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Rindge ME, Strainge L, O'Connor MK. A neuropsychological feedback model for memory clinic trainees. BMC Med Educ 2024; 24:40. [PMID: 38191384 PMCID: PMC10773085 DOI: 10.1186/s12909-023-04903-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/24/2023] [Indexed: 01/10/2024]
Abstract
Memory clinics that specialize in evaluating and treating cognitive decline in older adults are increasingly common and serve as an important training setting for neuropsychology practicum students, interns, and postdoctoral residents. Following a neuropsychological evaluation, trainees are tasked with sharing results, diagnoses, and treatment recommendations, a practice referred to as feedback. Despite the importance and complexity of providing feedback in this setting, no specific model of feedback delivery exists to guide trainees when learning this crucial skill within a memory clinic. The following article presents a feedback model for memory clinic trainees and details its development based on best practices available in the literature. The feedback model aims to promote trainees' confidence in their clinical skills and increase patient and visit partner understanding of evaluation results. It is also our hope that this model will advance the field of education within neuropsychology.
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Affiliation(s)
- Melissa E Rindge
- Neuropsychology Service, Bedford VA Healthcare System, 200 Springs Rd, Bedford, MA, 01730, USA.
| | - Lauren Strainge
- Neuropsychology Service, Bedford VA Healthcare System, 200 Springs Rd, Bedford, MA, 01730, USA
| | - Maureen K O'Connor
- Neuropsychology Service, Bedford VA Healthcare System, 200 Springs Rd, Bedford, MA, 01730, USA
- Geriatric Research Education and Clinical Center (GRECC), Bedford VA Healthcare System, Bedford, MA, USA
- Department of Neurology, Boston University, Boston, MA, USA
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Jamal Z, ElKhatib Z, AlBaik S, Horino M, Waleed M, Fawaz F, Loffreda G, Seita A, Witter S, Diaconu K. Social determinants and mental health needs of Palestine refugees and UNRWA responses in Gaza during the COVID-19 pandemic: a qualitative assessment. BMC Public Health 2022; 22:2296. [PMID: 36482403 PMCID: PMC9733234 DOI: 10.1186/s12889-022-14771-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Due to pre-existing difficulties, refugees are especially susceptible to the negative effects of the pandemic; nonetheless, the pandemic's effect on this group is still unclear. The purpose of this study was to determine the effects of the COVID-19 pandemic on the mental health of Palestine refugees in Gaza by identifying the role of social determinants. During the pandemic, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) enacted a number of policies and measures. The purpose of this research was to assess their efficacy and acceptability. METHODS This qualitative study took place between August and November 2020. Twenty-nine key-informant interviews were conducted remotely with UNRWA Headquarters, field and clinical staff in Gaza and with community members, aged ≥18 years and residing in Rafah and Jabalia camps. We sought informed consent verbally or via email. Data was coded based on the framework for social determinants of mental health. RESULTS Interview results indicated that the relationship might be unidirectional, with COVID-19 causing the degradation of living conditions and vice versa, with living conditions exacerbating the COVID-19 situation by facilitating virus transmission. In other instances, the association between mental health determinants and COVID-19 might be bidirectional. In terms of experiencing violence and anxieties, women, children, and daily-paid employees were significantly more disadvantaged than other groups in the community. UNRWA modified its service delivery techniques in order to continue providing essential services. In general, UNRWA's strategies throughout the pandemic were deemed beneficial, but insufficient to meet the needs of Gazans. CONCLUSION The pandemic highlights the need to go beyond disease treatment and prevention to address social determinants to improve refugees' health and reduce their susceptibility to future shocks. UNRWA has rapidly implemented telemedicine and mental telehealth services, making it imperative to assess the efficacy of these novel approaches to provide care at a distance. A long-term option may be to employ a hybrid strategy, which combines online and in-person therapy.
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Affiliation(s)
- Zeina Jamal
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Zoheir ElKhatib
- The United Nations for the Relief and Works Agency in the Near East (UNRWA) Field Office, Gaza, Palestine
| | - Shatha AlBaik
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Masako Horino
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan ,grid.21107.350000 0001 2171 9311Center for Human Nutrition and Sight & Life Global Nutrition Research Institute, Dept of Int’l Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Mohammed Waleed
- The United Nations for the Relief and Works Agency in the Near East (UNRWA) Field Office, Gaza, Palestine
| | - Farah Fawaz
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Giulia Loffreda
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Akihiro Seita
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Sophie Witter
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Karin Diaconu
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
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DePuccio MJ, Gaughan AA, Shiu-Yee K, McAlearney AS. Doctoring from home: Physicians' perspectives on the advantages of remote care delivery during the COVID-19 pandemic. PLoS One 2022; 17:e0269264. [PMID: 35653337 PMCID: PMC9162302 DOI: 10.1371/journal.pone.0269264] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/17/2022] [Indexed: 12/15/2022] Open
Abstract
Background During the COVID-19 pandemic, stay-at-home orders as well as shortages of personal protective equipment forced primary care physicians (PCPs) to transition rapidly from in-person visits to telehealth. While telehealth expanded extensively in a short period of time, research about the consequences of the shift to remote care is lacking. The objective of this qualitative study was to examine how telehealth benefited PCPs and their patients during the COVID-19 pandemic. Methods From July to August 2020, semi-structured interviews were conducted with 20 PCPs associated with a single academic medical center to examine their perspectives about delivering care remotely during the COVID-19 pandemic. All interviews were recorded, transcribed verbatim, coded, and analyzed using deductive thematic analysis. Results PCPs identified several benefits of remote care delivery for both physicians and patients. They indicated that (1) patients were reassured that they could receive safe and timely care, (2) remote visits were convenient for patients, (3) patients were comfortable receiving care at home, and (4) video visits enhanced patient- and family-centered care during the COVID-19 pandemic. Participants also noted that (1) telehealth accommodated working from home, (2) physicians were equitably reimbursed for telehealth visits, and that (3) telehealth promoted physician work-life balance. Conclusions Our data provides preliminary evidence that PCPs and their patients had positive experiences with remote care during the early months of the COVID-19 pandemic. Physicians identified opportunities by which telehealth could enhance the delivery of patient-centered care by allowing them to see patients’ home environments and to engage family members and caregivers during telehealth visits. More research is needed to understand how to sustain these benefits beyond the global COVID-19 pandemic and ensure patients’ needs are met.
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Affiliation(s)
- Matthew J. DePuccio
- Department of Health Systems Management, College of Health Sciences, Rush University, Chicago, Illinois, United States of America
| | - Alice A. Gaughan
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Karen Shiu-Yee
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Ann Scheck McAlearney
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- * E-mail:
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Haimi M, Gesser-Edelsburg A. Application and implementation of telehealth services designed for the elderly population during the COVID-19 pandemic: A systematic review. Health Informatics J 2022; 28:14604582221075561. [PMID: 35175881 PMCID: PMC8859483 DOI: 10.1177/14604582221075561] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Telehealth has many benefits, in routine care and especially during times of epidemics in which restrictions to direct patient/healthcare-provider interaction exist. OBJECTIVE To explore the availability, application, and implementation of telehealth services during the Covid-19 era, designed for the aged population (age 65 and more). METHODS This systematic review/analysis was conducted by searching the most popular databases including PubMed, Embase, and Web of Science. We included studies that clearly defined any use of telemedicine services in any aspect of healthcare during the COVID-19 pandemic, aimed at the elderly population, published in peer-reviewed journals. We independently assessed search results, extracted the relevant studies, and assessed their quality. RESULTS 3225 articles were identified after removing duplicates. After reading the full texts of 40 articles, 11 articles were finally included. Among the telehealth services, there were services aimed for triage and control during the outbreak of the COVID-19 pandemic, remote monitoring and treatment, follow-ups online meetings for patients residing in health centers, and application of online services. CONCLUSIONS Although the elderly population may benefit the most from telehealth services, especially during pandemics and social distancing restrictions, not enough services were developed and implemented to satisfy the needs of this population.
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Affiliation(s)
- Motti Haimi
- 36631Clalit Health Services, Israel.,Rappaport Faculty of Medicine, 26747Technion, Haifa, Israel.,School of Public Health, Faculty of Social Welfare & Health Sciences, 61196University of Haifa, Haifa, Israel
| | - Anat Gesser-Edelsburg
- School of Public Health, Faculty of Social Welfare & Health Sciences, 61196University of Haifa, Haifa, Israel.,Health and Risk Communication Research Center, 26748University of Haifa, Haifa, Israel
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Dowd C, Van Citters AD, Dieni O, Willis A, Powell L, Sabadosa KA. Design and methods for understanding the state of cystic fibrosis care amid the COVID-19 pandemic. J Cyst Fibros 2021; 20 Suppl 3:3-8. [PMID: 34930539 PMCID: PMC8683121 DOI: 10.1016/j.jcf.2021.08.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/12/2021] [Accepted: 08/24/2021] [Indexed: 02/06/2023]
Abstract
Background Novel therapies have dramatically changed cystic fibrosis (CF) and innovative care delivery systems are needed to meet future patient needs. Telehealth has been shown to be an efficient and desirable form of care delivery. The COVID-19 pandemic caused a rapid shift to telehealth, and this presented a unique opportunity to study facilitators, barriers, and satisfaction with this mode of care delivery. We aim to report survey methods, demographics and telehealth use among CF care programs, patients, and families during the pandemic. Methods CF programs completed two surveys between July 29 and September 18, 2020, and between April 19 and May 19, 2021. Patients and families completed a similar survey between August 31 and October 30, 2020. The surveys addressed topics assessing the pandemic's financial impact, telehealth modes and experiences, licensure and reimbursement issues, health screening, and remote monitoring. Quantitative data were analyzed with descriptive statistics and were compared to the CF Foundation Patient Registry. Results Most programs (278 at timepoint one and 274 at timepoint two) provided telehealth during the pandemic. The percent of visits containing either telephone or video components changed from 45% to 25% over the time periods. Additionally, 424 patients and families from various ages and backgrounds responded to the survey and 81% reported having a telehealth visit. Conclusions The pandemic accelerated telehealth adoption and these datasets are a valuable source for exploring telehealth barriers and facilitators, the quality-of-care experience, financial and workforce implications, the impact on underrepresented populations, and implications for coverage and reimbursement.
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Affiliation(s)
- Christopher Dowd
- Cystic Fibrosis Foundation, 4550 Montgomery Avenue, Suite 1100N, Bethesda, MD 20814, USA.
| | - Aricca D Van Citters
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Williamson Translational Research Building, Level 5, One Medical Center Drive, Lebanon, NH 03766 United States
| | - Olivia Dieni
- Cystic Fibrosis Foundation, 4550 Montgomery Avenue, Suite 1100N, Bethesda, MD 20814, USA
| | - Anne Willis
- Cystic Fibrosis Foundation, 4550 Montgomery Avenue, Suite 1100N, Bethesda, MD 20814, USA
| | - Leslie Powell
- Cystic Fibrosis Foundation, 4550 Montgomery Avenue, Suite 1100N, Bethesda, MD 20814, USA
| | - Kathryn A Sabadosa
- Cystic Fibrosis Foundation, 4550 Montgomery Avenue, Suite 1100N, Bethesda, MD 20814, USA
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Gao H, Yous ML, Connelly D, Hung L, Garnett A, Hay ME, Snobelen N, Salatino S. Virtual team-based care planning with older persons in formal care settings: a scoping review protocol. BMJ Open 2021; 11:e054900. [PMID: 34785560 PMCID: PMC8595297 DOI: 10.1136/bmjopen-2021-054900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION COVID-19 has necessitated greater adoption of virtual care (eg, telephone (audio), videoconference) delivery models. Virtual care provides opportunities for innovative practice in care planning with older persons and meaningful family engagement by synchronously involving multiple care providers. Nevertheless, there remains a paucity of summarising evidence regarding virtual team-based care planning for older persons. The purpose of this scoping review is to summarise evidence on the utilisation of virtual team-based care planning for older persons in formal care settings. Specifically, (1) what has been reported in the literature on the impact or outcomes of virtual team-based care planning? (2) What are the facilitators and barriers to implementation? METHODS AND ANALYSIS This scoping review will follow a rigorous and well-established methodology by the Joanna Briggs Institute, supplemented by the Arksey & O'Malley and Levac, Colquhoun, & O'Brien frameworks. A three-step search strategy will be used to conduct a search on virtual team-based care planning for older persons in formal care settings. Keywords and index terms will be identified from an initial search in PubMed and AgeLine, and used to conduct the full search in the databases PubMed, EMBASE, CINAHL, AgeLine, PsycInfo and Scopus. Reference lists of included articles and grey literature retrieved through Google and Google Scholar will also be reviewed. Three researchers will screen titles and abstracts, and will conduct full-text review for inclusion. Extracted data will be mapped in a table. ETHICS AND DISSEMINATION Research ethics approval is not required for data collection from publicly accessible information. Findings will be presented at conferences, submitted for open-access publication in a peer-reviewed journal and made accessible to multiple stakeholders. The scoping review will summarise the literature on virtual team-based care planning for the purpose of informing the implementation of a virtual PIECES™ intervention (Physical/Intellectual/Emotional health, Capabilities, Environment, and Social).
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Affiliation(s)
- Harrison Gao
- Faculty of Science, University of Western Ontario, London, Ontario, Canada
| | - Marie-Lee Yous
- McMaster University School of Nursing, Hamilton, Ontario, Canada
| | - Denise Connelly
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Lillian Hung
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Anna Garnett
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Melissa Erin Hay
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Nancy Snobelen
- Registered Practical Nurses Association of Ontario, Mississauga, Ontario, Canada
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Sun R, Blayney DW, Hernandez-Boussard T. Health management via telemedicine: Learning from the COVID-19 experience. J Am Med Inform Assoc 2021; 28:2536-2540. [PMID: 34459475 PMCID: PMC8499808 DOI: 10.1093/jamia/ocab145] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/09/2021] [Accepted: 06/30/2021] [Indexed: 11/26/2022] Open
Abstract
At the onset of the COVID-19 (coronavirus disease 2019) pandemic, telemedicine was rapidly implemented to protect patients and healthcare providers from infection. It is unlikely that care delivery will fully return to the pre-COVID form. Telemedicine offers many opportunities to improve care efficiency, accessibility, and patient outcomes, but many challenges exist related to technology interoperability, the digital divide, and usability. We propose that telemedicine evolve to support continuity of care throughout the patient journey, including multidisciplinary care teams and the seamless integration of data into the clinical workflow to support a learning healthcare system. Importantly, evidence is needed to support this paradigm shift in care delivery to ensure the quality and efficacy of care delivered via telemedicine. Here, we highlight gaps and opportunities that need to be addressed by the biomedical informatics community to move forward with safe and effective healthcare delivery via telemedicine.
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Affiliation(s)
- Ran Sun
- Department of Medicine, Stanford University, Stanford, California, USA
| | - Douglas W Blayney
- Stanford Cancer Institute, Stanford University, Stanford, California, USA
- Division of Medical Oncology, Department of Medicine, Stanford University, Stanford, California, USA
| | - Tina Hernandez-Boussard
- Department of Medicine, Stanford University, Stanford, California, USA
- Department of Biomedical Data Science, Stanford University, Stanford, California, USA
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Lambert G, Drummond K, Tahasildar B, Carli F. Virtual Prehabilitation in Surgical Cancer Patients During the Covid-19 Pandemic: A Prospective Feasibility Study (Preprint). JMIR Res Protoc 2021; 11:e29936. [PMID: 35522464 PMCID: PMC9123533 DOI: 10.2196/29936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 12/24/2021] [Accepted: 03/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Since the beginning of the COVID-19 pandemic, preoperative care, also termed prehabilitation, has become increasingly relevant due to the decreasing functional and psychosocial health of patients with cancer, which is a result of the pandemic restrictions. Concurrently, access to telehealth has improved; telehealth comprises all remote care delivery facilitated by information technologies (ie, virtually). Objective The aim of this protocol is to describe the rationale and methodology for a major trial investigating the feasibility and safety of multimodal virtual prehabilitation services (ie, teleprehabilitation). Methods This single-arm feasibility trial aims to recruit 100 patients with cancer to receive teleprehabilitation throughout their preoperative period. The inclusion criteria are as follows: (1) 18 years of age or older, (2) scheduled for elective cancer surgery and referred by a surgeon, (3) medically cleared by the referring physician to engage in physical activity, and (4) have a good comprehension of the English or French language. Feasibility will be assessed by documenting recruitment, adherence, and retention rates, in addition to patients’ motives for not participating in the trial, low participation, or discontinuation. The secondary outcome of safety will be assessed by reporting program-related adverse events. Results The Montreal General Hospital Foundation funded the project in August 2020. The protocol was then approved by the Research Ethics Board of the McGill University Health Centre in January 2021 (ID No. 2021-6730). The first patient was recruited in March 2021, and recruitment is expected to end in September 2022. As of March 2022, 36 patients have been recruited, including 24 who have completed their participation. No adverse events have been reported. Data collection is expected to conclude in November 2022. Data analysis will be performed, and the results will be published by the beginning of 2023. Conclusions This trial will provide guidance on the use of telehealth in the administration of prehabilitation services. The trial will provide a large amount of information that will respond to gaps in the literature, as there are minimal reports on the use of telehealth rehabilitation and prehabilitation services among elderly populations and in acute contexts, such as the preoperative period. Trial Registration ClinicalTrials.gov NCT0479956; https://clinicaltrials.gov/ct2/show/NCT04799561 International Registered Report Identifier (IRRID) DERR1-10.2196/29936
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Affiliation(s)
- Genevieve Lambert
- Department of Experimental Surgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Peri Operative Program, Department of Anesthesia, McGill University Health Center, Montreal, QC, Canada
| | - Kenneth Drummond
- Department of Experimental Surgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Peri Operative Program, Department of Anesthesia, McGill University Health Center, Montreal, QC, Canada
| | - Bhagya Tahasildar
- Peri Operative Program, Department of Anesthesia, McGill University Health Center, Montreal, QC, Canada
| | - Francesco Carli
- Department of Experimental Surgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Peri Operative Program, Department of Anesthesia, McGill University Health Center, Montreal, QC, Canada
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Lambert G, Drummond K, Ferreira V, Carli F. Teleprehabilitation during COVID-19 pandemic: the essentials of "what" and "how". Support Care Cancer 2021; 29:551-554. [PMID: 32918606 PMCID: PMC7486157 DOI: 10.1007/s00520-020-05768-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/08/2020] [Indexed: 02/07/2023]
Abstract
In view of the COVID-19 pandemic and recent global events, the healthcare system and its services have been negatively affected, contributing towards extensive surgical backlogs. Oncological surgical candidates have been the most impacted by these changes and recommended self-isolation practices, which could result in emotional distress, sedentary behavior, and poor lifestyle habits. Preoperative supportive intervention, prehabilitation, has been proven to improve patients' functional status and clinical trajectories. Presently, there is a critical need for prehabilitation to optimize patient health, as they experience extended wait times. However, in-hospital delivery may not be an ideal approach due to public health and safety measures. Telehealth is a field of research and practice, which has grown and evolved significantly in the last two decades, allowing for the remote delivery of health services. Therefore, the current commentary addresses the different modalities of telehealth delivery in perspective of their known feasibility and potential application in prehabilitation.
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Affiliation(s)
- Genevieve Lambert
- Department of Anesthesia, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Experimental Surgery, McGill University, Montreal, Quebec, Canada
| | - Kenneth Drummond
- Department of Anesthesia, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Experimental Surgery, McGill University, Montreal, Quebec, Canada
| | - Vanessa Ferreira
- Department of Anesthesia, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Kinesiology, McGill University, Montreal, Quebec, Canada
| | - Francesco Carli
- Department of Anesthesia, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
- Department of Experimental Surgery, McGill University, Montreal, Quebec, Canada.
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Nielsen DS, Hansen RF, Beck SH, Wensien J, Masud T, Ryg J. Older patients' perspectives and experience of hospitalisation during the COVID-19 pandemic: a qualitative explorative study. Int J Older People Nurs 2021; 16:e12362. [PMID: 33389798 PMCID: PMC7883232 DOI: 10.1111/opn.12362] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/07/2020] [Accepted: 11/26/2020] [Indexed: 02/02/2023]
Abstract
Background and Objectives The aim of this study was to gain in‐depth knowledge and an increased understanding on how isolation from close relatives and carers, during the COVID‐19 pandemic, impacted older patients during hospitalisation in a Geriatric department. Method We conducted a qualitative study using semi‐structured interviews and a phenomenological‐hermeneutic approach, to get an understanding of the older participants' perspectives and lived experiences. Complete interviews were available for 11 patients—six men and five women, between 69 and 91 years of age. Results The participants' narratives identified several themes. Feeling isolated from and having no contact with close relatives or carers was prominent. The COVID‐19 pandemic created fear and anxiety among hospitalized patients. Relationships with family members and some staff became strained. The transformation from being “a person” to being “a patient” and loss of dignity, autonomy and a “sense of self” were themes identified in the analysis. Although virtual contact can't replace the real world, the use of technology to maintain contact with family and carers, and the need for help from hospital staff in facilitating this contact was deemed important. The environment of care was a prominent theme. The attitude of staff made a difference to how patients felt and some patients expressed a loss of decision‐making capability. The interviews were challenging in some cases because the interviews had to be interrupted or shortened due to ethical considerations around the individual person's needs and condition. Conclusions and implication for practice Our study provided in‐depth knowledge on how older patients experienced hospitalisation during the COVID‐19 pandemic in a Danish hospital. The results emphasise that compassionate care includes a willingness to listen to older patients' narratives and to imagine life as depicted by them. This can lead to better understanding of an individual person's needs and increase the quality of care provided.
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Affiliation(s)
- Dorthe Susanne Nielsen
- Migrant Health Clinic, Odense University Hospital, Odense, Denmark.,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Sanne Have Beck
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Jette Wensien
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Tahir Masud
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Hanke AA, Sundermeier T, Boeck HT, Schieffer E, Boyen J, Braun AC, Rolff S, Stein L, Kück M, Schiffer M, Pape L, de Zwaan M, Haufe S, Kerling A, Tegtbur U, Nöhre M. Influence of Officially Ordered Restrictions During the First Wave of COVID-19 Pandemic on Physical Activity and Quality of Life in Patients after Kidney Transplantation in a Telemedicine Based Aftercare Program-A KTx360° Sub Study. Int J Environ Res Public Health 2020; 17:ijerph17239144. [PMID: 33297529 PMCID: PMC7730551 DOI: 10.3390/ijerph17239144] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 12/15/2022]
Abstract
Guidelines recommend a healthy lifestyle and regularly physical activity (PA) after kidney transplantation (KTx). The KTx360° program is a multicenter, multisectoral, multimodal, telemedicine-based follow-up care program. Effects of the first COVID-19 wave restrictions on health-related quality of life and PA of supervised KTx360° patients were evaluated using an online questionnaire. Six hundred and fifty-two KTx360° patients were contacted via email and were asked to complete the Freiburg questionnaire of physical activity and the Short form 12 Health Survey (SF-12) online. Pre-pandemic and lockdown data were compared in 248 data sets. While sporting activity decreased during the COVID-19 pandemic, basic and leisure activity increased, resulting in increased overall activity. The physical component scale of the SF-12 was in the low normal range before as well as during the pandemic, with a small but significant increase during the pandemic. The mental component scale showed normal values before and during pandemic with a small but statistically significant decrease. Our study supports the effectiveness of a telemedicine based program for KTx patient care in maintaining PA and quality of life during the first peak of the COVID-19 pandemic. However, further research and observation during the ongoing pandemic are required.
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Affiliation(s)
- Alexander A. Hanke
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
- Correspondence: ; Tel.: +49-511-5325499
| | - Thorben Sundermeier
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Hedwig T. Boeck
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Elisabeth Schieffer
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Johanna Boyen
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Ana Céline Braun
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Simone Rolff
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Lothar Stein
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Momme Kück
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Mario Schiffer
- Medical Clinic 4: Nephrology and Hypertension, University Hospital Erlangen, 91054 Erlangen, Germany;
| | - Lars Pape
- Department of Pediatric Nephrology, University Hospital Essen, 45122 Essen, Germany;
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany; (M.d.Z.); (M.N.)
| | - Sven Haufe
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
- Institute of Sports Science, Leibniz University Hannover, 30167 Hannover, Germany
| | - Arno Kerling
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Uwe Tegtbur
- Institute of Sports Medicine, Hannover Medical School, 30659 Hannover, Germany; (T.S.); (H.T.B.); (E.S.); (J.B.); (A.C.B.); (S.R.); (L.S.); (M.K.); (S.H.); (A.K.); (U.T.)
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, 30625 Hannover, Germany; (M.d.Z.); (M.N.)
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12
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El Hayek S, Nofal M, Abdelrahman D, Adra A, Al Harthi M, Al Shamli S, AlNuaimi N, Bensid L, Cheaito MA, Emberish AM, Larnaout A, Radwan A, Slaih M, Kobeissy F, Bizri M. Telepsychiatry in the Arab World: A Viewpoint Before and During COVID-19. Neuropsychiatr Dis Treat 2020; 16:2805-2815. [PMID: 33239877 PMCID: PMC7682595 DOI: 10.2147/ndt.s277224] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/05/2020] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Telepsychiatry, a subset of telemedicine, has been increasingly studied to meet the growing demands for psychiatric care. The utility of telepsychiatry is relevant now more than ever as the world endures the COVID-19 global pandemic. This paper describes the prior state and the changes that the COVID-19 outbreak brought to telepsychiatry in a selected group of Arab countries of the Middle East and North Africa (MENA) region. PATIENTS AND METHODS We invited twelve early-career psychiatrists from different Arab nations to share information related to telepsychiatry in their respective countries before and during the COVID-19 pandemic. The information was collected using a semi-structured guide. This was complemented by a search for relevant articles in five search engines using terms such as "COVID-19," "telepsychiatry," and "Arab world". RESULTS Before the pandemic, digital mental health services were provided in several Arab countries, mainly through hotlines and messaging services. The COVID-19 pandemic has marked a major shift in digital psychiatric services in the Arab MENA world, through the transformation of many clinics and some hospitals into digital mental health systems. Many non-governmental organizations also started remote initiatives for psychological support and psychiatric counseling. Three main barriers of patient-related, healthcare-related, and system-related hurdles of using telepsychiatry emanated from the analysis. CONCLUSION The use of digital mental health services varies between different Arab countries. Even though some nations have laws that regulate the provision of such services, most struggle with multifactorial barriers. As affordable and attainable solutions cannot only rely on training and recruiting more psychiatrists, telepsychiatry would help meet the exceeding demands in the Arab world, particularly after the COVID-19 outbreak.
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Affiliation(s)
- Samer El Hayek
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | | | | | - Ali Adra
- Department of Psychiatry, Damascus University, Damascus, Syria
| | - Mansour Al Harthi
- Department of Psychiatry, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Siham Al Shamli
- Oman Medical Specialty Board, Psychiatry Program, Muscat, Sultanet of Oman
| | - Nawaf AlNuaimi
- Psychiatric Department, Al Ain Hospital, Abu Dhabi, United Arab Emirates
| | - Lynda Bensid
- Department a, University of Algiers, Drid Hocine Hospital Specialized in Psychiatry, Algiers, Algeria
| | - Mohamad Ali Cheaito
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | | | - Amine Larnaout
- Psychiatry Department D, Razi Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Ahmed Radwan
- Mental Health Service, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Slaih
- National Center for Mental Health, Ministry of Health, Amman, Jordan
| | - Firas Kobeissy
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Maya Bizri
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
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13
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Hawley CE, Genovese N, Owsiany MT, Triantafylidis LK, Moo LR, Linsky AM, Sullivan JL, Paik JM. Rapid Integration of Home Telehealth Visits Amidst COVID-19: What Do Older Adults Need to Succeed? J Am Geriatr Soc 2020; 68:2431-2439. [PMID: 32930391 DOI: 10.1111/jgs.16845] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Our objective was to identify and address patient-perceived barriers to integrating home telehealth visits. DESIGN We used an exploratory sequential mixed-methods design to conduct patient needs assessments, a home telehealth pilot, and formative evaluation of the pilot. SETTING Veterans Affairs geriatrics-renal clinic. PARTICIPANTS Patients with scheduled clinic visits from October 2019 to April 2020. MEASUREMENTS We conducted an in-person needs assessment and telephone postvisit interviews. RESULTS Through 50 needs assessments, we identified patient-perceived barriers in interest, access to care, access to technology, and confidence. A total of 34 (68%) patients were interested in completing a home telehealth visit, but fewer (32 (64%)) had access to the necessary technology or were confident (21 (42%)) that they could participate. We categorized patients into four phenotypes based on their interest and capability to complete a home telehealth visit: interested and capable, interested and incapable, uninterested and capable, and uninterested and incapable. These phenotypes allowed us to create trainings to overcome patient-perceived barriers. We completed 32 home telehealth visits and 12 postvisit interviews. Our formative evaluation showed that our pilot was successful in addressing many patient-perceived barriers. All interviewees reported that the home telehealth visits improved their well-being. Home telehealth visits saved participants an average of 166 minutes of commute time. Five participants borrowed a device from a family member, and five visits were finished via telephone. All participants successfully completed a home telehealth visit. CONCLUSIONS We identified patient-perceived barriers to home telehealth visits and classified patients into four phenotypes based on these barriers. Using principles of implementation science, our home telehealth pilot addressed these barriers, and all patients successfully completed a visit. Future study is needed to understand methods to deploy larger-scale efforts to integrate home telehealth visits into the care of older adults.
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Affiliation(s)
- Chelsea E Hawley
- New England Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Nicole Genovese
- Department of Pharmacy, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Montgomery T Owsiany
- New England Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts, USA
| | | | - Lauren R Moo
- New England Geriatric Research, Education and Clinical Center, Bedford VA Medical Center, Bedford, Massachusetts, USA.,Center for Healthcare Organization and Implementation Research, Bedford, Massachusetts, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy M Linsky
- Center for Healthcare Organization and Implementation Research, Boston, Massachusetts, USA.,General Internal Medicine, VA Boston Healthcare System, Boston, Massachusetts, USA.,General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jennifer L Sullivan
- Center for Healthcare Organization and Implementation Research, Boston, Massachusetts, USA.,Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Julie M Paik
- New England Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts, USA.,Renal Section, VA Boston Healthcare System, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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14
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Abstract
The COVID-19 pandemic threatens to disrupt the provision of mental health services. In response, policymakers, administrators, and providers have taken bold steps toward enabling telepsychiatry to bridge this sudden gap in care for our most vulnerable populations. With rapid deregulation and adoption of this modality of care, careful consideration of issues related to policy and implementation is essential to maximize its effectiveness and mitigate unintended consequences. Though the crisis places the healthcare system under strain, it sets the stage for a lasting shift in not only how care is delivered, but also our beliefs around the system’s capacity for rapid, innovative change.
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Affiliation(s)
- Jacob T Kannarkat
- Department of Psychiatry & Behavioral Sciences, The University of Miami Heath System, 1695 NW 9th Ave, Suite 3100, Miami, FL, 33136, USA.
| | - Noah N Smith
- Department of Psychiatry & Behavioral Sciences, The University of Miami Heath System, 1695 NW 9th Ave, Suite 3100, Miami, FL, 33136, USA
| | - Stephen A McLeod-Bryant
- Department of Psychiatry & Behavioral Sciences, The University of Miami Heath System, 1695 NW 9th Ave, Suite 3100, Miami, FL, 33136, USA
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15
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Guo C, Keller C, Söderqvist F, Tomson G. Promotion by Education: Adolescent Mental Health Policy Translation in a Local Context of China. Adm Policy Ment Health 2020; 47:1-7. [PMID: 31549276 DOI: 10.1007/s10488-019-00964-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this paper is to describe how Chinese national adolescent mental health policy is translated into local plans and practice by means of the theoretical perspective of the policy triangle. Document analysis of national, provincial and local policy documents and semi-structured interviews with local policy actors were performed. National policies were implemented by a top-down process. The ministries were strong policy-makers on the national level, while the policy actors at the local level were mainly found in the educational sector. The content of the policy actions was moral education, knowledge dissemination and learning, rather than counselling and treatment.
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