Adapting the telephone assessment and skill-building kit to the telehealth technology preferences of stroke family caregivers.

Family caregivers exhibit a wide variety of needs and concerns while providing care to stroke survivors after discharge to the home setting. We report the results of two related studies utilizing a multimethod design in which stroke family caregivers (N = 12; N = 10) were interviewed using open-ended questions, followed by written caregiver ratings regarding the types of telehealth technologies they preferred for the telephone assessment and skill-building kit (TASK III). Qualitative data were analyzed using content analysis procedures with a provisional "start list" of codes in a matrix template based on the types of telehealth technologies in the rating forms. Descriptive statistics were used to analyze ratings with response scales ranging from 1 = strongly disagree to 5 = strongly agree. Average ratings for the telehealth technologies for the TASK III resource guide were obtained for the mailed hard copy binder (M = 3.58-4.13; SD = 0.35-1.00), an interactive website (https://www.task3web.com/; M = 3.86-4.17; SD = .72-1.07), an eBook (M = 3.17-3.67; SD = 0.84-1.17), and a USB drive (M = 3.75-4.00; SD = .82-.96). Average ratings for the telehealth technologies for the TASK III calls with the nurse were obtained for the use of a telephone (M = 4.36-5.00; SD = 0.00-0.89), FaceTime on an iOS device (e.g., iPhone or iPad; M = 3.73-4.40; SD = 0.79-0.98), or online videoconferencing (M = 3.17-3.50; SD = 0.82-1.47). Qualitative data revealed a wide variety of preferences for each type of telehealth technology, with advantages and disadvantages of each. The findings underscored the importance of offering multiple telehealth technology options to stroke family caregivers. Future studies are recommended that employ randomized control trial methodology to test theoretically-based interventions that are based on stroke family caregiver preferences for telehealth technologies.

Satisfaction and Technology Evaluation of a Telehealth Robotic Program to Optimize Healthy Independent Living for Older Adults.

BACKGROUND AND PURPOSE: With the growth in the aging population, and shortage of primary care providers, telehealth programs are needed to optimize healthy independent living for older adults. The purpose of this study was to evaluate a nurse-led intervention program delivered through a telepresence robot to promote healthy lifestyles and address chronic illness management among older adults living independently in a retirement community. Telepresence robots provide two-way video-mediated communication with remote in-home navigation. DESIGN AND METHODS: Satisfaction and technology evaluation ratings of the Telehealth Community Health Assistance Team (T-CHAT) program, as well as qualitative data from open-ended questions, were obtained from 26 older adults and 7 nurse practitioner students. FINDINGS: On a scale from 1 = strongly disagree to 5 = strongly agree, satisfaction ratings were positive for usefulness (M = 3.90), ease of use (M = 4.16), and acceptability (M = 4.06). Technology evaluation ratings were high for all sessions (M = 4.35). Older adults and nurse practitioner students were highly complementary of the program. Areas for improvement were identified. CONCLUSIONS: The T-CHAT program demonstrated high ratings for satisfaction (usefulness, ease of use, acceptability) and for evaluation of the telepresence robot technology. Further refinement of the T-CHAT program is warranted, as is testing outcomes of this potentially viable mode of healthcare delivery. CLINICAL RELEVANCE: Robotics is the wave of the future and provides an innovative mode of delivery to address health promotion and chronic illness management in older adults. Satisfaction and technology evaluation of robotic technology is paramount prior to implementation of such programs into practice.

Using telehealth to optimize healthy independent living for older adults: A feasibility study.

The purpose of this study was to test feasibility of the Telehealth Community Health Assistance Team (T-CHAT), a nurse-led intervention delivered through a telepresence robot designed to promote healthy independent living among older adults. Using a quasi-experimental design, 21 older adults were divided into a T-CHAT group (n = 11) or a waitlist control group (n = 10). The T-CHAT group received 3 weekly health coaching sessions from a nurse practitioner student through the telepresence robot. Data trends were analyzed using two-way repeated measures analysis of covariance (ANCOVA) with baseline values as co-variates; effect sizes using partial eta squared (η2). Medium to large improvements in unhealthy days, depressive symptoms, sleep, quality of life, and confidence/self-efficacy were found favoring the T-CHAT group. Recruitment and retention strategies were successful, with lessons learned for future studies. Further research is warranted to refine and test efficacy of the T-CHAT program to promote healthy independent living among older adults.

Designing and Evaluating a Goal-Setting Tip Sheet for Stroke Family Caregiver Health.

PURPOSE: The aim of the study was to design and evaluate a goal-setting tip sheet to improve stroke family caregiver health as part of the Telephone Assessment and Skill-Building Kit program. DESIGN: A multimethod design using open-ended questions and rating forms was used in this study. METHODS: In two studies, the goal-setting tip sheet was evaluated by caregivers (N = 12; N = 6), researchers (N = 10; N = 3), clinicians (N = 8; N = 4), and technology experts (N = 4; N = 4). Rigorous qualitative content analysis procedures were used with descriptive statistics for ratings. FINDINGS: Qualitative strengths and areas for improvement refined the goal-setting tip sheet. From 1 = strongly disagree to 5 = strongly agree, ratings averaged from 3.25 to 5.00 for strategies, accuracy, feasibility, and acceptability. CONCLUSIONS: The goal-setting tip sheet was found to be accurate, feasible, and acceptable. Future research is needed to determine the impact on caregiver health. CLINICAL RELEVANCE: Stroke caregivers often neglect their own health; goal setting has the potential to improve caregiver health.

Impact of Nurse-Led Interprofessional Rounding on Patient Experience.

Interprofessional collaborative practice (IPCP) was recommended to improve siloed and fragmented patient care. The Institute of Medicine recommended nurses lead this change through innovative models of patient-centered care and IPCP participation. One strategy to improve patient experience is rounding. This project presents a nurse-led interprofessional bedside rounding model to improve communication and collaboration between providers and with patients on a complex inpatient unit. Outcomes were analyzed using Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores to examine patient experience. Postimplementation results demonstrate an increase in HCAHPS patient experience scores for this patient population above hospital and national average.