the 1820 participants who completed the survey, 88.3% (1607/1820) had engaged in a health care consultation of some type in the previous 12 months, and 69.3% (1114/1607) of those had used telehealth. The most common type of consultation was with a GP (959/1114, 86.1%). Older people were more likely to have had a health care consultation but less likely to have had a telehealth consultation. There was no difference in use of telehealth between metropolitan and nonmetropolitan regions; however, people with a bachelor's degree or above were more likely to have used telehealth and to report a positive experience. A total of 87% (977/1114) of participants agreed or strongly agreed that they had received the information they required from their consultation, 71% (797/1114) agreed or strongly agreed that the outcome of their consultation was the same as it would have been face-to-face, 84% (931/1114) agreed or strongly agreed that the doctor or health care provider made them feel comfortable, 83% (924/1114) agreed or strongly agreed that the doctor or health care provider was equally as knowledgeable as providers they have seen in person; 57% (629/1114) of respondents reported that they would not have been able to access their health consultation if it were not for telehealth; 69% (765/1114) of respondents reported that they were satisfied with their telehealth consultation, and 60% (671/1114) reported that they would choose to continue to use telehealth in the future. CONCLUSIONS There was a relatively high level of engagement with telehealth over the 12 months leading up to the study period, and the majority of participants reported a positive experience and satisfaction with their telehealth consultation. While there was no indication that remoteness influenced telehealth usage, there remains work to be done to improve access to older people and those with less than a bachelor's degree.
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Affiliation(s)
- Elizabeth Thomas
- School of Population Health, Curtin University, Bentley, Australia
- Medical School, The University of Western Australia, Perth, Australia
| | | | - Richard Norman
- School of Population Health, Curtin University, Bentley, Australia
| | - Leanne Wells
- Consumers Health Forum of Australia, Canberra, Australia
| | - Tim Shaw
- Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Julia Nesbitt
- Consumers Health Forum of Australia, Canberra, Australia
| | - Isobel Frean
- Digital Health Cooperative Research Centre, Sydney, Australia
| | | | | | - Suzanne Robinson
- School of Population Health, Curtin University, Bentley, Australia
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Melbourne, Australia
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20
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Zachrison KS, Yan Z, White BA, Park L, Schwamm LH. Factors Associated with the Digital Patient Experience of Virtual Care Across Specialties. TELEMEDICINE REPORTS 2023; 4:227-235. [PMID: 37637376 PMCID: PMC10457601 DOI: 10.1089/tmr.2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/29/2023]
Abstract
Background We aimed to characterize patient experience with virtual care across medical specialties using validated survey data. Primary objective: to determine whether experience varied by visit modality (virtual vs. in-person) and whether relationships persisted after adjusting for patient and provider characteristics. Secondarily, among physicians with sufficient data, we compared virtual versus in-person patient experience scores at the physician level and identified characteristics associated with better experience scores for virtual care. Methods This was a retrospective analysis of administrative databases from a large New England health care system, including all ambulatory visits from October 1, 2020 to September 30, 2021 with patient experience scores recorded. We compared experience between virtual and in-person at the visit level (score: 0-10) and the physician level for likelihood of recommending the physician to friends or family. We used a series of cross-classified hierarchical models with visits grouped by patient and by physician to decompose sources of variation. Among physicians with sufficient data, we compared physicians with higher virtual versus higher in-person net promoter score (NPS). Results Of 378,472 visits performed by 3368 physicians, 86,878 (23%) were conducted virtually. Most scored ≥9 for either modality, with a small preference for virtual versus in-person care (9.6 vs. 9.5, p < 0.001). We found that more variation in scores was explained by patient than by physician (22.9% vs. 3%). Visit modality was of minimal explanatory value. Most physicians' virtual and in-person NPS were similar, and virtual visit volume was not associated. Conclusions We found robust evidence for the parity of patient experience between virtual and in-person modalities across specialties.
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Affiliation(s)
- Kori S. Zachrison
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Zhiyu Yan
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Benjamin A. White
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lee Park
- Department of Internal Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
- Mass General Brigham, Boston, Massachusetts, USA
| | - Lee H. Schwamm
- Mass General Brigham, Boston, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
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21
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Rose SB, Garrett SM, McKinlay E. Experience of telehealth for receipt of primary health care: an online survey of young people in a geographic region of Aotearoa New Zealand. Aust J Prim Health 2023; 29:319-326. [PMID: 36657735 DOI: 10.1071/py22073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 12/13/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Telehealth became more widely used when the global COVID-19 pandemic restricted access to in-person consultations for primary care during periods of 'lockdown'. METHODS In 2021 (August-September), 15-to 25-year-olds in the Wellington region of Aotearoa New Zealand were invited to participate in an online survey that aimed to find out about telehealth experiences, perceived advantages and disadvantages, and willingness to use it for receipt of primary care. RESULTS Surveys were completed by 346 participants, 133 of whom had ever used telehealth (38%). Overall, 73% (84/115) were happy with health care received via telehealth, but only 26% preferred it to in-person consultations. Perceived benefits related to convenience and time efficiency, but participants had concerns about the inability to be physically examined, technological issues, clarity around follow-up actions, payment and lack of privacy. All participants had access to a phone or device, yet almost half reported challenges with connectivity, coverage or data that might limit their ability to access telehealth (47.3%, 159/336). Half of participants wanted to use telehealth in future (preferring phone over video (160/315)). CONCLUSIONS Young people surveyed acknowledged the convenience of telehealth, but many were hesitant about receiving primary care in this way. Understanding young people's reservations and provision of detailed information about what telehealth entails will help prepare and support them to use telehealth in future.
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Affiliation(s)
- Sally B Rose
- Department of Primary Health Care and General Practice, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand
| | - Susan M Garrett
- Department of Primary Health Care and General Practice, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand
| | - Eileen McKinlay
- Department of Primary Health Care and General Practice, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand
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22
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Dodeja AK, Schreier M, Granger M, Mitchell D, Chumita R, Sisk T, Daniels CJ, Rajpal S. Patient Experience with Telemedicine in Adults with Congenital Heart Disease. Telemed J E Health 2023; 29:1261-1265. [PMID: 36656168 DOI: 10.1089/tmj.2022.0279] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Introduction: The COVID-19 pandemic has resulted in increased use of telemedicine. There are limited data on patient experience with telemedicine in adults with congenital heart disease (ACHD). We hypothesized that due to their complex medical history, ACHD would prefer in-person clinic visits over telemedicine. Methods: We conducted a nurse-administered telephone survey based on Agency for Healthcare Research and Quality recommendations to assess patient experience after ACHD telemedicine visits in the early part of the pandemic from March 2020 to June 2020. Results: Of 216 ACHD who had telemedicine visits, 136 (63%) agreed to participate in the survey. Mean age was 45 ± 18 years, majority (65%) being video encounters. Most (98%) patients expressed that the telemedicine visit was successful in addressing their health care needs. Only 21 (15%) patients reported technical issues. Most patients (76%) preferred telemedicine given testing was provided separately, 25 (18%) preferred in-person clinic visits, and 8 (6%) had no preference. Of the 25 patients over 65 years, 19 (76%) would choose telemedicine over the in-person clinic, and only 1 patient reported technical difficulties. Conclusion: ACHD reported a positive experience with telemedicine. Technical limitations were infrequent even among the elderly. The majority of patients felt that their health care needs were addressed and would consider telemedicine over clinic visits. These data are important as payors move away from supporting telemedicine and hospitals restructure, with and without ongoing COVID-19 concerns.
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Affiliation(s)
- Anudeep K Dodeja
- Division of Pediatric Cardiology, Connecticut Children's, Hartford, Connecticut, USA
| | - Matthew Schreier
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
- Division of Cardiovascular Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Matthew Granger
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Deborah Mitchell
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Rosemary Chumita
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Tracey Sisk
- Division of Cardiovascular Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Curt J Daniels
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
- Division of Cardiovascular Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Saurabh Rajpal
- Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA
- Division of Cardiovascular Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
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Ferguson MA, Eikelboom RH, Sucher CM, Maidment DW, Bennett RJ. Remote Technologies to Enhance Service Delivery for Adults: Clinical Research Perspectives. Semin Hear 2023; 44:328-350. [PMID: 37484990 PMCID: PMC10361795 DOI: 10.1055/s-0043-1769742] [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] [Indexed: 07/25/2023] Open
Abstract
There are many examples of remote technologies that are clinically effective and provide numerous benefits to adults with hearing loss. Despite this, the uptake of remote technologies for hearing healthcare has been both low and slow until the onset of the COVID-19 pandemic, which has been a key driver for change globally. The time is now right to take advantage of the many benefits that remote technologies offer, through clinical, consumer, or hybrid services and channels. These include greater access and choice, better interactivity and engagement, and tailoring of technologies to individual needs, leading to clients who are better informed, enabled, and empowered to self-manage their hearing loss. This article provides an overview of the clinical research evidence-base across a range of remote technologies along the hearing health journey. This includes qualitative, as well as quantitative, methods to ensure the end-users' voice is at the core of the research, thereby promoting person-centered principles. Most of these remote technologies are available and some are already in use, albeit not widespread. Finally, whenever new technologies or processes are implemented into services, be they clinical, hybrid, or consumer, careful consideration needs to be given to the required behavior change of the key people (e.g., clients and service providers) to facilitate and optimize implementation.
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Affiliation(s)
- Melanie A. Ferguson
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Robert H. Eikelboom
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
- Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Cathy M. Sucher
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
| | - David W. Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Rebecca J. Bennett
- Ear Science Institute Australia, Perth, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Centre for Ear Sciences, Medical School, The University of Western Australia, Perth, Australia
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Tsagkaris C, Trygonis N, Spyrou V, Koulouris A. Telemedicine in Care of Sarcoma Patients beyond the COVID-19 Pandemic: Challenges and Opportunities. Cancers (Basel) 2023; 15:3700. [PMID: 37509361 PMCID: PMC10378403 DOI: 10.3390/cancers15143700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has created a challenging environment for sarcoma patients. Most oncology societies published guidelines or recommendations prioritizing sarcoma patients and established telehealth as an efficient method of approaching them. The aim of this review is the assessment of current evidence regarding the utilization of telemedicine in diagnosis, treatment modalities, telerehabilitation and satisfaction among sarcoma patients and healthcare providers (HP). METHODS This systematic review was carried out using the databases PubMed and Ovid MEDLINE according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS The application of telemedicine to the management of sarcoma has yielded improved clinical and psychological outcomes. Specifically, significant progress has been demonstrated in the areas of tele-oncology and telerehabilitation during the last decade, and the COVID-19 outbreak has accelerated this transition toward them. Telehealth has been proven efficient in a wide spectrum of applications from consultations on physical therapy and psychological support to virtual care symptom management. Both HP and patients reported satisfaction with telehealth services at levels comparable to in-person visits. CONCLUSIONS Telehealth has already unveiled many opportunities in tailoring individualized care, and its role in the management of sarcoma patients has been established in the post-COVID-19 era, as well.
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Affiliation(s)
- Christos Tsagkaris
- European Student Think Tank, Public Health and Policy Working Group, 1058 DE Amsterdam, The Netherlands
| | - Nikolaos Trygonis
- Department of Orthopaedics, University Hospital of Heraklion, 70013 Heraklion, Greece
| | - Vasiliki Spyrou
- Post Covid Department, Theme Female Health, Karolinska University Hospital, 14157 Stockholm, Sweden
| | - Andreas Koulouris
- Department of Oncology-Pathology, Karolinska Institute, 17176 Stockholm, Sweden
- Thoracic Oncology Center, Theme Cancer, Karolinska University Hospital, 17177 Stockholm, Sweden
- Faculty of Medicine, University of Crete, 70013 Heraklion, Greece
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25
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Buchanan S, Peixoto C, Belanger C, Archibald D, Bjerre L, Fitzsimon J. Investigating Patient Experience, Satisfaction, and Trust in an Integrated Virtual Care (IVC) Model: A Cross-Sectional Survey. Ann Fam Med 2023; 21:338-340. [PMID: 36944507 PMCID: PMC10365871 DOI: 10.1370/afm.2978] [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] [Received: 06/01/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 03/23/2023] Open
Abstract
To improve access to primary care in underserved communities, we established a hybrid model of delivering team-based, comprehensive primary care using both in-person and virtual care options with family physician leadership. Using a cross-sectional online survey (n = 121), results showed high levels (90%) of patient satisfaction. Our findings suggest that a similar hybrid model for primary care delivery can provide levels of patient satisfaction comparable to traditional in-person models of primary care. This can be achieved regardless of whether patients had previously been attached to the same family physician before receiving care through the hybrid model.Annals "Online First" article.
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Affiliation(s)
| | | | - Christopher Belanger
- University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Ottawa, Ontario, Canada
| | - Douglas Archibald
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lise Bjerre
- University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Ottawa, Ontario, Canada
| | - Jonathan Fitzsimon
- University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
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26
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Alzahrani HS, Alharbi SA, Alsadan YI, Alghosn NS, Almazyad SM, Alotaibi N, Almansour M, Aldossari KK, Demyati E, Abulreesh RY. Awareness and acceptance of teleclinic services during COVID-19 in the general population in Riyadh: Cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:217. [PMID: 37546015 PMCID: PMC10402800 DOI: 10.4103/jehp.jehp_819_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 03/31/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND The first COVID-19 case in Saudi Arabia was reported on March 2, 2020. The Saudi government introduced the "937" service number as one of the telemedicine services for COVID-19 information. Telemedicine uses telecommunication and information technologies in the medical field to deliver healthcare services and improve patients' health status. This study aims to estimate the frequency of teleclinics usage during COVID-19, assess awareness of teleclinics, and assess acceptance of teleclinics during COVID-19 in the Saudi population. MATERIALS AND METHODS The cross-sectional study used a convenient sample encompassing the 1,583 Saudi and non-Saudi adult population of Riyadh, Saudi Arabia, and was conducted online between August 2020 and April 2021. A self-administrated online questionnaire was distributed to all participants and data were collected on sociodemographics, knowledge of use of teleclinics, and its acceptance. Analysis of quantitative data by t-test and association of qualitative variables by Chi-square test was conducted. Regression analysis was performed on the significant values of univariate analysis. Data were analyzed by SPSS 25. RESULTS Most (92.5%) participants were female and had a university education (65.9%). The main reason for using teleclinic was experiencing a new complaint (27.3%), next, for medications refill (13.2%), with COVID-19-related issues being the least common reason for using teleclinic (8.2%). The result shows that 77.1% of participants had a good level of acceptance of teleclinic. The regression analysis showed that number of teleclinics utilization, as an advantage it is more convenient, and recommending this service to someone else was significantly associated with acceptance of teleclinics in future. CONCLUSION As per the findings, the experience of using teleclinic positively impacts the level of acceptance of teleclinic among the population. The adoption of telemedicine for healthcare delivery during the COVID-19 pandemic helped limit the spread of the infection and reduce the risk of exposure to COVID-19 for both patients and healthcare providers. In the future, telemedicine can be used as an alternative to minor complaints and follow-up checkups. In this way, the burden of healthcare system can also be overcome.
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Affiliation(s)
- Hayat S. Alzahrani
- Department of Nursing, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Sarah A. Alharbi
- Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Yara I. Alsadan
- Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Nouf S. Alghosn
- Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Nowayer Alotaibi
- Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mohammed Almansour
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khaled K. Aldossari
- Family and Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Eyad Demyati
- Consultant in Family Medicine and Community Health Services Department, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Razan Y. Abulreesh
- Department of Nursing, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
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27
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van Rooij FB, Weeland J, Thonies C. Youth care in time of COVID-19: Experiences of professionals and adolescent clients with telehealth. CHILDREN AND YOUTH SERVICES REVIEW 2023; 148:106874. [PMID: 36817405 PMCID: PMC9925417 DOI: 10.1016/j.childyouth.2023.106874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/18/2023] [Accepted: 02/08/2023] [Indexed: 05/07/2023]
Abstract
Measures aimed at preventing the COVID-19 virus from spreading restricted all aspects of public life, including possibilities for meeting in-person. Youth care professionals were forced to turn to telehealth tools, such as video calling and e-health methods, to be able to continue support and treatment of children, adolescents, caregivers, and families. This study consists of two qualitative interview studies on the experiences with and transition to telehealth during COVID-19: (1) interviews with youth care professionals (N = 20), and (2) interviews with adolescents who used mental health care support (N = 14). We specifically asked participants about five themes which were selected based on pre-COVID literature on telehealth: (1) tools (i.e., which programs are being used), (2) privacy, (3) methods (i.e., what was the same and what was different compared to in-person sessions), (4) relationship/therapeutic alliance, and (5) effectiveness (i.e., what was their impression of effectiveness of telehealth). The majority of professionals reported that they had very little to no experience with telehealth prior to the pandemic. Both professionals and adolescent clients mentioned benefits and limitations of telehealth. On several themes professionals and adolescent clients mentioned similar barriers in the transition to telehealth during COVID such as limitations of the available hard- and software (theme 1: tools); forced changes in the content and methods of the sessions (theme 3: methods); and difficulties with non-verbal communication (theme 4: alliance). However, whereas most professionals expressed the intention to keep using several aspects of telehealth after restrictions due to COVID are lifted, most adolescent clients expressed they see telehealth as a temporary solution and prefer meeting professionals in person. Their experiences and the barriers and enabling aspects they mentioned may provide important insights in the acceptability and usability of telehealth for youth care organizations, youth care professionals, researchers and higher educational training programs.
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Affiliation(s)
- Floor B van Rooij
- Research Institute of Child Development and Education, University of Amsterdam, the Netherlands
| | - Joyce Weeland
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, the Netherlands
| | - Carlo Thonies
- Herlaarhof, Centre of Child and Adolescent Psychiatry, Reinier van Arkel, the Netherlands
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Crocker KM, Gnatt I, Haywood D, Butterfield I, Bhat R, Lalitha ARN, Jenkins ZM, Castle DJ. The impact of COVID-19 on the mental health workforce: A rapid review. Int J Ment Health Nurs 2023; 32:420-445. [PMID: 36461629 PMCID: PMC9878253 DOI: 10.1111/inm.13097] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 12/04/2022]
Abstract
The COVID-19 pandemic led to significant adaptations to healthcare. Provision of mental healthcare in a changing environment presented healthcare workers with unique challenges and demands, including changes in workload and expectations. To inform current and future healthcare service responses, and adaptations, the current review aimed to collate and examine the impact of the pandemic on mental healthcare workers (MHWs). We conducted a rapid systematic review to examine the overall impact of the COVID-19 pandemic on MHWs. Searches were conducted in Ovid Medline and PsycInfo and restricted to articles published from 2020. Inclusion criteria specified articles written in English, published in peer-reviewed journals, and that examined any outcome of the impact of COVID-19 on MHWs; 55 articles fulfilled these criteria. Outcomes were categorized into 'work-related outcomes' and 'personal outcomes'. Mental healthcare workers worldwide experienced a range of work-related and personal adversities during the pandemic. Key work-related outcomes included increased workload, changed roles, burnout, decreased job satisfaction, telehealth challenges, difficulties with work-life balance, altered job performance, vicarious trauma and increased workplace violence. Personal outcomes included decreased well-being, increased psychological distress and psychosocial difficulties. These outcomes differed between inpatient, outpatient and remote settings. The COVID-19 pandemic significantly altered the delivery of mental healthcare and MHWs experienced both work-related and personal adversities during the COVID-19 pandemic. With the continuation of changes introduced to healthcare in the initial stages of the pandemic, it will be important to maintain efforts to monitor negative outcomes and ensure supports for MHWs, going forward.
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Affiliation(s)
- Kaitlyn M Crocker
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Inge Gnatt
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Darren Haywood
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Ingrid Butterfield
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Ravi Bhat
- Department of Rural Health, University of Melbourne, Shepparton, Victoria, Australia
| | | | - Zoe M Jenkins
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | - David J Castle
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Centre for Complex Interventions, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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29
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von der Groeben S, Czaplicki A, Hegerl U, Reich H. Telemedicine during the COVID-19 pandemic in Germany: Results from three nationally representative surveys on use, attitudes and barriers among adults affected by depression. Internet Interv 2023; 32:100622. [PMID: 37091132 PMCID: PMC10114311 DOI: 10.1016/j.invent.2023.100622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/14/2023] [Accepted: 04/17/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction The COVID-19 pandemic has necessitated a reduction in face-to-face consultations, resulting in significant limitations in healthcare for individuals with depression. To ensure safe and adequate care, e-health services, such as telemedicine, gained a more prominent role. Governments have eased restrictions on the use of telemedicine, enabling healthcare professionals to increasingly offer video and telephone consultations. Objective This study examines, 1) possible changes over the course of the pandemic in reported use of video and telephone consultations and intended future use of video consultations with healthcare professionals among adults with diagnosed depression; 2) their attitudes towards video and telephone consultations and perceived barriers towards using e-health after prolonged time of the pandemic; and 3) differences in results between subgroups based on sociodemographic and clinical characteristics. Methods Three population-representative online surveys were conducted in Germany at different timepoints (t) during the COVID-19 pandemic. Respondents aged 18-69 years with a professionally diagnosed depression were included in the present analyses (t1: June/July 2020 with n = 1094; t2: February 2021 with n = 1038; t3: September 2021 with n = 1255). Results The overall proportion of adults with depression who used video or telephone consultations did not change significantly in the time surveyed (t1: 16.51 %, n = 179; t2: 20.23 %, n = 210; t3: 18.47 %, n = 230). However, among users, reported use of video consultations with a psychotherapist increased significantly from t1 (34.83 %, n = 62) to t3 (44.98 %, n = 102, p = .023). Intended future use of VC for healthcare varied depending on the purpose of the consultation. Significant differences over time were only found for the purpose of using VC to discuss clinical findings, laboratory results and diagnostic analyses with a doctor, with higher intentions reported at t2 during lockdown in Germany. At t3, the majority of adults with depression felt that video and telephone consultations were too impersonal and considered them more as a helpful support rather than an alternative to face-to-face psychotherapy. Key barriers to using e-health were found within the societal context and the lacking support from significant others for using e-health, while knowledge and skills represented facilitators for using e-health. Conclusion Despite ambivalent attitudes towards video and telephone consultations among adults with depression, reported use of video consultations with a psychotherapist increased during the COVID-19 pandemic.
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Affiliation(s)
- S von der Groeben
- Goethe University Frankfurt, University Hospital, Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Germany
| | - A Czaplicki
- Goethe University Frankfurt, University Hospital, Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Germany
- German Depression Foundation, Leipzig, Germany
| | - U Hegerl
- Goethe University Frankfurt, University Hospital, Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Germany
- German Depression Foundation, Leipzig, Germany
- Johann Christian Senckenberg Distinguished Professorship, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt am Main, Germany
| | - H Reich
- Goethe University Frankfurt, University Hospital, Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Germany
- German Depression Foundation, Leipzig, Germany
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30
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Jiang Y, Nuerdawulieti B, Chen Z, Guo J, Sun P, Chen M, Li J. Effectiveness of patient decision aid supported shared decision-making intervention in in-person and virtual hybrid pulmonary rehabilitation in older adults with chronic obstructive pulmonary disease: A pilot randomized controlled trial. J Telemed Telecare 2023:1357633X231156631. [PMID: 36919365 DOI: 10.1177/1357633x231156631] [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: 03/16/2023]
Abstract
INTRODUCTION Tele-pulmonary rehabilitation is increasingly advocated but cannot completely substitute for in-person services for chronic conditions. Adherence to Pulmonary rehabilitation (PR) remains low in chronic obstructive pulmonary disease (COPD) patients. Shared decision-making (SDM) promotes patients' participation in PR decisions and helps patients and healthcare providers to jointly make decisions that patients are informed and aligned with patient preferences and values, which are critical for patient adherence to PR. OBJECTIVE This study aimed to develop a hybrid in-person and virtual model of home-based PR services for older COPD patients and study the effectiveness of the patient decision aid (PDA)-supported recurring SDM intervention on patient adherence to PR, rehabilitation outcomes, and decision-related outcomes, as well as to explore the mechanisms of the intervention on PR adherence. METHODS A total of 78 older COPD patients were randomly assigned to the PR group (n = 39) or PDA-PR group (n = 39). Both groups were conducted hybrid in-person and virtual PR intervention for 3 months. The primary outcomes were patients' quality of life and PR adherence. The secondary outcomes were dyspnea symptoms, exercise self-efficacy, knowledge, and decision-related outcomes. RESULTS A total of 72 participants completed the 3-month PR program. There were statistically significant differences in PR adherence (p = 0.033), COPD assessment test (CAT) scores (p = 0.016), PR knowledge (p < 0.001), decision self-efficacy (p < 0.001), decision conflict (p < 0.001), and decision regret scores (p = 0.027) between the two groups. The modified Medical Research Council Dyspnoea scale (mMRC) score was significantly decreased only in PDA-PR group (p = 0.011). No statistically significant differences were observed in St George's Respiratory Questionnaire (SGRQ) score (p = 0.078), Exercise Self-Regulatory Efficacy Scale (Ex-SRES) score (p = 0.29) and COPD knowledge (p = 0.086) between the two groups. PR value score had a significant effect on adherence to PR (p = 0.007) and CAT score (p = 0.028). CONCLUSIONS PDA supported recurring SDM intervention was helpful in maintaining older COPD patients' PR adherence and had advantages in improving quality of life, enhancing PR knowledge, decision self-efficacy, and reducing decision conflict and decision regret, but did not improve SGRQ and Ex-SRES. PR value score influenced patients' rehabilitation adherence and quality of life. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR): ChiCTR1900028563; http://apps.who.int/trialsearch/default.aspx.
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Affiliation(s)
- Yuyu Jiang
- Department of Nursing, Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, 66374Jiangnan University, Wuxi, China
| | - Baiyila Nuerdawulieti
- Department of Nursing, Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, 66374Jiangnan University, Wuxi, China
| | - Zhongyi Chen
- Department of Nursing, Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, 66374Jiangnan University, Wuxi, China
| | - Jianlan Guo
- Department of Nursing, Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, 66374Jiangnan University, Wuxi, China
| | - Pingping Sun
- Department of Nursing, Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, 66374Jiangnan University, Wuxi, China
| | - Mengjie Chen
- Department of Nursing, Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, 66374Jiangnan University, Wuxi, China
| | - Jinping Li
- Department of Public Health and Preventive Medicine, Wuxi School of Medicine, 66374Jiangnan University, Wuxi, China
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Galvin K, Sucher CM, Bennett RJ, Ebrahimi-Madiseh A, Crosland P, Eikelboom RH. Willingness to consider and to pay for a variety of telehealth services amongst adult hearing clinic clients. Int J Audiol 2023; 62:286-294. [PMID: 35191802 DOI: 10.1080/14992027.2022.2039965] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To examine willingness to consider and to pay for various one-to-one telehealth appointments and online group training/information sessions amongst hearing service clients interested in future telehealth. DESIGN Online survey exploring telehealth usage and attitudes more broadly. STUDY SAMPLE One-hundred-and-sixty-eight (39.8%) of the 422 survey respondents who answered the question were interested in future hearing-related telehealth. Data were analysed for the 148 providing demographic information. RESULTS At least some respondents were interested in each type of one-to-one appointment (∼30-60% for most types) and group training/information session (∼30-50% for most types). Some inconsistent associations were found between willingness to consider individual appointment types and a metropolitan location, younger age, and female gender. Associations with having a hearing device fitted may have been influenced by the different needs of those without devices. Younger respondents were more likely to consider a wide range of appointment types. Being younger was associated with an interest in 7 of the 9 different group session types. The acceptable price range was AUD$30-$86 (USD$22-$62) (n = 129) for one-to-one appointments and AUD$47-$103 (USD$34-$73) for three group sessions (n = 99). CONCLUSIONS Despite additional communication needs, hearing service clients have a strong interest in a range of individual and group telehealth services.
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Affiliation(s)
- Karyn Galvin
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
| | - Catherine M Sucher
- Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia
| | - Rebecca J Bennett
- Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia
| | - Azadeh Ebrahimi-Madiseh
- Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia.,Telethon Speech and Hearing, Wembley, Western Australia
| | - Paul Crosland
- Deakin Health Economics, Institute Health Transformation, Deakin University, Burwood, Australia
| | - Robert H Eikelboom
- Ear Science Institute Australia, Subiaco, Australia.,Ear Sciences Centre, Medical School, The University of Western Australia, Nedlands, Australia.,Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
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Wu TC, Ho CTB. Barriers to Telemedicine Adoption during the COVID-19 Pandemic in Taiwan: Comparison of Perceived Risks by Socioeconomic Status Correlates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3504. [PMID: 36834205 PMCID: PMC9966241 DOI: 10.3390/ijerph20043504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Telemedicine is the use of technology to deliver healthcare services from a distance. In some countries, telemedicine became popular during the COVID-19 pandemic. Its increasing popularity provides new research opportunities to unveil users' perceptions toward its adoption and continued use. Existing studies have provided limited information and understanding of Taiwanese users and the various sociodemographic factors that influence their intention to use telemedicine services. Thus, the goals of this study were twofold: identifying the dimensions of perceived risks of telemedicine services in Taiwan and providing specific responses to those perceptions as well as determining strategies to promote telemedicine to local policymakers and influencers by providing a better understanding of the perceived risks in relation to socioeconomic status. We collected 1000 valid responses using an online survey and found performance risk to be the main barrier, which was followed by psychological, physical, and technology risks. Older adults with lower levels of education are less likely to use telemedicine services compared to other categories because of multiple perceived risks, including social and psychological concerns. Understanding the differences in perceived risks of telemedicine services by socioeconomic status may aid in identifying the actions required to overcome barriers and may consequently improve adoption of the technology and user satisfaction.
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Affiliation(s)
- Tzu-Chi Wu
- Institute of Technology Management, National Chung-Hsing University, Taichung 402, Taiwan
- Department of Emergency Medicine, Show Chwan Memorial Hospital, Changhua 500, Taiwan
| | - Chien-Ta Bruce Ho
- Institute of Technology Management, National Chung-Hsing University, Taichung 402, Taiwan
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Mavragani A, Batterham PJ, Gulliver A, Morse A, Calear AL, McCallum S, Banfield M, Shou Y, Newman E, Dawel A. The Factors Associated With Telehealth Use and Avoidance During the COVID-19 Pandemic: Longitudinal Survey. J Med Internet Res 2023; 25:e43798. [PMID: 36649254 PMCID: PMC9947771 DOI: 10.2196/43798] [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: 10/25/2022] [Revised: 11/16/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Social distancing requirements due to the COVID-19 pandemic saw a rapid increase in the delivery of telehealth consultations as an alternative to face-to-face health care services. OBJECTIVE The aims of this study were to assess the use and acceptability of telehealth during the early stages of the pandemic and identify factors associated with telehealth avoidance during this period. METHODS Data were obtained from waves 4 and 7 of a longitudinal survey designed to assess the impact of the COVID-19 pandemic on the health and behavior of a representative sample of Australian adults. Participants reported on their use or avoidance of telehealth during the assessment period, as well as the mode of telehealth used and acceptability. RESULTS Approximately 30% of participants reported using telehealth during the assessment periods, with the most common telehealth modality being the telephone. Acceptance of telehealth was generally high and was higher among those who used telehealth compared with those who did not. Approximately 18% of participants reported avoiding health care due to telehealth. Across assessment waves, avoidance was associated with younger age, speaking a language other than or in addition to English, having a current medical diagnosis, and lower levels of telehealth acceptability. CONCLUSIONS While most participants in this study were accepting of telehealth services, there remain barriers to use, especially among those from particular sociodemographic groups. At a population level, avoidance of health services in nearly one in five adults may have considerable long-term impacts on morbidity and potentially mortality. Targeted efforts to promote engagement with telehealth services are critical if these adverse outcomes are to be avoided, particularly during periods when access to face-to-face services may be limited.
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Affiliation(s)
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Amelia Gulliver
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Alyssa Morse
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Sonia McCallum
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Michelle Banfield
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Yiyun Shou
- Research School of Psychology, The Australian National University, Canberra, Australia.,Saw See Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Lloyd's Register Foundation Institute for the Public Understanding of Risk, National University of Singapore, Singapore, Singapore
| | - Eryn Newman
- Research School of Psychology, The Australian National University, Canberra, Australia
| | - Amy Dawel
- Research School of Psychology, The Australian National University, Canberra, Australia
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Smyth L, Roushdy S, Jeyasingham J, Whitbread J, O'Brien P, Lloyd C, Lueck CJ, Hawkins CA, Reynolds G, Perriman D. Clinician perspectives on rapid transition to telehealth during COVID-19 in Australia - a qualitative study. AUST HEALTH REV 2023; 47:92-99. [PMID: 36261136 DOI: 10.1071/ah22037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/26/2022] [Indexed: 02/04/2023]
Abstract
Objective The coronavirus disease 2019 (COVID-19) pandemic precipitated a major shift in the use of telehealth in Australia. The changes highlighted gaps in our knowledge regarding the efficacy of, and clinician attitudes to, the use of telehealth. The current study expands and deepens the available evidence as a result of being collected in unique circumstances that removed one of the major barriers (lack of Medicare rebates) and also one major enablers (willingness) of telehealth uptake. Methods Using a semi-structured interview, we invited clinicians (N = 39) to share their perspectives, attitudes and experiences of using telehealth. Topics covered included perceptions of the strengths and challenges of telehealth, and how experience of using telehealth during the COVID-19 pandemic had influenced clinicians' views and intentions regarding their future practice. Participants included clinicians from five disciplines across public and private practice: paediatrics, neurology, immunology, rural general practice, and orthopaedics. Results We found three key dimensions for consideration when assessing the suitability of telehealth for ongoing practice: the attributes of the patient population, the attributes of the clinical context and environment, and the risks and benefits of a telehealth approach. These findings map to the existing literature and allow us to infer that the experiences of clinicians who previously would have chosen telehealth did not differ significantly from those of our 'pandemic-conscripted' clinicians. Conclusions Our findings map clearly to the existing literature and allow us to infer that the experiences of the clinicians who have chosen telehealth (and are already represented in the literature) did not differ significantly from those trying out telehealth under the unique circumstances of the removal of the Medicare Benefits Scheme barrier and external pressure that over-rides the 'willingness' enabling factor in uptake decisions.
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Affiliation(s)
- Lillian Smyth
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Suzannah Roushdy
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Jerusha Jeyasingham
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Joshua Whitbread
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Peta O'Brien
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Charles Lloyd
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Christian J Lueck
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia; and Department of Neurology, Canberra Hospital, Canberra, ACT, Australia
| | - Carolyn A Hawkins
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia; and Department of Immunology, Canberra Hospital, Canberra, ACT, Australia
| | - Graham Reynolds
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia
| | - Diana Perriman
- Medical School, College of Health and Medicine, Australian National University, Florey Building 54, Canberra, ACT 2601, Australia; and Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, ACT, Australia
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Hamlett GE, Tyler J, Bredemeier K, Ballentine E, Brown LA. The impact of COVID-19 on treatment seeking and interest in internet-based therapy for anxiety-related disorders: An interrupted time-series analysis. Psychiatry Res 2023; 320:115044. [PMID: 36638695 PMCID: PMC9798668 DOI: 10.1016/j.psychres.2022.115044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 12/30/2022]
Abstract
AIMS To examine whether the onset of the COVID-19 pandemic led to a change in demand for psychiatric treatment, interest in internet-based therapy, and differences in treatment requests by self-reported diagnoses (e.g., Posttraumatic Stress Disorder, Obsessive Compulsive Disorder, Generalized Anxiety Disorder, and Social Anxiety Disorder). METHODS Using an interrupted time series design, we analyzed intake questionnaires of treatment-seeking patients (N = 1,954) at an anxiety treatment center between June 6, 2019 through September 13, 2021. RESULTS The change in general treatment-seeking from before to immediately after the global pandemic declaration was not statistically significant. However, there was a steady increase in treatment seeking, with a more pronounced increase from 2020 into 2021. Interest in internet-based therapy increased significantly after the onset of COVID-19. The number of treatment-seeking individuals who self-reported "concerns or diagnoses" of PTSD increased significantly. CONCLUSION The study supports anecdotal reports from clinics across the country about unprecedented demand for services. It highlights that many patients experienced an immediate impact of the pandemic on their self-reported concerns about trauma and PTSD symptoms, which has important clinical implications. It also highlights a shifting openness to internet-based services during the pandemic.
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Affiliation(s)
- Gabriella E. Hamlett
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA,Harvard University, Department of Psychology, Cambridge, MA, USA
| | - Jeremy Tyler
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA
| | - Keith Bredemeier
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA
| | - Emily Ballentine
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA
| | - Lily A. Brown
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, Philadelphia, PA, USA,Corresponding author
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36
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Ivancic L, Bond DM, Nassar N. Impact of the COVID-19 pandemic on access and use of health services by middle-aged and older Australians. AUST HEALTH REV 2023; 47:100-109. [PMID: 36395815 DOI: 10.1071/ah22183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022]
Abstract
Objectives To examine: the impact of the coronavirus disease 2019 (COVID-19) pandemic on access to health services by middle-aged and older Australians; and the use of telehealth services during the COVID-19 pandemic and its ongoing usefulness. Methods A cross-sectional survey was conducted among participants who completed the COVID-19 supplement in the 45 and Up Study 2020 Survey. Multivariable logistic regression analysis was used to examine the association between socio-demographic characteristics and health conditions with missed/delayed access to health services, changes in health outcomes resulting from missed/delayed access, and use of telehealth services. Results Data for 45 071 participants were analysed (56% female, 72% aged ≥65 years). Almost half (42.2%) reported they had missed/delayed access to health care due to COVID-19; mainly for dental services (26.1%), visits to a general practitioner (GP) (16.3%) and specialists (12.6%). Missed/delayed visits to GPs and specialists were more likely among females, participants from non-English-speaking backgrounds, with disability/illness, living in outer regional/remote areas or with chronic health conditions. People with a disability or high/very high psychological distress were twice as likely to report worse health as a result of missed/delayed care. Half (48.0%) the study participants used telehealth during the COVID-19 pandemic and 81.9% indicated telehealth would be useful post-pandemic. Conclusions The COVID-19 pandemic impacted access to healthcare services, particularly for people with a disability, and chronic or mental health issues who also reported worse health. This may account for their higher use of telehealth services as an alternate way of accessing health care. Ongoing evaluation of telehealth services for vulnerable groups post-pandemic is required.
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Affiliation(s)
- Lorraine Ivancic
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, 2nd Floor, Charles Perkins Centre, University of Sydney, NSW 2006, Australia; and Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, 2nd Floor, Charles Perkins Centre, University of Sydney, NSW 2006, Australia
| | - Diana M Bond
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, 2nd Floor, Charles Perkins Centre, University of Sydney, NSW 2006, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, 2nd Floor, Charles Perkins Centre, University of Sydney, NSW 2006, Australia; and Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, 2nd Floor, Charles Perkins Centre, University of Sydney, NSW 2006, Australia
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Patient behaviors during virtual clinic encounters in palliative care. Palliat Support Care 2023; 21:178-180. [PMID: 35670297 DOI: 10.1017/s1478951522000669] [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: 11/07/2022]
Abstract
Telehealth use has accelerated since the COVID-19 pandemic and provided access for palliative care patients often facing challenges with travel and limited specialist availability. Our palliative care clinic at the University of Texas MD Anderson Cancer Center has rapidly adopted telehealth which continues to grow and provide care for patients since the pandemic, becoming a routine part of our center. While we strive to maintain consistency when it comes to compassionate, sensitive verbal and non-verbal communication, we have witnessed both advantages and disadvantages to telehealth services. We have come across unanticipated virtual visit challenges while trying to deliver quality care, surprising us from the other side of the camera. In this paper, we describe three cases of unexpected telehealth etiquette that posed new challenges in being able to complete virtual visits. We propose guidelines for setting patient etiquette for a productive telehealth palliative visit.
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Doctor for Every Citizen: Telehealth Visits at Dubai Health Authority during COVID-19 Pandemic in Dubai, United Arab Emirates. Healthcare (Basel) 2023; 11:healthcare11030294. [PMID: 36766869 PMCID: PMC9914661 DOI: 10.3390/healthcare11030294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Digital health significantly affects healthcare delivery. Moreover, empirical studies on the utilization of telehealth in Dubai are limited. Accordingly, this study examines the utilization of telehealth services in Dubai Health Authority (DHA) facilities and the factors associated with telehealth appointment completion and turnaround time. METHODS This cross-sectional study examines patients who used telehealth services in DHA from 2020 through 2021 using 241,822 records. A binary logistic regression model was constructed to investigate the association between appointment turnaround time as a dependent variable and patient and visit characteristics as independent variables. RESULTS Of the total scheduled telehealth visits, more than three-quarter (78.55%) were completed. Older patients, non-Emiratis, patients who had their visits in 2020, patients who had video visits, and those who sought family medicine as a specialty had a shorter turnaround time to receive their appointment. CONCLUSIONS This study identifies several characteristics associated with the turnaround time. Moreover, technological improvements focusing on specialties that can readily be addressed through telehealth and further research in this domain will improve service provision and support building an evidence-base in the government sector of the emirate of Dubai.
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Halcomb EJ, Ashley C, Dennis S, McInnes S, Morgan M, Zwar N, Williams A. Telehealth use in Australian primary healthcare during COVID-19: a cross-sectional descriptive survey. BMJ Open 2023; 13:e065478. [PMID: 36604135 PMCID: PMC9826926 DOI: 10.1136/bmjopen-2022-065478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE This study aimed to investigate Australian primary healthcare professionals' experiences of the rapid upscaling of telehealth during COVID-19. DESIGN A cross-sectional survey. PARTICIPANTS AND SETTING Two hundred and seventeen general practitioners, nurses and allied health professionals employed in primary healthcare settings across Australia were recruited via social media and professional organisations. METHODS An online survey was disseminated between December 2020 and March 2021. The survey comprised items about individual demographics, experiences of delivering telehealth consultations, perceived quality of telehealth consultations and future perceptions of telehealth. RESULTS Telephone was the most widely used method of providing telehealth, with less than 50% of participants using a combination of telephone and video. Key barriers to telehealth use related to the inability to undertake physical examination or physical intervention. Telehealth was perceived to improve access to healthcare for some vulnerable groups and those living in rural settings, but reduced access for people from non-English-speaking backgrounds. Quality of telehealth care was considered mostly or somewhat the same as care provided face-to-face, with actual or perceived negative outcomes related to missed or delayed diagnosis. Overwhelmingly, participants wanted telehealth to continue with guaranteed ongoing funding. Some 43.7% of participants identified the need to further improve telehealth models of care. CONCLUSION The rapid shift to telehealth has facilitated ongoing care during the COVID-19 pandemic. However, further work is required to better understand how telehealth can be best harnessed to add value to service delivery in usual care.
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Affiliation(s)
- Elizabeth J Halcomb
- School of Nursing, University of Wollongong Faculty of Science, Medicine and Health, Wollongong, New South Wales, Australia
| | - Christine Ashley
- School of Nursing, University of Wollongong Faculty of Science, Medicine and Health, Wollongong, New South Wales, Australia
| | - Sarah Dennis
- Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Susan McInnes
- School of Nursing, University of Wollongong Faculty of Science, Medicine and Health, Wollongong, New South Wales, Australia
| | - Mark Morgan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Nicholas Zwar
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Anna Williams
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- School of Nursing and Midwifery, University of Notre Dame Australia, Sydney, New South Wales, Australia
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Telehealth for COVID-19: A Conceptual Framework. JOURNAL OF HEALTHCARE ENGINEERING 2023; 2023:3679829. [PMID: 36818384 PMCID: PMC9929206 DOI: 10.1155/2023/3679829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/02/2022] [Accepted: 05/12/2022] [Indexed: 02/10/2023]
Abstract
The world has been going through the global crisis of the coronavirus (COVID-19). It is a challenging situation for every country to tackle its healthcare system. COVID-19 spreads through physical contact with COVID-positive patients and causes potential damage to the country's health and economy system. Therefore, to overcome the chance of spreading the disease, the only preventive measure is to maintain social distancing. In this vulnerable situation, virtual resources have been utilized in order to maintain social distance, i.e., the telehealth system has been proposed and developed to access healthcare services remotely and manage people's health conditions. The telehealth system could become a regular part of our healthcare system, and during any calamity or natural disaster, it could be used as an emergency response to deal with the catastrophe. For this purpose, we proposed a conceptual telehealth framework in response to COVID-19. We focused on identifying critical issues concerning the use of telehealth in healthcare setups. Furthermore, the factors influencing the implementation of the telehealth system have been explored in detail. The proposed telehealth system utilizes artificial intelligence and data science to regulate and maintain the system efficiently. Before implementing the telehealth system, it is required that prearrangements be made, such as appropriate funding measures, the skills to know technological usage, training sessions, and staff endorsement. The barriers and influencing factors provided in this article can be helpful for future developments in telehealth systems and for making fruitful progress in fighting pandemics like COVID-19. At the same time, the same approach can be used to save the lives of many frontline workers.
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Shaw F, Fomiatti R, Farrugia A, Fraser S. Proper distance in the age of social distancing: Hepatitis C treatment, telehealth and questions of care and responsibility. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:19-36. [PMID: 36214600 PMCID: PMC10092018 DOI: 10.1111/1467-9566.13558] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 08/02/2022] [Indexed: 06/16/2023]
Abstract
During the COVID-19 pandemic, telehealth has played a prominent role in the treatment of hepatitis C. As part of a qualitative study on the accessibility and effectiveness of telehealth for hepatitis C treatment during this period in Australia, this article considers how health-care practitioners and patients experience and manage their proximity to each other in telehealth encounters of care. Comparisons between telehealth and in-person health-care tend to focus on measures of patient satisfaction rather than qualitative changes in treatment relationships. Media scholar Silverstone (Digital media revisited: Theoretical and conceptual innovations in digital domains, MIT Press, 2003) uses the term 'proper distance' to theorise how ethical relationships are mediated by technology. Drawing on this concept, we explore how patients and health-care practitioners understand telehealth as affecting distance and proximity. We find that both groups express some ambivalence about the impact of telehealth on relationships, on the one hand expecting and privileging simple, transactional relationships, and on the other hand, expressing concerns about the loss of more intimate relationships in health care and about 'missing something' while providing health care. Given that proximity is important to the development of ethical relationships in health care, we conclude with some considerations for establishing and sustaining attentive and responsive relationships in telehealth.
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Affiliation(s)
- Frances Shaw
- Australian Research Centre in Sex, Health and SocietyLa Trobe UniversityMelbourneVictoriaAustralia
- ARC Centre of Excellence for Automated Decision‐Making and SocietySwinburne University of TechnologyHawthornVictoriaAustralia
| | - Renae Fomiatti
- Australian Research Centre in Sex, Health and SocietyLa Trobe UniversityMelbourneVictoriaAustralia
- School of Humanities and Social SciencesFaculty of Arts and EducationDeakin UniversityBurwoodVictoriaAustralia
| | - Adrian Farrugia
- Australian Research Centre in Sex, Health and SocietyLa Trobe UniversityMelbourneVictoriaAustralia
| | - Suzanne Fraser
- Australian Research Centre in Sex, Health and SocietyLa Trobe UniversityMelbourneVictoriaAustralia
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Islam MI, Bagnulo S, Wang Y, Ramsden R, Wrightson T, Masset A, Colbran R, Edwards M, Martiniuk A. Job Satisfaction of Health Practitioners Providing Outreach Health Services during COVID-19 in Rural New South Wales (NSW) and the Australian Capital Territory (ACT), Australia. Healthcare (Basel) 2022; 11:healthcare11010003. [PMID: 36611463 PMCID: PMC9819187 DOI: 10.3390/healthcare11010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Outreach health practitioners play a key role in enhancing access to healthcare for remote, rural, regional, and Aboriginal and Torres Strait Islander communities in Australia. Outreach health practitioners are those providing ongoing and integrated health services in communities that would otherwise have limited access. In the context of the COVID-19 pandemic, it is important to understand the job satisfaction of health workers as it correlates with long-term retention of the workforce, as well as effectiveness in the role and clinical outcomes for patients. Method: The study analysed data from 258 outreach health practitioners who responded to two cross-sectional surveys conducted by the NSW Rural Doctors Network during the COVID-19 pandemic in 2020/21 and 2021/22 in NSW and the ACT, Australia. Both bivariate and multivariate analyses were employed to assess the associations between the outcome variable (outreach health practitioners' job satisfaction) and independent variables (sociodemographic factors, motivation, self-confidence, communication, capability). Results: Overall, the study showed that 92.2% of health practitioners were satisfied in their role providing outreach health services during the COVID-19 pandemic. In the multivariable model, factors significantly associated with higher satisfaction included good communication with other local health practitioners, using telehealth along with in-person care, and having high self-rated capability compared to those health practitioners who said they had lower job satisfaction. Conclusions: Outreach health practitioners' job satisfaction is important because poor satisfaction may lead to suboptimal healthcare delivery, poor clinical outcomes, and poor retention of staff in rural settings. These findings should be taken into consideration when developing future strategies to improve job satisfaction among rural outreach health practitioners and to enhance attraction, recruitment and retention and may be applicable to the broader health workforce.
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Affiliation(s)
- Md Irteja Islam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
- Centre for Health Research and Faculty of Health, Engineering and Sciences, The University of Southern Queensland, West Street, Darling Heights, Toowoomba, QLD 4350, Australia
- Correspondence:
| | - Sharif Bagnulo
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
- Australasian College of Health Service Management, 11/41-43 Higginbotham Rd., Gladesville, Sydney, NSW 2111, Australia
| | - Yiwen Wang
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
| | - Robyn Ramsden
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
- School of Health and Social Development, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, VIC 3220, Australia
| | - Trent Wrightson
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Amanda Masset
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Richard Colbran
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Mike Edwards
- NSW Rural Doctors Network, Suite 1, 53 Cleary Street, Hamilton, Sydney, NSW 2303, Australia
| | - Alexandra Martiniuk
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006, Australia
- Office of the Chief Scientist, The George Institute for Global Health, Level 5/1 King Street, Newtown, Sydney, NSW 2042, Australia
- Dalla Lana School of Public Health, The University of Toronto, 155 College Street Room 500, Toronto, ON M5T 3M7, Canada
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Nugent K, Quinlan E, Cleary S, O'Driscoll H, Rohan C, Trousdell J, Williams J, Dunne M, McArdle O, Duane F. Implementation of 26 Gy in five fractions over 1 week adjuvant radiotherapy for breast cancer: Prospective report of acute skin toxicity and consideration of resource implications. Breast 2022; 67:55-61. [PMID: 36603414 PMCID: PMC9756602 DOI: 10.1016/j.breast.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/24/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE In March 2020, a 1-week adjuvant breast radiotherapy schedule, 26 Gy in 5 fractions, was adopted to reduce the risk of COVID19 for staff and patients. This study quantifies acute toxicity rates and the effect on linac capacity. MATERIALS AND METHODS This is a report of consecutive patients receiving ultrafractionated breast radiotherapy ( ± sequential boost) Mar-Aug 2020. Virtual consultations assessed acute skin toxicity during treatment and weeks 1, 2, 3 and 4 post treatment using CTCAE V5 scoring criteria. The number of linac minutes saved was estimated accounting for boost and DIBH use. RESULTS In total, 128/135 (95%) patients, including 31/33 boost patients, completed at least 3/5 assessments. 0/128 (0%) reported moist desquamation not confined to skin folds or minor bleeding (Grade 3), 41/128 (32%) reported brisk erythema, moist desquamation confined to skin folds or breast swelling (Grade 2), 62/128 (48%) reported faint erythema or dry desquamation (Grade 1) as their worst skin toxicity, with the remaining 20% reporting no skin toxicity. The highest prevalence of grade 2 toxicity occurred week 1 following treatment (20%), reducing to 3% by week 4. There was no difference in toxicity between those who received a boost versus not (p = 1.00). Delivering this schedule to 135 patients over six months saved 21,300 linac minutes and 1485 hospital visits compared to a 3-week schedule. CONCLUSION Rapidly implementing ultrahypofractionated breast radiotherapy is feasible and acute toxicity rates are acceptable even when followed by boost.
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Affiliation(s)
- K. Nugent
- St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland
| | - E. Quinlan
- St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland
| | - S. Cleary
- St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland
| | - H. O'Driscoll
- St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland
| | - C. Rohan
- St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland
| | - J. Trousdell
- St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland
| | - J. Williams
- St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland
| | - M. Dunne
- St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland
| | - O McArdle
- St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland
| | - F.K. Duane
- St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland,Trinity St James's Cancer Institute, St. James's Hospital, Dublin, Ireland,School of Medicine, Trinity College Dublin, Ireland,Corresponding author. St Luke's Radiation Oncology Network and Trinity St. James's Cancer Institute, St James's Hospital, Dublin 8, Ireland.
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Poitras ME, Poirier MD, Couturier Y, T Vaillancourt V, Cormier C, Gauthier G, Massé S, Gendron A, Oswick ML, Morin A, Blanchette P, Bernier A. Chronic conditions patient's perception of post-COVID-19 pandemic teleconsulting continuation in primary care clinics: a qualitative descriptive study. BMJ Open 2022; 12:e066871. [PMID: 36521903 PMCID: PMC9755907 DOI: 10.1136/bmjopen-2022-066871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has led to the prioritisation of teleconsultation instead of face-to-face encounters. However, teleconsultation revealed some shortcomings and undesirable effects that may counterbalance benefits. This study aims to explore the perspective of patients with chronic diseases on teleconsultation in primary care. This article also proposes recommendations to provide patient-oriented and appropriate teleconsultations. DESIGN We conducted a qualitative descriptive study that explored the patients' perception regarding teleconsultation services and the following themes: access, perceived benefits and disadvantages, interprofessional collaboration, patient-centred approach, specific competencies of professionals, and patient's global needs and preferences. SETTING Six primary care clinics in three regions of Quebec. PARTICIPANTS 39 patients were interviewed by telephone through semistructured qualitative interviews. RESULTS Patients want to maintain teleconsultation for the postpandemic period as long as their recommendations are followed: be able to choose to come to the clinic if they wish to, feel that their individual and environmental characteristics are considered, feel involved in the choice of the modality of each consultation, feel that interprofessional collaboration and patient-centred approach are promoted, and to maintain the professionalism, which must not be lessened despite the remote context. CONCLUSION Patients mainly expressed high satisfaction with teleconsultation. However, several issues must be addressed. Patients do and should contribute to the implementation of teleconsultation in primary care. They wish to be frequently consulted about their preferred consultation modality, which may change over time. The patient perspective must, therefore, be part of the balanced implementation of optimal teleconsultation that is currently taking place.
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Affiliation(s)
- Marie-Eve Poitras
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Québec, Canada
| | - Marie-Dominique Poirier
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Québec, Canada
| | - Yves Couturier
- School of social work, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Vanessa T Vaillancourt
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Québec, Canada
| | - Caroline Cormier
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Québec, Canada
| | - Gilles Gauthier
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Québec, Canada
| | - Sylvie Massé
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Québec, Canada
| | - Audrey Gendron
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Megan L Oswick
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Anaelle Morin
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Patricia Blanchette
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Andréanne Bernier
- Department of Health Sciences, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, Canada
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Seidler ZE, Wilson MJ, Oliffe JL, Kealy D, Ogrodniczuk JS, Walther A, Rice SM. "I could hang up if the practitioner was a prat": Australian men's feedback on telemental healthcare during COVID-19. PLoS One 2022; 17:e0279127. [PMID: 36516184 PMCID: PMC9749969 DOI: 10.1371/journal.pone.0279127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic restrictions, uncertainties and management inconsistencies have been implicated in men's rising distress levels, which in turn have somewhat normed the uptake of telemental healthcare services (i.e., phone and/or video-conference-based therapy). Given past evidence of poor engagement with telemental health among men, this mixed-methods study examined Australian men's use of, and experiences with telemental health services relative to face-to-face care during the pandemic. A community sample of Australian-based men (N = 387; age M = 47.5 years, SD = 15.0 years) were recruited via Facebook advertising, and completed an online survey comprising quantitative items and open-response qualitative questions with the aim of better understanding men's experiences with telemental healthcare services. In total, 62.3% (n = 241) of participants reported experience with telemental health, and regression analyses revealed those who engaged with telemental health were on average younger, more likely to be gay and university educated. Men who had used telemental health were, on average, more satisfied with their therapy experience than those who had face-to-face therapy. Among those who had telemental healthcare, marginally lower satisfaction was observed among regional/rural based relative to urban men, and those who had to wait longer than 2 months to commence therapy. Qualitative findings highlighted positive aspects of telemental healthcare including comfort with accessing therapy from familiar home environments and the convenience and accessibility of telemental health alongside competing commitments and COVID-19 restrictions. Conversely, drawbacks included technical limitations such as crosstalk impeding therapeutic progress, disconnects and audio-visual lag-times and the 'impersonal' nature of telemental healthcare services. Findings broadly signal COVID-19 induced shifts norming of the use of virtual therapy services, with clear scope for improvement in the delivery of therapeutic practice using digital modalities, especially among help-seeking men.
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Affiliation(s)
- Zac E. Seidler
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Movember, Melbourne, Australia
- * E-mail:
| | - Michael J. Wilson
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - John L. Oliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
- Department of Nursing, The University of Melbourne, Melbourne, Australia
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Simon M. Rice
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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Frankowska A, Szymkowiak M, Walkowiak D. Teleconsultations Quality During the COVID-19 Pandemic in Poland in the Opinions of Generation Z Adults. Telemed J E Health 2022; 28:1843-1851. [PMID: 35446678 DOI: 10.1089/tmj.2021.0552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction: The aim of the study was to collect and evaluate the opinions of representatives of Generation Z on their satisfaction with medical teleconsultation services during the COVID-19 pandemic in Poland. Methods: An online survey was conducted from April to June 2021. We received replies from 424 students. The research tools used comprised a validated Doctor-Patient Communication (DPC) questionnaire, the Telehealth Satisfaction Scale (TeSS), and a self-authored questionnaire. Results: About 60% of the respondents rated communication with a doctor during the remote visit as medium, with a DPC score value in the intermediate range (36-50). Only 7.5% of students rated DPC as high (DPC score over 50). Also, satisfaction with telemedicine measured by the modified Telehealth Satisfaction Scale was assessed as intermediate by 61.3% of respondents. DPC and satisfaction with telemedicine services are better assessed by students living in large cities and those who used paid telemedicine services. Conclusions: The need to improve the quality of DPC has been observed. Also, the functioning of telemedicine platforms, with the possibility of using images in teleconsultations would be welcome, with the concomitant leveling out of the disproportions in the quality of telemedicine services and DPC between urban and rural areas, as well as between commercial and noncommercial services. This could improve the service delivery process and, consequently, be beneficial for the competitiveness of telemedicine, which will be based on medical rather than organizational aspects.
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Affiliation(s)
- Anna Frankowska
- Department of Organization and Management in Healthcare, Poznań University of Medical Sciences, Poznań, Poland
| | - Marcin Szymkowiak
- Institute of Informatics and Quantitative Economics, Poznań University of Economics and Business, Poznań, Poland.,Statistical Office in Poznań, Poznań, Poland
| | - Dariusz Walkowiak
- Department of Organization and Management in Healthcare, Poznań University of Medical Sciences, Poznań, Poland
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Pool J, Namvar M, Akhlaghpour S, Fatehi F. Exploring public opinion about telehealth during COVID-19 by social media analytics. J Telemed Telecare 2022; 28:718-725. [PMID: 36346934 PMCID: PMC9646901 DOI: 10.1177/1357633x221122112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/10/2022] [Indexed: 12/02/2023]
Abstract
While COVID-19 catalyzed the acceptance and use of telehealth, our understanding of how it is perceived by multi-stakeholders such as patients, clinicians, and health authorities is limited. Drawing on social media analytics, this research examines social media discourses and users' opinions about telehealth during the COVID-19 pandemic. It applies natural language processing and deep learning to explore word of mouth on telehealth with a contextualized focus on the COVID-19 pandemic. We conducted topic modeling, sentiment analysis, and emotion analysis (fearful, happy, sad, surprised, and angry emotions). The topic modeling analysis led to the identification of 18 topics, representing 6 themes of digital health service delivery, pandemic response, communication and promotion, government action, health service domains (e.g. mental health, cancer, aged care), as well as pharma and drug. The sentiment analysis revealed that while most opinions expressed in tweets were positive, the public expressed mostly negative opinions about certain aspects of COVID-19 such as lockdowns and cyberattacks. Emotion analysis of tweets showed a dominant pattern of fearful and sad emotions in particular topics. The results of this study that inductively emerged from our social media analysis can aid public health authorities and health professionals to address the concerns of telehealth users and improve their experiences.
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Affiliation(s)
- Javad Pool
- Business School, The University of
Queensland, Brisbane, Australia
| | - Morteza Namvar
- Business School, The University of
Queensland, Brisbane, Australia
| | | | - Farhad Fatehi
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Centre for Health Services Research, The University of
Queensland, Brisbane, Australia
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Erdoğan S, Can AA, Abiç A, Yilmaz DV. Examination of individuals' depression, anxiety, and stress levels during the COVID-19 pandemic in Turkey. Arch Psychiatr Nurs 2022; 41:96-102. [PMID: 36428081 PMCID: PMC9307468 DOI: 10.1016/j.apnu.2022.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/31/2022] [Accepted: 07/10/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE This research was conducted to determine the depression, anxiety, and stress levels of individuals during the COVID-19 epidemic. In addition, the compatibility of the Depression-Anxiety-Stress Scale (DASS-21) scale results with the participants' feeling depressed, anxious, and stressed were examined. DESIGN AND METHODS The sample of the study consisted of 870 individuals over the age of 18 between May-August 2021. The data of the study were collected online, using the personal information form and DASS-21. RESULTS In our study, it was observed that 22.3 % of the participants were severely depressed, 19.0 % were highly anxious and 14.3 % were highly stressed. In addition, a relationship was determined between many sociodemographic variables and depression, anxiety, and stress levels. It was found that individuals who were not vaccinated, did not receive health care, and were not satisfied with health care were more depressed, anxious, and stressed. The agreement between all DASS-21 sub-dimensions and participants' feeling is poor in terms of Cohen's kappa. The agreement is poor in the anxiety sub dimension, but moderate in the other sub-dimensions in terms of Gwet's AC1. PRACTICE IMPLICATIONS It is recommended that nurses develop new care and evaluation strategies for the psychosocial field in order to protect and maintain the health of individuals during the COVID-19 pandemic process, as well as more practices promoting the COVID-19 vaccine in our country.
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Affiliation(s)
- Semra Erdoğan
- Department of Biostatistics and Medical Informatics, Mersin University Faculty of Medicine, 33343 Mersin, Turkey.
| | - Ahu Aksoy Can
- Department of Obstetrics and Gynecology Nursing, Mersin University Faculty of Nursing, 33343 Mersin, Turkey
| | - Arzu Abiç
- Department of Nursing, Faculty of Health Sciences, Eastern Mediterranean University, Famagusta, North Cyprus, via Mersin 10, Turkey.
| | - Duygu Vefikuluçay Yilmaz
- Department of Obstetrics and Gynecology Nursing, Mersin University Faculty of Nursing, 33343 Mersin, Turkey; Department of Obstetrics and Gynecology Nursing, Mersin University Faculty of Nursing, Mersin, 33343 Mersin, Turkey
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Green H, Fernandez R, MacPhail C. Well-being and social determinants of health among Australian adults: A national cross-sectional study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4345-e4354. [PMID: 35561090 PMCID: PMC10084241 DOI: 10.1111/hsc.13827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/25/2022] [Accepted: 04/22/2022] [Indexed: 05/07/2023]
Abstract
The social determinants of health affect an individual's capacity to cope during a crisis such as the COVID-19 pandemic which could potentially impact their well-being. The aim of this study was to examine the relationship between well-being and the social determinants of health among Australian adults during the COVID-19 pandemic. A cross-sectional study of adults residing in Australia was conducted using SurveyMonkey between 20 August and 14 October 2020. Participants were recruited via social media. Well-being was measured using the 10-item Multicultural Quality of Life Index and social determinants of health were measured using validated tools and investigator developed questions. Data were analysed using SPSS version 25. Inferential statistics, including independent t-test and one-way ANOVA, were undertaken. Multiple regression analysis was used to investigate the predictors of well-being. In total, 1211 responses were received. Females accounted for 80.7% of the responses, men 16.7% and transgender/non-binary 2.6%. The mean age of the respondents was 43 years (SD 14.2). The mean score for total well-being was 62.58 (SD 21.22). The significant predictors of higher well-being were housing security (p = 0.000), food security (p = 0.000), social support (p = 0.000) and access to healthcare (p = 0.000). This study demonstrates that those with poor social support, difficulty accessing healthcare, insecure housing and food insecurity had significantly poorer well-being during the COVID-19 pandemic. It shows that the COVID-19 pandemic has exacerbated social vulnerabilities and highlights the need for action to address the social determinants of health and inequalities.
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Affiliation(s)
- Heidi Green
- Centre for Research in Nursing and HealthSt George HospitalNew South WalesAustralia
- School of NursingUniversity of WollongongNew South WalesAustralia
- Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of ExcellenceWollongongNew South WalesAustralia
| | - Ritin Fernandez
- Centre for Research in Nursing and HealthSt George HospitalNew South WalesAustralia
- School of NursingUniversity of WollongongNew South WalesAustralia
- Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of ExcellenceWollongongNew South WalesAustralia
| | - Catherine MacPhail
- School of Health and SocietyUniversity of WollongongNew South WalesAustralia
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O’Mara B, Monani D, Carey G. Telehealth, COVID-19 and Refugees and Migrants in Australia: Policy and Related Barriers and Opportunities for More Inclusive Health and Technology Systems. Int J Health Policy Manag 2022; 11:2368-2372. [PMID: 33906333 PMCID: PMC9808256 DOI: 10.34172/ijhpm.2021.31] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/16/2021] [Indexed: 01/12/2023] Open
Affiliation(s)
- Ben O’Mara
- Department of Media and Communication, Faculty of Health, Arts and Design, Swinburne University, Melbourne, VIC, Australia
| | - Devaki Monani
- School of Social Work, College of Health and Human Sciences, Charles Darwin University, Casuarina, NT, Australia
| | - Gemma Carey
- Centre for Social Impact, University of New South Wales, Sydney, NSW, Australia
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