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1.
BMC Health Serv Res ; 24(1): 729, 2024 Jun 14.
Article in English | MEDLINE | ID: mdl-38877459

ABSTRACT

BACKGROUND: Videoconferencing is considered an alternative to face-to-face consultations and a possibility to help overcome access-to-care barriers in mental health care services. Barriers to child and adolescent mental health services are particularly apparent in the case of children and adolescents receiving child welfare services. This scoping review aims to provide an overview of research on videoconferencing in the mental health treatment of children and adolescents receiving support from child welfare services. METHODS: This scoping review follows the review framework outlined by the Joanna Briggs Institute. The following databases were searched from January 2012 to April 2024: Scopus, Web of Science, PubMed, PsycINFO (Ovid), CINAHL Plus, Social Services Abstracts (ProQuest), Sociological Abstracts (ProQuest), and Google Scholar. RESULTS: The search yielded 4322 unique records and resulted in the inclusion of 22 articles that met the inclusion criteria. The studies originated from Denmark, England, Australia, Norway, Canada, Chile, and the USA, and were grouped into four areas: (1) videoconferencing to increase access to mental health treatment for vulnerable groups (2) young people's perspectives (3) videoconferencing in interdisciplinary collaborative meetings, and (4) use, awareness, and acceptance of videoconferencing among health and social care providers. CONCLUSIONS: This scoping review shows that if videoconferencing in mental health care is to become an established and trusted method aimed at children and adolescents receiving child welfare services, several unresolved and potentially negative issues need attention and more research. This particularly applies to whether videoconferencing decreases or exacerbates inequalities in access to mental health services. A further question is whether new barriers are raised by screen-based treatment to threaten good therapeutic relationships, and by extension treatment quality and clinical outcomes.


Subject(s)
Mental Health Services , Videoconferencing , Humans , Child , Adolescent , Health Services Accessibility , Child Welfare
2.
Clin Psychol Psychother ; 31(3): e3015, 2024.
Article in English | MEDLINE | ID: mdl-38850261

ABSTRACT

OBJECTIVE: Telepresence may play a fundamental role in establishing authentic interactions and relationships in online psychological interventions and can be measured by the Telepresence in Videoconference Scale (TVS), which was validated only with patients to date. This post hoc study aimed to validate the Italian version of the TVS with mental health professionals. METHOD: The Italian TVS was included in an online survey, whose primary aim was to assess the experiences of Italian psychologists and psychotherapists with online interventions during the first wave of the COVID-19 pandemic and was filled in by 296 participants (83.4% females, mean age = 42 years old). RESULTS: Exploratory factor analysis supported the original factor structure only partially because the scale 'Absorption' (i.e., the feeling of losing track of time), as it was formulated, did not measure telepresence. Correlations were also explored between the TVS scales and some survey items pertaining to intimacy and emotional closeness to patients, comfort and positive as well as negative experiences with online interventions. CONCLUSION: The TVS may be a useful tool to measure physical and social telepresence in online interventions, both in patients and in professionals.


Subject(s)
COVID-19 , Psychotherapists , Videoconferencing , Humans , COVID-19/psychology , Female , Male , Adult , Italy , Psychotherapists/psychology , Telemedicine , Surveys and Questionnaires , Middle Aged , SARS-CoV-2 , Reproducibility of Results , Psychometrics , Pandemics , Psychotherapy/methods , Psychology/methods
3.
BMC Health Serv Res ; 24(1): 740, 2024 Jun 17.
Article in English | MEDLINE | ID: mdl-38886714

ABSTRACT

BACKGROUND: The population is aging, leading to an increased need for palliative care and end-of-life care. There is a lack of research on the use of video consultations for knowledge transfer between specialist and general palliative care. The aim of this study was to describe healthcare professionals' experiences of video consultations in palliative care in community homecare and nursing homes in rural areas. METHODS: Individual interviews (n = 11) were conducted with five community nurses, one occupational therapist, two specialist palliative nurses, and three specialist palliative care physicians. The data were analysed using reflexive thematic analysis. RESULTS: The analysis identified three themes: feeling comfortable with increased availability of specialist expertise; seeing each other facilitates communication; and being supported by physically present care professionals is essential. CONCLUSION: HCPs suggest that video consultations are an effective way to increase access to specialist palliative care and provide more equal care to patients with palliative care needs in rural community care.


Subject(s)
Palliative Care , Rural Health Services , Humans , Female , Male , Attitude of Health Personnel , Home Care Services , Qualitative Research , Interviews as Topic , Middle Aged , Adult , Videoconferencing , Nursing Homes , Rural Population , Referral and Consultation , Health Personnel/psychology
4.
Subst Use Misuse ; 59(10): 1447-1454, 2024.
Article in English | MEDLINE | ID: mdl-38803212

ABSTRACT

Objective: Underreporting of adolescent substance use is a known issue, with format of assessment (in-person vs. remote) a potentially important factor. We investigate whether being assessed remotely (via phone or videoconference) versus in-person affects youth report of substance use patterns, attitudes, and access, hypothesizing remote visits would garner higher levels of substance use reporting and more positive substance use attitudes. Methods: We used the Adolescent Brain and Cognitive DevelopmentSM [ABCD] Study data between 2021-2022 during the COVID-19 pandemic. Participants chose whether to complete assessments in-person (n=615; 49% female; meanage=13.9; 57% White) or remotely (n=1,467; 49% female, meanage=13.7; 49% White). Regressions predicted substance use patterns, attitudes, and access, by visit format, controlling for relevant sociodemographic factors. Effect sizes and standardized mean differences are presented. Results: 17% of adolescent participants reported any level of substance use. Youth interviewed remotely reported more negative expectancies of alcohol and cannabis. In addition, those queried remotely were less likely to endorse use), sipping alcohol, eating cannabis), and reported less curiosity or intent to try alcohol, though these differences did not survive an adjustment for multiple testing. Effect sizes ranged from small to medium. Conclusions: Preliminary evidence suggests youth completing remote visits were more likely to disclose negative expectancies toward alcohol and cannabis. Effect sizes were modest, though 37 of 39 variables examined trended toward restricted reporting during remote sessions. Thus, format of substance use assessment should be controlled for, but balanced by other study needs (e.g., increasing accessibility of research to all sociodemographic groups).


Subject(s)
COVID-19 , Substance-Related Disorders , Humans , Adolescent , Female , Male , Substance-Related Disorders/psychology , Substance-Related Disorders/epidemiology , COVID-19/psychology , COVID-19/epidemiology , Videoconferencing , Adolescent Behavior/psychology , Telephone
5.
Surgery ; 176(1): 115-123, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38734503

ABSTRACT

BACKGROUND: Surgeons rapidly adopted video visits during the COVID-19 pandemic. However, video visit use among surgeons has significantly declined, pointing to the need to better understand current attitudes and barriers to their use in surgical care. METHODS: From August 2022 to March 2023, a nationwide survey was conducted among practicing surgeons in 6 specialties. The survey included multiple-choice and free-response questions based on an implementation determinants framework, covering demographics, provider, patient, and organizational factors. RESULTS: A total of 170 surgeons responded (24% response rate). Overall, 67% of surgeons said their practice lacked motivation for video visit implementation. Additionally, 69% disagreed with using video visits as the sole means for preoperative surgical consultation, even with relevant medical history, labs, and imaging. Nearly 43% cited the need for a physical examination, whereas 58% of surgeons said video visits carried a greater malpractice risk than in-person visits. Other barriers included technological limitations, billing, and care quality concerns. Nevertheless, 41% agreed that video visits could improve outcomes for some patients, and 60% expressed openness to using video visits exclusively for postoperative consultations in uncomplicated surgeries. CONCLUSION: Surgeons recognize the potential benefits of video visits for certain patients. However, perceived barriers include the need for a physical examination, technological limitations, care quality concerns, and malpractice risks.


Subject(s)
Attitude of Health Personnel , COVID-19 , Surgeons , Humans , COVID-19/epidemiology , Surgeons/statistics & numerical data , Surgeons/psychology , Male , Female , Surveys and Questionnaires/statistics & numerical data , Telemedicine/statistics & numerical data , United States , Middle Aged , Adult , Surgical Procedures, Operative/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , SARS-CoV-2 , Videoconferencing
6.
J Clin Nurs ; 33(7): 2578-2592, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38716789

ABSTRACT

AIM: To investigate the feasibility and acceptability of the training process, procedures, measures and recruitment strategies necessary for a future investigation to test the reliability and validity of using positivity resonance measures in health care encounters. BACKGROUND: Although the measurement of positivity resonance is promising, and non-participant observation is considered effective, their approaches to studying nurse-patient relationships have not been fully explored. DESIGN: A mixed-methods observational study. METHODS: Video recordings of 30 nurse-patient dyads completing telehealth video visit encounters were edited and coded using behavioural indicators of positivity resonance. A post-visit survey gathered data on the participants' perceptions of positivity resonance and the study procedures. The research team completed memos and procedural logs to provide narrative data on the study's training, coding, recruitment and operational procedures. The study included 33 persons with cancer and 13 oncology nurses engaging in telehealth video visit encounters at an academic oncology ambulatory care center located in the southeastern United States. RESULTS: Study procedures were found to be feasible and acceptable to participants. An adequate sample of participants (N = 46) were enrolled and retained in the study. Interrater reliability, as evidenced by Cohen's weighted kappa, ranged from .575 to .752 and interclass correlation coefficients >.8 were attainable within a reasonable amount of time and with adequate training. Behavioural indicators of positivity resonance were observed in all telehealth visits and reported by the participants in the perceived positivity resonance survey. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist guided reporting. CONCLUSIONS: Designing research around the concept of positivity resonance is an innovative and feasible approach to exploring how rapport is cultivated within nurse-patient relationships. RELEVANCE TO PROFESSIONAL PRACTICE: Measuring positivity resonance may hold promise for exploring patient and nurse outcomes including trust, responsiveness, health-related behaviours, well-being, resilience and satisfaction. REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist guided the reporting of results to ensure that adequate details of the study were provided to ensure an accurate and complete report. PATIENT OR PUBLIC CONTRIBUTION: Planning of the research design and study procedures was done in consultation with nurse clinicians with experience with telehealth and managers responsible within the practice setting where the study was conducted. This ensured the study procedures were ethical, safe, secure and did not create unnecessary burden to the study participants. The study included collecting data from nurse and patient participants about the acceptability of the study procedures.


Subject(s)
Feasibility Studies , Nurse-Patient Relations , Telemedicine , Videoconferencing , Humans , Female , Male , Middle Aged , Adult , Aged , Neoplasms/nursing , Reproducibility of Results , Southeastern United States
7.
Soc Sci Med ; 351: 116965, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38762998

ABSTRACT

In the contemporary landscape of technologically mediated healthcare, video consultations introduce a dynamic interplay of challenges and opportunities. Taking the notion of 'the art of medicine' as an analytical frame, and drawing on interviews with medical specialists as well as participant observation of video consultations with patients (carried out between February 2022 and January 2023), this article investigates how video consultation technology changes the practices of medical specialists in the Danish healthcare system. Informed by post-phenomenology, we approach video consultations metaphorically as 'windows' between medical specialists and patients, unveiling three pivotal dimensions characterizing these changes. First, the shift from a physical to a virtual consultation room requires a reevaluation of the authoritative nature of the clinic, emphasizing the need for negotiating and staging the clinical space online. Second, while video consultations limit doctors' ability to rely on traditional non-verbal cues such as body language, they offer glimpses into patients' home environments, exposing the influence of social preconceptions on medical evaluations. Third, the adoption of video consultations introduces new conditions for doctors' use of senses, accentuating the importance of reflecting on the roles of different sensory impressions in the art of medicine. Our study illuminates how video consultation technology simultaneously expands and constrains the engagement between medical specialists and patients. Despite their inherent limitations, video consultations bring medical specialists closer to some of the intricacies of patients' lives. This proximity offers new insights and renders visible the roles of caregivers and relatives in the patient's care. The metaphor of 'the video window' encapsulates this tension between distance and closeness in video consultations, portraying the patient as both fragmented and socially situated. Our study extends beyond traditional patient and provider satisfaction evaluations, providing nuanced insights into how video consultations reconfigure the art of medicine.


Subject(s)
Videoconferencing , Humans , Denmark , Physician-Patient Relations , Qualitative Research , Female , Male , Remote Consultation , Specialization
8.
J Psychosom Res ; 182: 111801, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38761536

ABSTRACT

OBJECTIVE: Symptoms of somatic symptom disorder (SSD) are one of the most common reasons for consultations in primary care. However, specialized psychological services are mostly unavailable. This pilot trial aimed to determine the feasibility, acceptability, and safety of the integrated mental health video consultations VISION model for patients with SSD in primary care. METHODS: We conducted a parallel group, randomized controlled pilot trial involving fifty-one patients with SSD from ten primary care practices in Germany, who we randomized to the VISION model or enhanced treatment-as-usual (eTAU). The VISION model comprised five video consultations which featured diagnostic clarification, psychoeducation (acknowledging and legitimizing of symptoms), and brief psychological therapy. eTAU included training primary care practice teams on the DSM-5 concept of SSD and on current guideline recommendations for its treatment in primary care. We assessed feasibility as the primary outcome at 6-months, measuring efficiency of recruitment, intervention acceptability, and safety. RESULTS: Recruitment was efficient reflected in an overall recruitment yield (number randomized per number screened) of 55% (51/92) and a consent rate (number randomized per number eligible) of 94% (51/54). Acceptability of the intervention was high with 98% (123/125) of the video consultations conducted as planned. No serious adverse events were reported in either group. CONCLUSION: An integrated mental health video consultations VISION model for patients with SSD presenting to primary care is feasible, acceptable, and safe. Potential clinical effectiveness of the model should be evaluated in confirmatory trial implementing the multifaceted approach tailored to the individual patient with SSD directly into primary care practice. TRIAL REGISTRATION: The trial protocol was registered at German Clinical Trials Register (number: DRKS00026075, https://www.drks.de).


Subject(s)
Medically Unexplained Symptoms , Primary Health Care , Somatoform Disorders , Humans , Pilot Projects , Female , Male , Middle Aged , Adult , Somatoform Disorders/therapy , Germany , Referral and Consultation , Feasibility Studies , Videoconferencing
9.
Support Care Cancer ; 32(5): 325, 2024 May 03.
Article in English | MEDLINE | ID: mdl-38700712

ABSTRACT

People with advanced cancer and cachexia experience significant body weight loss, adversely impacting physical function and quality of life (QOL). Effective, evidence-based treatments for cancer cachexia are lacking, leaving patients with unmet needs. Exercise holds promise to improve patient QOL. However, information on patients' experiences of exercise, including their ability to cope with structured exercise, is limited. PURPOSE: To explore patient experiences completing a structured, supervised exercise program for people with cachexia due to advanced cancer. METHODS: Semi-structured interviews were conducted with participants enrolled in a phase II feasibility, randomized controlled trial to explore their experiences of an 8-week virtually supervised exercise program delivered via videoconference technology. Interviews were analysed using reflexive thematic analysis. RESULTS: Seventeen participants completed interviews (female n = 9, 53%). Main interview themes included the following: (1) Deciding to exercise involves balancing concerns and expectations, (2) the exercise program is a positive experience, and (3) moving forward after the exercise program. While some participants initially held doubts about their physical capabilities and exercise safety, most wanted to exercise to enhance their wellbeing. Participants described the exercise program as a positive experience, offering diverse benefits. Some would have preferred in-person exercise, but all agreed the virtual format increased convenience. Participants emphasized the need to recommend the program to others in similar circumstances. They underscored the necessity and desire for ongoing support to sustain their new exercise habits. CONCLUSION: Based on patient experiences, virtually supervised exercise programming appears to be feasible and meaningful to people with advanced cancer and cachexia.


Subject(s)
Cachexia , Exercise Therapy , Neoplasms , Qualitative Research , Quality of Life , Humans , Cachexia/etiology , Cachexia/therapy , Female , Neoplasms/complications , Neoplasms/psychology , Male , Middle Aged , Exercise Therapy/methods , Aged , Adult , Feasibility Studies , Videoconferencing , Interviews as Topic
10.
Sci Rep ; 14(1): 10260, 2024 05 04.
Article in English | MEDLINE | ID: mdl-38704442

ABSTRACT

Digital communication technologies are rapidly evolving, and understanding their impact on group dynamics and cognitive performance in professional settings becomes central. This study investigates the psychological impact of different interaction settings-two-dimensional Video Conferencing (VC), Face-To-Face (FTF), and Virtual Reality (VR)-on group dynamics, cognitive performance, and aspects of well-being in a professional context. Utilizing a sample of 40 participants from a large Italian electricity transmission company, the study employs a within-subjects design to explore various metrics, including flow, creativity, fatigue and aspects of interaction. The results indicate that FTF interactions are optimal for idea generation and task absorption. VR, although initially more fatiguing for first-time users, fosters a more collaborative and peaceful environment, encouraging participants to engage more openly with each other. VC was found to be the least fatiguing, but also the least engaging in terms of task absorption and idea generation. Additionally, age-related differences were observed, particularly in the perception of motivational and emotional fatigue in the VR setting. The study provides empirical evidence supporting the integration of VR in professional settings for specific types of meetings, while also highlighting the limitations and areas for future research. These findings have implications for organizational well-being, cognitive ergonomics, and the evolving landscape of remote work technologies.


Subject(s)
Creativity , Decision Making , Fatigue , Virtual Reality , Workplace , Humans , Male , Adult , Female , Workplace/psychology , Videoconferencing , Middle Aged , Young Adult
11.
WMJ ; 123(2): 124-126, 2024 May.
Article in English | MEDLINE | ID: mdl-38718241

ABSTRACT

INTRODUCTION: COVID-19 ended in-person communication training workshops at our institution, so we sought to provide a way for family medicine residents to hone their telephone and audio-visual skills online. METHODS: We developed a 2-hour online workshop where residents practiced delivering serious news to family members via telephone or videoconferencing call and measured participant confidence via pre-, post-, and 6-month surveys. RESULTS: Participant confidence in delivering serious news via telephone and videoconferencing increased. Sustained confidence at 6-month follow-up was not confirmed. DISCUSSION/CONCLUSIONS: Offering an online opportunity to practice delivering serious news by telephone or videoconferencing call appears to be a successful way to bolster confidence. Participants found using realistic scenarios and discussion of best practices most helpful.


Subject(s)
COVID-19 , Internship and Residency , SARS-CoV-2 , Telemedicine , Videoconferencing , Humans , Female , Family Practice/education , Communication , Male , Pandemics , Wisconsin , Adult , Telephone
13.
BMC Med Inform Decis Mak ; 24(1): 139, 2024 May 27.
Article in English | MEDLINE | ID: mdl-38802921

ABSTRACT

BACKGROUND: Few studies have been conducted on the usage of telehealth focusing on consultations between patients' families and physicians. This study aimed to identify the usage and limitations of online medical consultations with patients' families compared to the traditional in-person consultations. METHODS: We conducted a prospective cohort study from April 1, 2020, to September 30, 2021, at an educational acute-care hospital in Japan. The study included hospitalized patients aged 20 years or older and their family members for whom an online or in-person medical consultation between the family member and physician was conducted during the hospitalization period. The primary endpoints assessed were three topics pertaining to medical consultation: medical conditions and treatment plans, policies for life-threatening events, and post-discharge support. The secondary endpoint was the number of consultations required. RESULTS: Online consultations and traditional in-person consultations were provided to 58 and 53 patients' families, respectively. Of the patients in the online consultation group who underwent multiple consultations, 46 (79%) also underwent in-person consultations. Regarding the topics, all the patients' families in both consultation groups had consultations on medical conditions and treatment plans; regarding the policy for life-threatening events, 47% of patient families in the online consultation group were consulted compared to 53% of those in the in-person group. Regarding post-discharge support, 59% of patient families in the online group were consulted compared to 40% in the in-person group. In the online consultation group of 58 patients' families, 188 consultations were conducted, including 95 online and 93 in-person consultations. Consultations on policy for life-threatening events were significantly more frequent in in-person consultations than in online consultations (p < 0.05). Regarding post-discharge support, online consultations were significantly more frequent than in-person consultations (p < 0.05). The number of family members who attended online consultations was significantly higher than those who attended in-person consultations (p < 0.05). CONCLUSIONS: Online consultation between the physician and patient's family may be an alternative to in-person consultation for explaining medical conditions and treatment plans. However, in-person consultation still plays an important role in sensitive topics, such as policy consultation for life-threatening events.


Subject(s)
Family , Humans , Female , Male , Prospective Studies , Middle Aged , Adult , Aged , Japan , Telemedicine , Remote Consultation , Videoconferencing , Referral and Consultation , Aged, 80 and over
14.
BMJ Open Qual ; 13(2)2024 May 24.
Article in English | MEDLINE | ID: mdl-38789279

ABSTRACT

Discharge from hospitals to postacute care settings is a vulnerable time for many older adults, when they may be at increased risk for errors occurring in their care. We developed the Extension for Community Healthcare Outcomes-Care Transitions (ECHO-CT) programme in an effort to mitigate these risks through a mulitdisciplinary, educational, case-based teleconference between hospital and skilled nursing facility providers. The programme was implemented in both academic and community hospitals. Through weekly sessions, patients discharged from the hospital were discussed, clinical concerns addressed, errors in care identified and plans were made for remediation. A total of 1432 discussions occurred for 1326 patients. The aim of this study was to identify errors occurring in the postdischarge period and factors that predict an increased risk of experiencing an error. In 435 discussions, an issue was identified that required further discussion (known as a transition of care event), and the majority of these were related to medications. In 14.7% of all discussions, a medical error, defined as 'any preventable event that may cause or lead to inappropriate medical care or patient harm', was identified. We found that errors were more likely to occur for patients discharged from surgical services or the emergency department (as compared with medical services) and were less likely to occur for patients who were discharged in the morning. This study shows that a number of errors may be detected in the postdischarge period, and the ECHO-CT programme provides a mechanism for identifying and mitigating these events. Furthermore, it suggests that discharging service and time of day may be associated with risk of error in the discharge period, thereby suggesting potential areas of focus for future interventions.


Subject(s)
Patient Discharge , Subacute Care , Videoconferencing , Humans , Patient Discharge/statistics & numerical data , Patient Discharge/standards , Female , Subacute Care/methods , Subacute Care/statistics & numerical data , Subacute Care/standards , Male , Aged , Videoconferencing/statistics & numerical data , Aged, 80 and over , Continuity of Patient Care/statistics & numerical data , Continuity of Patient Care/standards , Skilled Nursing Facilities/statistics & numerical data , Skilled Nursing Facilities/organization & administration , Medical Errors/statistics & numerical data , Medical Errors/prevention & control , Patient Transfer/methods , Patient Transfer/statistics & numerical data , Patient Transfer/standards
15.
BMC Health Serv Res ; 24(1): 646, 2024 May 21.
Article in English | MEDLINE | ID: mdl-38769512

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, numerous long-term care (LTC) homes faced restrictions that prevented face-to-face visits. To address this challenge and maintain family connections, many LTC homes facilitated the use of electronic tablets to connect residents with their family caregivers. Our study sought to explore the acceptability of this practice among staff members and managers, focusing on their experiences with facilitating videoconferencing. METHODS: A convergent mixed method research was performed. Qualitative and quantitative data collection through semi-structured interviews to assess the acceptability of videoconferencing in long-term care homes and to explore the characteristics of these settings. Quantitative data on the acceptability of the intervention were collected using a questionnaire developed as part of the project. The study included a convenience sample of 17 staff members and four managers. RESULTS: Managers described LTC homes' characteristics, and the way videoconferencing was implemented within their institutions. Affective attitude, burden, ethicality, opportunity costs, perceived effectiveness, and self-efficacy are reported as per the constructs of the Theoretical Framework of Acceptability. The results suggest a favorable acceptability and a positive attitude of managers and staff members toward the use of videoconferencing in long-term care to preserve and promote contact between residents and their family caregivers. However, participants reported some challenges related to the burden and the costs regarding the invested time and staff shortage. CONCLUSIONS: LTC home staff reported a clear understanding of the acceptability and challenges regarding the facilitation of videoconferencing by residents to preserve their contact with family caregivers.


Subject(s)
COVID-19 , Long-Term Care , Videoconferencing , Humans , COVID-19/epidemiology , Female , Male , Pandemics , SARS-CoV-2 , Attitude of Health Personnel , Nursing Homes , Middle Aged , Adult , Caregivers/psychology , Aged , Qualitative Research , Health Personnel/psychology
16.
Lancet Digit Health ; 6(6): e418-e427, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38789142

ABSTRACT

BACKGROUND: Few people with problematic alcohol use reach treatment and dropout is frequent. Therapy for problematic alcohol use delivered via video conference (e-alcohol therapy) might overcome treatment barriers. In this randomised study, we tested whether proactive e-alcohol therapy outperformed face-to-face alcohol therapy (standard care) regarding treatment initiation, compliance, and weekly alcohol intake at 3-month and 12-month follow-up. METHODS: In this two-arm randomised controlled trial, we recruited individuals who had problematic alcohol use, defined as a score of 8 or more on the Alcohol Use Disorders Identification Test; were 18 years or older; and had access to a personal computer, smartphone, or tablet with internet access in Denmark through online advertisements. Participants were assigned to receive alcohol therapy delivered either face-to-face or via video conference. The number, frequency, and duration of therapy sessions were individualised in both groups. Data analysis was conducted using masked data. Primary analyses were based on an intention-to-treat sample. The study is registered with ClinicalTrials.gov (NCT03116282). FINDINGS: Between Jan 22, 2018, and June 29, 2020, 816 individuals signed up for the trial and 502 (63%) were assessed for eligibility. We randomly assigned 379 to proactive e-alcohol therapy (n=187) or standard care (n=192), of which, 170 (48%) participants were female and 186 (52%) were male. In the intervention group, more participants initiated treatment (155 [88%] of 177 vs 96 [54%] of 179; odds ratio [OR] 6·3; 95% CI 2·8 to 13·8; p<0·0001 at 3 months; 151 [85%] of 177 vs 115 [64%] of 179; OR 3·2; 95% CI 1·6 to 6·2; p=0·0007 at 12 months) and complied with treatment (130 [73%] of 177 vs 74 [41%] of 179; OR 4·0; 95% CI 2·2 to 7·2; p<0·0001 at 3 months; 140 [79%] of 177 vs 95 [53%] of 179; OR 3·4; 95% CI 1·8 to 6·3; p=0·0002 at 12 months). Weekly alcohol intake was significantly lower in the intervention group only after 3 months (13·0 standard drinks per week vs 21·3 standard drinks per week; adjusted difference -6·7; 95% CI -12·3 to -1·0; p=0·019). INTERPRETATION: Proactive e-alcohol therapy was associated with increased treatment initiation and compliance and is promising as an easily accessible and effective alcohol treatment for individuals with problematic alcohol use. FUNDING: TrygFonden.


Subject(s)
Alcohol Drinking , Humans , Female , Male , Denmark , Adult , Alcohol Drinking/therapy , Middle Aged , Alcoholism/therapy , Patient Compliance , Treatment Outcome , Telemedicine , Videoconferencing
17.
Acta Paediatr ; 113(7): 1524-1530, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38641967

ABSTRACT

AIM: The aim of this study is to evaluate an early discharge programme with video consultations for preterm infants. METHODS: A homecare programme for preterm infants was developed. Prospective data on readmissions, length of stay, growth, breastfeeding rates, and parent self-reports about satisfaction were collected from April 2021 to August 2023. Additionally, retrospective data were collected from the Norwegian Neonatal Network Central Database from 2020. RESULTS: Preterm infants, 72 and parents, 128 were included. The infants were discharged from the hospital at a median of 35 + 6 (34 + 0-42 + 4) weeks postmenstrual age. The median length of stay in the program was 18 days (3-37). There were four readmissions. The Z-score of infant weight slightly increased during the follow up, with a mean of 0.16. By discharge, 75% of the infants were exclusively breastfed. Growth and breastfeeding rates were in line with retrospective data (85 infants). The response rate of the parents to the survey was 61 (52%). Overall, the parents (n = 54) were highly satisfied (96%). The video consultations contributed to ensuring parents to feel safe in caring for their infant at home. CONCLUSION: Follow up by video consultations is a viable healthcare service for preterm infants, the infants' growth is sufficient, breastfeeding rates are maintained, and parents feel safe and satisfied.


Subject(s)
Infant, Premature , Patient Discharge , Humans , Infant, Newborn , Female , Male , Retrospective Studies , Prospective Studies , Parents , Videoconferencing , Norway
18.
Am J Audiol ; 33(2): 465-475, 2024 Jun 04.
Article in English | MEDLINE | ID: mdl-38619443

ABSTRACT

PURPOSE: Telehealth has proven effective for service delivery to remote and rural locations and was helpful during lockdowns when patients were unable to see clinicians in person. To assure the reliability of clinical services, the aim of the present study was to evaluate a telehealth protocol to measure speech perception skills through virtual meeting applications such as Zoom. METHOD: A total of 20 participants with normal hearing and cognition participated in the study. Participants' speech perception performance was measured in two sessions: one over a Zoom call and one in person in the laboratory. Speech perception was measured using Quick Speech-in-Noise Test, Bamford-Kowal-Bench Speech-in-Noise Test, and Words-in-Noise Test. RESULTS: Statistical analysis revealed no significant differences between speech perception scores obtained over the Zoom and in-person methodologies for any of the tests. Additionally, our study found no significant difference in the scores obtained between wired and wireless headphones during Zoom calls. CONCLUSION: These results suggest that Zoom can be used as a reliable method to measure speech perception in young individuals with normal hearing using these three tests in situations where conventional methods cannot be utilized.


Subject(s)
Speech Perception , Telemedicine , Videoconferencing , Humans , Female , Male , Adult , Young Adult , Reproducibility of Results
19.
Front Public Health ; 12: 1326412, 2024.
Article in English | MEDLINE | ID: mdl-38686035

ABSTRACT

Aging is characterized by substantial changes in sleep architecture that negatively impact fitness, quality of life, mood, and cognitive functioning. Older adults often fail to reach the recommended level of physical activity to prevent the age-related decline in sleep function, partly because of geographical barriers. Implementing home-based interventions could surmount these obstacles, thereby encouraging older adults to stay active, with videoconference administration emerging as a promising solution. Increasing the availability of biological rhythms synchronizers, such as physical activity, light exposure, or vestibular stimulation, represents a viable non-pharmacological strategy for entraining circadian rhythms and potentially fortifying the sleep-wake cycle, thereby enhancing sleep in aging. This study aims to (1) assess the impact of remote physical exercise training and its combination with bright light exposure, and (2) investigate the specific contribution of galvanic vestibular stimulation, to sleep quality among healthy older adults with sleep complaints. One hundred healthy older adults aged 60-70 years with sleep complaints will be randomly allocated to one of four groups: a physical exercise training group (n = 25), a physical exercise training combined with bright light exposure group (n = 25), a galvanic vestibular stimulation group (n = 25) or a control group (i.e., health education) (n = 25). While physical exercise training and health education will be supervised via videoconference at home, bright light exposure (for the physical exercise training combined with bright light exposure group) and vestibular stimulation will be self-administered at home. Pre-and post-tests will be conducted to evaluate various parameters, including sleep (polysomnography, subjective questionnaires), circadian rhythms (actigraphy, temperature), fitness (physical: VO2 peak, muscular function; and motor: balance, and functional mobility), cognition (executive function, long-term memory), quality of life and mood (anxiety and depression). The findings will be anticipated to inform the development of recommendations and non-pharmaceutical preventive strategies for enhancing sleep quality in older adults, potentially leading to improvements in fitness, cognition, quality of life, and mood throughout aging.


Subject(s)
Videoconferencing , Humans , Aged , Middle Aged , Female , Male , Exercise , Quality of Life , Sleep/physiology
20.
BMC Geriatr ; 24(1): 375, 2024 Apr 26.
Article in English | MEDLINE | ID: mdl-38671367

ABSTRACT

BACKGROUND: Decisions surrounding the permanent residential care placement of people living with dementia can be stressful and distressing; however, providing access to targeted information and support prior to placement may help carers better cope. This mixed methods study aimed to test the feasibility, acceptability, and potential benefits of providing a tailored, individual counselling program (the Residential Care Transition Module), delivered via videoconferencing, to Australian family carers of a relative with dementia during the transition to permanent residential care. METHODS: A total of 18 family carers were randomly allocated to receive either the counselling intervention (six sessions delivered over 12 weeks) or a check-in call, delivered by a trained Transition Counsellor. Both groups received help-sheets about residential care, coping with placement, and managing feelings. Carers completed online surveys about stress, guilt, anxiety, depression, grief, and support for caring at baseline and four months post-baseline. Carers were also invited to participate in semi-structured exit interviews, conducted after follow-up surveys were completed. Process data relating to recruitment, retention, intervention dose and delivery were collected via logs. Quantitative data were analysed using descriptive statistics and repeated measures ANOVA. Qualitative data, relating to feasibility, acceptability, and perceived benefits of the program, were analysed using the 'framework' approach developed by the Medical Research Council to inform the process evaluation of complex interventions. RESULTS: Qualitative findings indicated that delivery of the counselling program during the transition period was deemed by participants to be feasible and acceptable. Delivery via videoconferencing was deemed convenient and acceptable, with few technical issues. The skills and knowledge of the Transition Counsellor were perceived to be important mechanisms of impact. Though not statistically significant, promising quantitative findings were identified in terms of reduced carer stress and guilt and improved support for caring. CONCLUSIONS: Delivery of a tailored counselling program via videoconferencing to family carers of people living with dementia during the transition to residential care was feasible and acceptable. The program has the potential to improve transitional support to family carers. TRIAL REGISTRATION: This study was registered in the Australian New Zealand Clinical Trials Registry: ACTRN12621001462875.


Subject(s)
Caregivers , Counseling , Dementia , Feasibility Studies , Videoconferencing , Humans , Caregivers/psychology , Dementia/therapy , Dementia/psychology , Male , Female , Counseling/methods , Middle Aged , Pilot Projects , Aged , Aged, 80 and over , Adult
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