Telerehabilitation during the COVID-19 Pandemic: Patients and Physical Therapists' Experiences.

OBJECTIVES: This study aimed to explore satisfaction and attitudes of patients towards the use of telerehabilitation during the COVID-19 pandemic and to report the experience of physical therapists (PTs) with the use of telerehabilitation. SUBJECTS AND METHODS: A modified Telemedicine Satisfaction and Usefulness Questionnaire was used to assess the satisfaction and attitudes of musculoskeletal patients who had received telerehabilitation services during the COVID-19 pandemic. Face-to-face semi-structured interviews were conducted with eight PTs to explore their experiences with telerehabilitation, including difficulties and benefits. RESULTS: Out of 53 patients who received telerehabilitation, 46 questionnaires were completed, with a response rate of 86.8%. In general, the patients were satisfied with and had positive attitudes towards the telerehabilitation services. The majority (89.2%) of the patients felt more involved in their care via telerehabilitation and a majority (93.5%) believed that video call sessions were a convenient form of telerehabilitation during the COVID-19 pandemic. Seven out of 8 PTs reported benefits of telerehabilitation (i.e., reduced patients' waiting lists and improved access to physical therapy care). Also, they were in favour of continuing using telerehabilitation to support the conventional physical therapy care, despite the lack of technological infrastructure. CONCLUSION: The patients as well as the PTs were generally satisfied with their telerehabilitation experiences. Using telerehabilitation in Kuwait was favoured as an adjunct method during and after the COVID-19 pandemic. However, with extensive training, optimal allocation of resources, and the development of local guidelines, telerehabilitation would become an effective mean for the health delivery system in Kuwait.

Physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic.

BACKGROUND: Telerehabilitation has been considered a suitable alternative healthcare delivery system during the COVID-19 outbreak, and many studies have promoted its feasibility in delivering physical care to patients who live with pain and disability. Physiotherapists' perceptions and willingness are two key factors that influence the provision of remote physiotherapy. AIM: To investigate physiotherapists' perceptions of and willingness to use telerehabilitation in Kuwait during the COVID-19 pandemic and to explore the barriers that may hinder the use of telerehabilitation in this sector. METHODS: The following methods were used: (1) a cross-sectional survey and (2) face-to-face semi-structured interviews. In the cross-sectional survey, an electronic questionnaire was sent to 747 physiotherapists who were working in the governmental health sector. The questionnaire included four sections: perceptions of telerehabilitation, comfort with technology, willingness to use telerehabilitation, and barriers to using telerehabilitation. Six interviews were conducted with physiotherapy managers to explore the barriers and facilitators of telerehabilitation practice. DATA ANALYSIS: In this study, descriptive data analysis was conducted, and a cross-tabulation technique was used to find the associations between the variables, in which chi-square tests were used to identify the significance of the results, where p < 0.05. Thematic content analysis was used for the interviews. RESULTS: Only 273 completed questionnaires were received, giving a response rate of 36.5%. Most of the respondents (237; 86.8%) considered telerehabilitation a viable option to deliver healthcare to patients during the COVID-19 pandemic. In spite of the lack of information and communication technology (ICT) (156; 57.1%), 89% (243) of the respondents were willing to integrate telerehabilitation into their conventional practice, as cultural and social norms were not against the use of telerehabilitation systems. The results indicate that the more the physiotherapists used the internet and email in their work and the more comfortable they were with technology, the more willing they were to use telerehabilitation systems (p = 0.01). The physiotherapy managers reported that patients' privacy and the confidentiality of their data were considered barriers. CONCLUSION: In Kuwait, physiotherapists show overall positive perceptions towards and a willingness to use telerehabilitation to facilitate patients' access to physiotherapy services. There are several barriers to employing telerehabilitation. Accordingly, recommendations are suggested.

Usefulness of smartphone use among surgeons in clinical practice during the pandemic of COVID-19: a cross-sectional study.

BACKGROUND: With the magnitude and severity of the COVID-19 pandemic, the usual face-to-face consultation within a clinical setting is no longer feasible. Thus, this led to the need for alternate means to provide adequate patient care for surgical patients. This is where the role of smartphones comes into play, in which it is thus of paramount importance. This research study aimed to assess the usefulness of smartphones in surgical practice during COVID-19 pandemic. METHODS: This cross-sectional study is based on a questionnaire distributed among surgeons in different levels of practice working at Kuwait governmental hospitals during the COVID-19 pandemic. The questionnaire was developed via Google Docs to collect data for the current study. RESULTS: Out of 600 surgeons, 180 have responded to the questionnaire, giving a response rate of 30%. Of these, 42.8%, 85.5%, and 58.9% were aged between 35 and 44 years, were male, and Kuwaiti nationals, respectively. Almost all of the respondents (99.5%) were using smartphones for hospital-related work. The most common uses of the smartphones involved texting (70%), and viewing or taking images and videos using built-in cameras (60%) either in the emergency department, outpatient clinics, wards, or operating rooms. The majority of the respondents (88%) rated the use of smartphones in practice as important. CONCLUSION: This study revealed that using smartphones in surgical practice was prevalent among the respondent surgeons in Kuwait during the pandemic. The majority of them considered using smartphones in practice to be important, due to its benefits in facilitating doctor-doctor and patient-doctor communication, reviewing the literature, and making clinical decisions. Guidelines are required for proper and legal use of smartphone devices in medical practice. Accordingly, recommendations are suggested.

Evaluating the success of the tele-pathology system in governmental hospitals in Kuwait: an explanatory sequential mixed methods design.

BACKGROUND: Telepathology is the practice of reviewing and exchanging pathological images through telecommunication systems to obtain diagnoses remotely. Studying the factors that make such a system successful and favourable is important to ensure the merits of its implementation in clinical practice. OBJECTIVE: This study aims to evaluate the success of a telepathology system from the users' perspectives, using specific evaluation criteria, namely: system quality, information quality, technical service quality, user satisfaction, and benefits. METHODS: A sequential explanatory mixed methods design was adopted in this study, which consists of two phases. Initially, a questionnaire was distributed via WhatsApp to all of the pathologists (total: 45) working at governmental hospitals in Kuwait. Followed by, semi-structured interviews with ten senior pathologists. RESULTS: Forty pathologists responded to the questionnaire, giving an 89% response rate. There were 42.5% of the respondents aged between 35-44 years old, and 52.5% were male. The quantitative results reveal that most of the respondents were satisfied with the quality of the telepathology system with a mean of 2.6025 (Standard Deviation (SD) = 0.47176), whereas they were dissatisfied with the quality of the information with a mean of 2.4100 (SD = 1.580) and the technical support services with a mean of 2.2750 (SD = 0.99535). In addition, there was disagreement on the benefits of telepathology in clinical practice among the pathologists with a mean of 2.4667 (SD = 0.77552). The qualitative results indicate that the lack of interest in and little experience with using the system were behind the general dissatisfaction of most of the respondents. All of the interviewees were satisfied with the performance of the telepathology system and considered it successful; however, the quality of the technical support services, including training workshops, was deemed deficient. CONCLUSION: This study concluded that telepathology system in Kuwait is functioning well and has been successful in its implementation; however, pathologists are dissatisfied with it, mainly due to the deficient quality of the technical support services provided. In addition, the successful implementation of such advanced technologies requires careful steps to be taken on multiple levels: technical, organisational, and managerial. Recommendations were suggested.

The detrimental impacts of smart technology device overuse among school students in Kuwait: a cross-sectional survey.

BACKGROUND: Children and adolescents are becoming the most prolific users of smart technology (ST) devices due to the numerous advantages presented by these devices. However, the overuse of ST devices can have detrimental impacts on health. Therefore, the aim of this study was to investigate the pattern of ST device use among school students in Kuwait and the possible associated health problems. METHODS: This cross-sectional survey used a pretested questionnaire to collect data from students of different educational levels within the governmental sector: primary, secondary and high school. Chi-square tests were applied to find associations or significant differences between the categorical variables, in which p < 0.05 was considered statistically significant. RESULTS: This study included 3015 students, of whom 53.6% were female. The sample had an equal distribution of primary (33.8%), secondary (32.4%) and high school students (33.8%). Almost all of the participants (99.7%) owned a ST device, chiefly smartphones (87.7%). Most of the students used ST devices for > 4 total hours per day on average, which is categorised as "overuse". Among those overusing ST devices, the symptoms most commonly experienced included headaches (35.0%), sleep disturbances (36.6%) and neck/shoulder pain (37.7%). Students who used ST devices for < 1 h per session experienced eye-related problems. Moreover, students who played sports on a regular basis were more likely to spend less time per session on ST devices. The prolonged use of ST devices was associated with higher reporting of seizures, eye squints and transient vision loss. CONCLUSION: The overuse of ST devices per day and per session by school-aged children has the potential to have a detrimental impact on their health, as has been noticed among students in Kuwait. Healthcare professionals, school authorities and parents could use these results to plan strategies to change ST device use behaviours among schoolchildren.

An exploratory study of public' awareness about robotics-assisted surgery in Kuwait.

BACKGROUND: The adoption of robotic-assisted surgery (RAS) requires a clear willingness, not only from healthcare organization to operate the robotic system but also from the public that is going to perceive it. This study aims to explore public's awareness, understanding and their perceptions towards RAS in Kuwait. METHODS: This cross-sectional study used a survey questionnaire that was disseminated on a tablet device to people at their convenience in governmental institutions. RESULTS: A total of 1087 people agreed to participate in this study. The study results showed that only 36.8% of respondents had heard of RAS and 27.1% knew what RAS is. Moreover, 47.6% of the respondents were uncertain about its safety, while 29.7% thought RAS was safe. The results also showed that 40.9 and 34.4% of respondents thought that RAS is more precise and faster than conventional surgical procedures, respectively, whereas 30.6% feared malfunctioning issues during surgical procedures. CONCLUSION: This public survey among a Middle Eastern population reveals lack of awareness and limited understanding of RAS. However, there was a tendency towards believing that RAS may have potential advantages in terms of better outcomes compared to conventional surgical procedures.

Smartphone use by government dermatology practitioners in Kuwait: a self-reported questionnaire based cross-sectional study.

BACKGROUND: The potential for smartphones to revolutionize the way that medical doctors practice has become a reality, particularly in specialities where visual examination is a principal step in assessing a medical case, like dermatology. Smartphones as devices hold similar capabilities to personal computers and laptops and could play an important role in supporting medical practitioners in clinical practice at the point of care and beyond. This study aimed to assess the role of smartphone technology use in dermatology practice in Kuwait, together with the potential of digital photography and users' concerns. METHODS: This cross-sectional survey involved a population of dermatology practitioners of all levels working in 11 dermatology centers distributed across six health regions in Kuwait. A validated self-reported questionnaire was used to collect data from the participants about their smartphone use. Quantitative analytical methods were undertaken to analyse the questionnaire responses. RESULTS: A total of 210 dermatologists were approached in their workplaces. Of these, 101 (48%) responded to the survey questionnaire, with a mean age of 39.1 years (±10.7 SD) and equal representation from both genders. All the respondents were using smartphone technology, wherein 94.1% used it to access medical information through various Internet search engines. The most prevalent applications used were medical and drug reference applications (69.3 and 66.3%, respectively). In all, 65% of the dermatologists were using smartphones to take clinical photographs of patients for special purposes, and this type of usage was significantly higher (p < 0.05) among females and those older than 40. CONCLUSION: This study concludes that smartphone technology has an impactful role in dermatology practice, and many of its functions can be employed to achieve better practice and better patient care. Recommendations are suggested for clinicians using smartphones in dermatology practice.

The readiness of hospital pharmacists in Kuwait to practise evidence-based medicine: a cross-sectional study.

BACKGROUND: The evolving role of pharmacists in providing pharmaceutical care, as part of the healthcare team, challenges them to acquire up-to-date knowledge of medicines to make the best clinical decisions. The volume of medical literature is on the increase, and it is important to utilise these resources to optimise patients' therapeutic outcomes. This study aimed at assessing the readiness of government hospital pharmacists in practising evidence-based medicine (EBM) in Kuwait in regards to their attitude, knowledge and skills, as well as the perceived barriers and facilitators. METHODS: This descriptive cross-sectional study used pre-tested self-reported questionnaires to collect information from pharmacists working at government hospitals in Kuwait. In addition, one-to-one, face-to-face semi-structured interviews were conducted with the chief pharmacists of all health regions in Kuwait to discuss and identify the barriers and facilitators of implementing EBM in the hospitals. Quantitative and qualitative analytical measures were undertaken for the data acquired from the questionnaires and interviews, respectively. RESULTS: A total of 176 pharmacists (of 445) working in secondary and tertiary government hospitals in Kuwait agreed to take part in the study, giving a response rate of 40%. Over half of the study sample (n = 94, 53.4%) had good confidence in performing online database searches. Approximately 50% of the pharmacists were familiar with searching the Internet for medical resources, asking answerable clinical questions and retrieving research evidence. However, 67% of the pharmacists (n = 118) were neither able to apply research evidence to patient care nor capable of identifying knowledge gaps in practice. Barriers to EBM practice were identified, which included limited access to EBM resources (75%), a lack of time and patient overload (71.6%). The interview results confirmed the willingness of the hospital pharmacists to adopt EBM in their practice if necessary resources such as computers and internet connection were provided. CONCLUSION: The hospital pharmacists in Kuwait showed good attitude and willingness towards EBM, however, they need to acquire adequate knowledge and skills for applying it in "real life" practise. Using the current results, clinical implications were recommended to demonstrate how to overcome the barriers, wherein hospital pharmacists could be ready to practice EBM.

Investigating Students' Perceptions towards Artificial Intelligence in Medical Education.

Implementing a reform in medical education requires students' awareness regarding the importance of artificial intelligence (AI) in modern medical practice. The objective of this study was to investigate students' perceptions of AI in medical education. A cross-sectional survey was conducted from June 2021 to November 2021 using an online questionnaire to collect data from medical students in the Faculty of Medicine at Kuwait University, Kuwait. The response rate for the survey was 51%, with a sample size of 352. Most students (349 (99.1%)) agreed that AI would play an important role in healthcare. More than half of the students (213 (60.5%)) understood the basic principles of AI, and (329 (93.4%)) students showed comfort with AI terminology. Many students (329 (83.5%)) believed that learning about AI would benefit their careers, and (289 (82.1%)) believed that medical students should receive AI teaching or training. The study revealed that most students had positive perceptions of AI. Undoubtedly, the role of AI in the future of medicine will be significant, and AI-based medical practice is required. There was a strong consensus that AI will not replace doctors but will drastically transform healthcare practices.

The associations between smart device use and psychological distress among secondary and high school students in Kuwait.

BACKGROUND: Smart devices (SDs) are widely used among adolescents. Numerous studies have recommended further research on this topic to find out the prevalence of SD overuse among school students and to what extent this is associated with psychological distress. The present study aimed to investigate the pattern of SD use among secondary and high school students in the state of Kuwait, as well as the possible associations with psychological problems, weight, physical activity, and school performance. MATERIALS AND METHODS: The correlational study design aimed to survey students from public schools by using a questionnaire and valid instruments, which included: Smartphone Addiction Scale-Short Version (SAS-SV) and Stress, Anxiety, and Depression Scale-(DASS-21). Pearson's correlation coefficient, t-tests, one-way ANOVA were applied to find associations or significant differences between the categorical variables, in which p < 0.05 was considered statistically significant. RESULTS: The study included 1,993 students from secondary schools (48.9%) and high schools (51.1%), of which 47.5% were male and 52.5% were female. There were significant statistical differences in the pattern of use of SDs, addiction to SD use, stress, anxiety, and depression according to gender, school type, school performance, and sport engagement. In addition, there were positive correlations between students' addiction to SD use and stress, anxiety, and depression. CONCLUSIONS: The findings suggest that excessive SD use is associated with addiction among secondary and high school students. In addition, levels of stress, anxiety, and depression differ according to the number of hours of SD use. Strategies should be developed at the community and school levels to avoid the overuse of SDs among school-aged students.