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1.
Rev. enferm. UERJ ; 28: e51821, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1117686

RESUMO

Objetivo: compreender a vivência do enfrentamento e repercussões da COVID-19, na percepção de mulheres em tratamento oncológico. Método: estudo qualitativo, do tipo ação-participante, fundamentado no Itinerário de Pesquisa de Paulo Freire, que possui três fases: Investigação Temática; Codificação e Descodificação; Desvelamento Crítico. Foi realizado Círculo de Cultura virtual, com a participação de 12 mulheres em tratamento do câncer de mama, de diferentes localidades do Brasil. Resultados: no Círculo de Cultura virtual discutiram dois temas: desafios no enfrentamento do câncer e da COVID-19; aprendizados gerados nessa vivência, considerando um renascimento das próprias cinzas. Considerações finais: o momento pandêmico tem instigado reflexões sobre o viver. Assim, as mulheres em tratamento oncológico e também em restrição social puderam expressar seus sentimentos, descobrindo e redescobrindo fragilidades e fortalezas para ressignificar e crescer como seres, em uma sociedade, que pode e deve articular estratégias para promoção da saúde.


Objective: to understand the experience of coping with COVID-19, as perceived by women undergoing cancer treatment. Method: qualitative, participatory action research based on the three phases of Paulo Freire's Research Itinerary: Thematic Investigation; Coding and Decoding; and Critical Unveiling. A Culture Circle was held online with 12 women from different places in Brazil undergoing breast cancer treatment. Results: in the virtual Culture Circle, they discussed two themes: challenges in coping with cancer and COVID-10; and learning generated in that experience, with a view to rebirth from their own ashes. Final considerations: the pandemic has prompted thinking about living. Accordingly, women undergoing cancer treatment and also under social restrictions were able to express their feelings, and in discovering and rediscovering weaknesses and strengths, to resignify themselves and to grow in a society that can and should deploy strategies for health promotion.


Objetivo: comprender la experiencia de afrontamiento del COVID-19, según la perciben las mujeres en tratamiento oncológico. Método: investigación-acción cualitativa y participativa basada en las tres fases del Itinerario de Investigación de Paulo Freire: Investigación Temática; Codificación y decodificación; y revelación crítica. Se realizó un Círculo Cultural en línea con 12 mujeres de diferentes lugares de Brazil sometidas a tratamiento contra el cáncer de mama. Resultados: en el Círculo de Cultura virtual se discutieron dos temas: desafíos en el afrontamiento del cáncer y COVID-10; y el aprendizaje generado en esa experiencia, con miras a renacer de sus propias cenizas. Consideraciones finales: la pandemia ha llevado a pensar en vivir. En consecuencia, las mujeres en tratamiento oncológico y también bajo restricciones sociales pudieron expresar sus sentimientos, y al descubrir y redescubrir debilidades y fortalezas, resignificarse y crecer en una sociedad que puede y debe desplegar estrategias de promoción de la salud.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias da Mama/psicologia , Adaptação Psicológica , Quarentena/psicologia , Infecções por Coronavirus/epidemiologia , Promoção da Saúde , Aprendizagem , Brasil , Processo Saúde-Doença , Telemedicina , Pesquisa Qualitativa , Emoções , Acontecimentos que Mudam a Vida
3.
5.
Can Vet J ; 61(10): 1092-1100, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33012826

RESUMO

As a result of the various restrictions associated with the current COVID-19 pandemic, the practice of veterinary telehealth is likely to grow substantially. One area in which high quality care can be maintained while respecting physical distancing is teleconsulting, which describes the relationship between an attending and off-site consulting veterinarian. This guide uses a dentistry case to illustrate the provision of real-time anesthesia consulting, with a focus on the technological considerations central to facilitating live, 2-way video-communication. Case selection, teamwork, and patient safety are also discussed.


Assuntos
Anestesia , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Telemedicina , Anestesia/efeitos adversos , Anestesia/veterinária , Animais , Betacoronavirus
6.
J Nurs Educ ; 59(10): 570-576, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33002163

RESUMO

BACKGROUND: In March 2020, due to the COVID-19 pandemic, universities halted in-person education and health care pivoted to telehealth delivery models. This article describes a nurse-led educational program that transitioned to fully online delivery to prepare interprofessional teams of health care students to use telehealth during the pandemic and beyond. METHOD: Participants included 67 students from seven professions. Researchers developed "the four Ps of telehealth" model to guide the curriculum. The program used pre- and postassessments including the Confidence in Planning for Telehealth Scale, the Telehealth Etiquette Knowledge Scale, and the Confidence in Providing Telehealth Scale. RESULTS: There were significant improvements in scores on all scales following the program (p = .000). CONCLUSION: The results suggest that comprehensive telehealth education should focus on more than just delivering telehealth but also planning and preparing for its delivery. Programs such as this online program can serve as a model for future telehealth programs to prepare providers. [J Nurs Educ. 2020;59(10):570-576.].


Assuntos
Infecções por Coronavirus/prevenção & controle , Educação a Distância/organização & administração , Educação em Enfermagem/organização & administração , Relações Interprofissionais , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Telemedicina/organização & administração , Adulto , Infecções por Coronavirus/epidemiologia , Currículo , Feminino , Humanos , Masculino , Modelos Educacionais , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem , Pneumonia Viral/epidemiologia , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem
8.
JAMA Netw Open ; 3(10): e2021476, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33006622

RESUMO

Importance: Little is known about the association between the coronavirus disease 2019 (COVID-19) pandemic and the level and content of primary care delivery in the US. Objective: To quantify national changes in the volume, type, and content of primary care delivered during the COVID-19 pandemic, especially with regard to office-based vs telemedicine encounters. Design, Setting, and Participants: Analysis of serial cross-sectional data from the IQVIA National Disease and Therapeutic Index, a 2-stage, stratified nationally representative audit of outpatient care in the US from the first calendar quarter (Q1) of 2018 to the second calendar quarter (Q2) of 2020. Main Outcomes and Measures: Visit type (office-based or telemedicine), overall and stratified by patient population and geographic region; assessment of blood pressure or cholesterol measurement; and initiation or continuation of prescription medications. Results: In the 8 calendar quarters between January 1, 2018, and December 31, 2019, between 122.4 million (95% CI, 117.3-127.5 million) and 130.3 million (95% CI, 124.7-135.9 million) quarterly primary care visits occurred in the US (mean, 125.8 million; 95% CI, 121.7-129.9 million), most of which were office-based (92.9%). In 2020, the total number of encounters decreased to 117.9 million (95% CI, 112.6-123.2 million) in Q1 and 99.3 million (95% CI, 94.9-103.8 million) in Q2, a decrease of 21.4% (27.0 million visits) from the average of Q2 levels during 2018 and 2019. Office-based visits decreased 50.2% (59.1 million visits) in Q2 of 2020 compared with Q2 2018-2019, while telemedicine visits increased from 1.1% of total Q2 2018-2019 visits (1.4 million quarterly visits) to 4.1% in Q1 of 2020 (4.8 million visits) and 35.3% in Q2 of 2020 (35.0 million visits). Decreases occurred in blood pressure level assessment (50.1% decrease, 44.4 million visits) and cholesterol level assessment (36.9% decrease, 10.2 million visits) in Q2 of 2020 compared with Q2 2018-2019 levels, and assessment was less common during telemedicine than during office-based visits (9.6% vs 69.7% for blood pressure; P < .001; 13.5% vs 21.6% for cholesterol; P < .001). New medication visits in Q2 of 2020 decreased by 26.0% (14.1 million visits) from Q2 2018-2019 levels. Telemedicine adoption occurred at similar rates among White individuals and Black individuals (19.3% vs 20.5% of patient visits, respectively, in Q1/Q2 of 2020), varied by region (low of 15.1% of visits [East North Central region], high of 26.8% of visits [Pacific region]), and was not correlated with regional COVID-19 burden. Conclusions and Relevance: The COVID-19 pandemic has been associated with changes in the structure of primary care delivery, with the content of telemedicine visits differing from that of office-based encounters.


Assuntos
Visita a Consultório Médico/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Adulto , Afro-Americanos , Idoso , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Assistência à Saúde/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
9.
J Med Internet Res ; 22(10): e18835, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33006571

RESUMO

BACKGROUND: In recent decades, advances in information technology have given new momentum to telemedicine research. These advances in telemedicine range from individual to population levels, allowing the exchange of patient information for diagnosis and management of health problems, primary care prevention, and education of physicians via distance learning. OBJECTIVE: This scientometric investigation aims to examine collaborative research networks, dominant research themes and disciplines, and seminal research studies that have contributed most to the field of telemedicine. This information is vital for scientists, institutions, and policy stakeholders to evaluate research areas where more infrastructural or scholarly contributions are required. METHODS: For analyses, we used CiteSpace (version 4.0 R5; Drexel University), which is a Java-based software that allows scientometric analysis, especially visualization of collaborative networks and research themes in a specific field. RESULTS: We found that scholarly activity has experienced a significant increase in the last decade. Most important works were conducted by institutions located in high-income countries. A discipline-specific shift from radiology to telestroke, teledermatology, telepsychiatry, and primary care was observed. The most important innovations that yielded a collaborative influence were reported in the following medical disciplines, in descending order: public environmental and occupational health, psychiatry, pediatrics, health policy and services, nursing, rehabilitation, radiology, pharmacology, surgery, respiratory medicine, neurosciences, obstetrics, and geriatrics. CONCLUSIONS: Despite a continuous rise in scholarly activity in telemedicine, we noticed several gaps in the literature. For instance, all the primary and secondary research central to telemedicine was conducted in the context of high-income countries, including the evidence synthesis approaches that pertained to implementation aspects of telemedicine. Furthermore, the research landscape and implementation of telemedicine infrastructure are expected to see exponential progress during and after the COVID-19 era.


Assuntos
Bibliometria , Pesquisa , Telemedicina , Betacoronavirus , Infecções por Coronavirus , Assistência à Saúde , Educação a Distância , Saúde Ambiental , Política de Saúde , Humanos , Enfermagem , Saúde do Trabalhador , Pandemias , Médicos , Pneumonia Viral , Atenção Primária à Saúde , Psiquiatria , Publicações , Radiologia , Telerreabilitação
10.
Sleep Med Clin ; 15(3S): e1-e7, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33008491

RESUMO

Prior to the COVID-19 pandemic, few pediatric sleep medicine clinicians routinely engaged in telemedicine visits because thorough examinations were difficult to perform; there was lack of consistent reimbursement; and many clinicians were busy with their in-office practices. This article reviews how telemedicine has been explored in pediatric sleep medicine prior to the pandemic, current applications of telemedicine, challenges, and reimagining pediatric sleep within the realm of telemedicine.


Assuntos
Pediatria , Medicina do Sono , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/terapia , Telemedicina/métodos , Betacoronavirus , Criança , Pressão Positiva Contínua nas Vias Aéreas , Infecções por Coronavirus , Humanos , Otolaringologia , Pandemias , Pneumonia Viral , Polissonografia , Encaminhamento e Consulta , Síndrome das Pernas Inquietas/diagnóstico , Síndrome das Pernas Inquietas/terapia , Sono , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/terapia , Transtornos do Sono do Ritmo Circadiano/diagnóstico , Transtornos do Sono do Ritmo Circadiano/terapia , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/terapia
11.
Lima; Perú. Ministerio de Salud; 20201000. 49 p. ilus.
Monografia em Espanhol | LILACS, MINSAPERU | ID: biblio-1122243

RESUMO

El documento contiene los objetivos, estrategias y acciones en salud digital del Sector Salud alineados a la función rectora del Ministerio de Salud.


Assuntos
Saúde , Estratégias , Telemedicina , Políticas , Exclusão Digital , Objetivos
14.
RMD Open ; 6(3)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33011680

RESUMO

OBJECTIVE: There is emerging evidence that COVID-19 disproportionately affects people from racial/ethnic minority and low socioeconomic status (SES) groups. Many physicians across the globe are changing practice patterns in response to the COVID-19 pandemic. We sought to examine the practice changes among rheumatologists and what they perceive the impact to be on their most vulnerable patients. METHODS: We administered an online survey to a convenience sample of rheumatologists worldwide during the initial height of the pandemic (between 8 April and 4 May 2020) via social media and group emails. We surveyed rheumatologists about their opinions regarding patients from low SES and racial/ethnic minority groups in the context of the COVID-19 pandemic. Mainly, what their specific concerns were, including the challenges of medication access; and about specific social factors (health literacy, poverty, food insecurity, access to telehealth video) that may be complicating the management of rheumatologic conditions during this time. RESULTS: 548 rheumatologists responded from 64 countries and shared concerns of food insecurity, low health literacy, poverty and factors that preclude social distancing such as working and dense housing conditions among their patients. Although 82% of rheumatologists had switched to telehealth video, 17% of respondents estimated that about a quarter of their patients did not have access to telehealth video, especially those from below the poverty line. The majority of respondents believed these vulnerable patients, from racial/ethnic minorities and from low SES groups, would do worse, in terms of morbidity and mortality, during the pandemic. CONCLUSION: In this sample of rheumatologists from 64 countries, there is a clear shift in practice to telehealth video consultations and widespread concern for socially and economically vulnerable patients with rheumatic disease.


Assuntos
Doenças Autoimunes/etnologia , Betacoronavirus , Grupos de Populações Continentais , Infecções por Coronavirus/epidemiologia , Grupos Étnicos , Grupos Minoritários , Pneumonia Viral/epidemiologia , Pobreza , Doenças Reumáticas/etnologia , Doenças Autoimunes/mortalidade , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/virologia , Abastecimento de Alimentos/economia , Letramento em Saúde , Habitação , Humanos , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , Doenças Reumáticas/mortalidade , Reumatologistas , Inquéritos e Questionários , Telemedicina
15.
BMJ Case Rep ; 13(10)2020 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-33012707

RESUMO

This is a report of the first three cases of endovascular aneurysm treatment that were proctored by a remote interventionalist using a novel high-resolution low-latency streaming technology. The proctor was located in a neurovascular centre and supported the treating interventional teams in two distant cities (up to 800 km/500 miles apart). All aneurysms were treated using the Woven EndoBridge (WEB) embolisation system, either electively or following subarachnoid haemorrhage. On-site proctoring was not possible due to travel restrictions during the COVID-19 pandemic. WEB placement was feasible in all cases. Good rapport between proctors and treating physicians was reported, enabled by the high-resolution image transmission and uninterrupted feedback/discussion via audiostream. No clinical complications were encountered. Short-term follow-up revealed adequate occlusion of all treated aneurysms. The employed streaming technology provided effective remote proctoring during complex aneurysm cases, including the management of technical complications.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Procedimentos Endovasculares/métodos , Aneurisma Intracraniano/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Telemedicina/métodos , Angiografia Digital/métodos , Humanos , Aneurisma Intracraniano/diagnóstico por imagem
16.
Cancer Control ; 27(1): 1073274820964800, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33023342

RESUMO

Emergence of the COVID-19 crisis has catalyzed rapid paradigm shifts throughout medicine. Even after the initial wave of the virus subsides, a wholesale return to the prior status quo is not prudent. As a specialty that values the proper application of new technology, radiation oncology should strive to be at the forefront of harnessing telehealth as an important tool to further optimize patient care. We remain cognizant that telehealth cannot and should not be a comprehensive replacement for in-person patient visits because it is not a one for one replacement, dependent on the intention of the visit and patient preference. However, we envision the opportunity for the virtual patient "room" where multidisciplinary care may take place from every specialty. How we adapt is not an inevitability, but instead, an opportunity to shape the ideal image of our new normal through the choices that we make. We have made great strides toward genuine multidisciplinary patient-centered care, but the continued use of telehealth and virtual visits can bring us closer to optimally arranging the spokes of the provider team members around the central hub of the patient as we progress down the road through treatment.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Neoplasias/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde , Quartos de Pacientes/organização & administração , Pneumonia Viral/epidemiologia , Telemedicina/métodos , Realidade Virtual , Comorbidade , Humanos , Neoplasias/epidemiologia , Pandemias , Satisfação do Paciente
17.
Br J Community Nurs ; 25(10): 480-488, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33030369

RESUMO

People with chronic pain faced potential treatment disruption during the COVID-19 pandemic in Singapore, as the focus of healthcare shifted. A model of rapid integration of a pain centre with community healthcare teams was implemented to care for vulnerable older patients with chronic pain and multiple comorbidities. Telemedicine and home visits by community nurses were used, with risk-mitigation measures, ensuring comprehensive assessment and treatment compliance. Medications from pain physicians were delivered at home through a hospital pharmacy. A secure national electronic health records system used by all teams ensured seamless access and documentation. Potential emergency department visits, admissions and delayed discharges were thus avoided. Integration of community teams with chronic pain management services can be recommended to ensure pandemic preparedness.


Assuntos
Dor Crônica/terapia , Enfermagem em Saúde Comunitária , Infecções por Coronavirus , Visita Domiciliar , Clínicas de Dor , Manejo da Dor , Pandemias , Pneumonia Viral , Telemedicina , Betacoronavirus , Comportamento Cooperativo , Assistência à Saúde , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Encaminhamento e Consulta , Singapura , Fluxo de Trabalho
18.
BMC Public Health ; 20(1): 1520, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33032564

RESUMO

BACKGROUND: New approaches on paediatric cancer treatment aim to maintain long-term health. As a result of radiotherapy, chemotherapy or surgery, paediatric cancer survivors tend to suffer from any chronic health condition. Endocrine dysfunction represents one of the most common issues and affects bone health. Exercise is key for bone mass accrual during growth, specifically plyometric jump training. The iBoneFIT study will investigate the effect of a 9-month online exercise programme on bone health in paediatric cancer survivors. This study will also examine the effect of the intervention on body composition, physical fitness, physical activity, calcium intake, vitamin D, blood samples quality of life and mental health. METHODS: A minimum of 116 participants aged 6 to 18 years will be randomized into an intervention (n = 58) or control group (n = 58). The intervention group will receive an online exercise programme and diet counselling on calcium and vitamin D. In addition, five behaviour change techniques and a gamification design will be implemented in order to increase the interest of this non-game programme. The control group will only receive diet counselling. Participants will be assessed on 3 occasions: 1) at baseline; 2) after the 9 months of the intervention; 3) 4 months following the intervention. The primary outcome will be determined by dual energy X-ray absorptiometry (DXA) and the hip structural analysis, trabecular bone score and 3D-DXA softwares. Secondary outcomes will include anthropometry, body composition, physical fitness, physical activity, calcium and vitamin D intake, blood samples, quality of life and mental health. DISCUSSION: Whether a simple, feasible and short in duration exercise programme can improve bone health has not been examined in paediatric cancer survivors. This article describes the design, rationale and methods of a study intended to test the effect of a rigorous online exercise programme on bone health in paediatric cancer survivors. If successful, the iBoneFIT study will contribute to decrease chronic health conditions in this population and will have a positive impact in the society. TRIAL REGISTRATION: Prospectively registered in isrctn.com: isrctn61195625 . Registered 2 April 2020.


Assuntos
Densidade Óssea , Sobreviventes de Câncer/estatística & dados numéricos , Terapia por Exercício/métodos , Telemedicina , Adolescente , Criança , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa
20.
Curr Allergy Asthma Rep ; 20(11): 73, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33006664

RESUMO

PURPOSE OF REVIEW: Coding for patient visits and monitoring via telehealth have expanded over the past years with a wide acceptance of telemedicine as a consequence of the coronavirus pandemic. Coding topics of interest to the allergist/immunologist in regard to services provided via telemedicine will be of increasing importance in the coming years. RECENT FINDINGS: CPT coding for telephone as well as synchronous face-to-face telehealth visits has changed over the past few years. With the need for distancing and patient protection during the coronavirus pandemic, telehealth services have increased dramatically. The introduction of newer devices to remotely monitor patients will increase and be incorporated into patient care. This review will summarize current codes available for designating what services have been provided. The area of telemedicine is changing and will continue to evolve as other platforms for visits are designed and other methods of monitoring patients become available. Coding for these services will be an ongoing need for the provider.


Assuntos
Current Procedural Terminology , Telemedicina , Humanos , Relações Interprofissionais
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