The Aphasia Action, Success, and Knowledge Programme: Results from an Australian Phase I Trial of a Speech-Pathology-Led Intervention for People with Aphasia Early Post Stroke

2017 ◽  
Vol 18 (3) ◽  
pp. 284-298 ◽  
Author(s):  
Brooke Ryan ◽  
Kyla Hudson ◽  
Linda Worrall ◽  
Nina Simmons-Mackie ◽  
Emma Thomas ◽  
...  
Keyword(s):  
Social Impact ◽  
Phase 1 ◽  
Family Members ◽  
Randomised Control Trial ◽  
Speech Pathology ◽  
Face To Face ◽  
Post Stroke ◽  
Level Of Satisfaction

Background: Speech pathologists work to optimise communication and reduce the emotional and social impact of communication disability in patients with aphasia but need evidence-based interventions to effectively do so.Objective: This phase 1 study aims to evaluate an Australian speech-pathology-led intervention called the Aphasia Action, Success, and Knowledge (Aphasia ASK) programme for patients with aphasia early post stroke.Methods: A convergent parallel mixed-methods design was utilised. The intervention included up to six individual face-to-face sessions with seven participants with aphasia and their nominated family member(s). Quantitative outcomes assessing mood, quality of life, and communication confidence were conducted for the participants with aphasia. Follow-up interviews were conducted with both participants with aphasia and family members to determine their perceptions of the programme.Results: Significant improvements were found in communication confidence and mood after treatment and the gains were maintained at 3-month follow-up. Participants with aphasia and their family members reported a good level of satisfaction with the programme.Conclusions: Findings suggest the Aphasia ASK programme is a suitable intervention with positive initial outcomes for people with aphasia. A larger scale evaluation with a greater variety of participants is now required. An Australian cluster randomised control trial is planned.

scholarly journals 829 Is There an Ongoing Role For 'Telephone Triage Clinics' Post COVID-19?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
B Holmes ◽  
U Mirza ◽  
C Manning ◽  
R Cooke ◽  
R Jugdey
Keyword(s):  
Common Theme ◽  
Telephone Triage ◽  
Telephone Consultation ◽  
Face To Face ◽  
Clinician Satisfaction ◽  
Set Up ◽  
Local Protocol ◽  
Telephone Questionnaire

Abstract Introduction COVID-19 has placed unprecedented demand on services at ELHT and it has become necessary to have telephone clinics to reduce the number of face-to-face clinics. A ‘telephone triage clinic’ was set up for referrals from A&E. Our project evaluated patient and clinician satisfaction on this. Method We carried out a retrospective telephone questionnaire with patients over a one-week period during the pandemic. We focussed on overall satisfaction of the consultation and quality of communication. Consultants were also surveyed for their opinion on the clinics. Results From 30 patients, 77% said they were ‘very satisfied’ with the overall experience. 80% of patients were ‘very satisfied’ with the overall length of the telephone consultation. 50% of patients felt the clinician was only ‘adequately’ able to assess them over the telephone. The consultants were less satisfied with the overall experience of telephone consultation. A common theme was that they felt ED documentation could be improved to help inform ongoing management. Conclusions Overall, patients were satisfied with the consultations. It has been successful in minimising face to face consultations however some presentations necessitate further evaluation. We need to identify those injuries appropriate for virtual follow up and design a local protocol for these.

scholarly journals Teledermatology in Times of COVID-19 Confinement: Comparing Patients’ and Physicians’ Satisfaction by the Standardized Brest Teledermatology Questionnaire

Dermatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Joachim W. Fluhr ◽  
Annie Gueguen ◽  
Delphine Legoupil ◽  
Emilie Brenaut ◽  
Claire Abasq ◽  
...  
Keyword(s):  
Main Question ◽  
Chronic Patients ◽  
Dermatology Department ◽  
Global Satisfaction ◽  
Technical Parameters ◽  
Face To Face ◽  
Almost All ◽  
Outpatient Settings

The French government imposed the first COVID-19 pandemic lockdown from March 17 until May 11, 2020. Only emergency cases and teledermatology (TD) were allowed in outpatient settings. A standardized questionnaire was developed to compare the satisfaction level of patients and their treating physicians. Our main question was whether the patients would perceive TD as a valid alternative for direct physical face-to-face consultation. Eighty-two patients and their 4 treating dermatologists from one dermatology department participated in the study (43 females, 39 males) with a mean age of 46.6 years (SD ±23.9). The reason for TD was a chronic disease in the majority (87.8%), and mainly as a follow-up (96.3%). Regarding satisfaction, almost all categories rated around 9 on a 0–10 verbal analogue scale. The same level of global satisfaction could be seen between the patients and the physicians as well as for the quality of the patient-physician relation and whether all questions could be addressed during the TC. Physicians showed significantly higher scores than patients only for the category of “length” of the consultation. Gender, age, as well as distance between the clinic and home of the patient were not influencing factors for satisfaction. Regarding the technical parameters, the evaluation was mostly comparable for patients and physicians, but overall lower than the relational satisfaction parameters, especially for image quality. Patients were significantly more motivated to continue the TD after the lockdown than their treating dermatologists. We see an interest for implementing TD in specialized centers with chronic patients coming from remote places for regular follow-ups. TD cannot replace in-person patient-physician interaction, but was helpful during the lockdown. As a result, TD might become part of dermatology training to prepare for future lockdown situations.

scholarly journals Education in Neurology Resident Documentation Using Payroll Simulation

2017 ◽  
Vol 9 (2) ◽  
pp. 231-236 ◽  
Author(s):  
John W. Liang ◽  
Vicki L. Shanker
Keyword(s):  
Medical Decision ◽  
Financial Loss ◽  
Income Loss ◽  
Face To Face ◽  
Number Of Patients ◽  
Specific Feedback ◽  
Didactic Lecture ◽  
E Mail

ABSTRACT Background Approaches for teaching neurology documentation include didactic lectures, workshops, and face-to-face meetings. Few studies have assessed their effectiveness. Objective To improve the quality of neurology resident documentation through payroll simulation. Methods A documentation checklist was created based on Medicaid and Medicare evaluation and management (E/M) guidelines. In the preintervention phase, neurology follow-up clinic charts were reviewed over a 16-week period by evaluators blinded to the notes' authors. Current E/M level, ideal E/M level, and financial loss were calculated by the evaluators. Ideal E/M level was defined as the highest billable level based on the documented problems, alongside a supporting history and examination. We implemented an educational intervention that consisted of a 1-hour didactic lecture, followed by e-mail feedback “paystubs” every 2 weeks detailing the number of patients seen, income generated, income loss, and areas for improvement. Follow-up charts were assessed in a similar fashion over a 16-week postintervention period. Results Ten of 11 residents (91%) participated. Of 214 charts that were reviewed preintervention, 114 (53%) had insufficient documentation to support the ideal E/M level, leading to a financial loss of 24% ($5,800). Inadequate documentation was seen in all 3 components: history (47%), examination (27%), and medical decision making (37%). Underdocumentation did not differ across residency years. Postintervention, underdocumentation was reduced to 14% of 273 visits (P < .001), with a reduction in the financial loss to 6% ($1,880). Conclusions Improved documentation and increased potential reimbursement was attained following a didactic lecture and a 16-week period in which individual, specific feedback to neurology residents was provided.

The Nature stroke study; NASTRU - A randomised controlled trial of nature-based post-stroke fatigue rehabilitation

2019 ◽  
Author(s):  
Anna María Pálsdóttir ◽  
Kjerstin Stigmar ◽  
Bo Norrving ◽  
Patrik Grahn ◽  
Ingemar F Petersson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomised Controlled Trial ◽  
Standard Care ◽  
Controlled Trial ◽  
Perceived Value ◽  
Control Group ◽  
Post Stroke ◽  
Randomised Controlled

Abstract Fatigue is common after stroke and contributes to disability and impaired quality of life. Currently, there is insufficient evidence on the efficacy of any intervention for post-stroke fatigue. The aim of the study was to examine whether 10 weeks Nature-based rehabilitation (NRB) as add-on to standard care may improve post-stroke fatigue, perceived value of everyday occupations, function, activity and participation compared to standard care only (Clinical Trial.gov Identifier: NCT02435043, 2012/352, 05-06-2015). The study was carried out as a single blinded two-armed randomised controlled trial. Stroke survivors identified through routine 3-month follow-up visit (sub-acute) or medical records (chronic stroke > 1 year earlier) were randomised to Standard care + NBR or Standard care only. Blinded evaluations were conducted at follow-up 8 and 14 months after randomisation. The primary outcomes were post-stroke fatigue (Mental Fatigue Scale, total score) and perceived value of everyday occupations (Oval-pd) 8 months after randomisation. About a quarter of the screened patients were eligible; half accepted to participate and 101 were randomised, mean age 67 years, 60% female. The patients with sub-acute stroke were highly compliant with the intervention. Fatigue decreased to a value below the suggested cut-off for mental fatigue (<10.5) in the intervention group but not in the control group; no statistically significant differences were found though between the groups. Conclusion: NASTRU is the first randomised study on NBR for patients with post stroke fatigue. NBR was feasible and well tolerated. The study was underpowered due to difficulties in recruiting participants. No significant differences were detected between intervention and control group. A larger RCT is warranted. Keywords: clinical trial, enriched environment, everyday occupations, horticulture therapy, quality of life.

Superintendent Perceptions of Quantity and Quality of Principal Candidates

2003 ◽  
Vol 13 (2) ◽  
pp. 159-180 ◽  
Author(s):  
Kathryn S. Whitaker
Keyword(s):  
Professional Preparation ◽  
Depth Information ◽  
Induction Programs ◽  
Preparation Programs ◽  
Principal Candidates ◽  
Level Of Satisfaction ◽  
Superintendent Perceptions ◽  
Principal Roles

This article presents data from a study of superintendents on their perceptions of the quality and quantity of principal candidates in one state. Through a survey, superintendents were asked to provide information about the quantity and quality of candidates for the principalship, level of satisfaction with mentoring/induction programs, and level of satisfaction with professional preparation programs. The respondents were also asked to provide responses to the factors discouraging applicants for the principalship, and suggestions to increase the pool of candidates for the principalship. Follow-up interviews were conducted with 10 superintendents in the state for more in-depth information about the quantity and quality of candidates for the principalship. Recommendations are offered about methods to increase candidate pools and retain quality individuals in principal roles.

scholarly journals An Effectiveness Study of a Digital Mindfulness-Based Program for Upper Secondary Education Students

Mindfulness ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 2494-2505
Author(s):  
Oskari Lahtinen ◽  
Christina Salmivalli
Keyword(s):  
Controlled Trial ◽  
Attrition Rate ◽  
Education Students ◽  
Online Questionnaire ◽  
Face To Face ◽  
Upper Secondary Education ◽  
Randomized Controlled ◽  
Upper Secondary

Abstract Objectives Mindfulness-based programs/interventions (MBPs) are emerging as treatments for anxiety and stress for adults and adolescents. MBPs can also be helpful as universal interventions for healthy subjects. Few studies have looked at how beneficial MBP effects transfer to digital MBPs. Methods The study was a randomized controlled trial with 1349 participants aged mostly 16–19. We compared a digital MBP vs. a waitlist condition. Online questionnaire data were collected pre-program, post-program, and at 3-month follow-up. Results Completing the MBP resulted in a small-to-moderate reduction in anxiety (F1,681 = 13.71, p < .01, d = .26), a small reduction in depression (F1,686 = 8.54, p < .01, d = .15), and a small increase in psychological quality of life (F1,708 = 3.94, p = .05, d = .16). Attrition rate for the MBP was 41.5%. Conclusions The results suggest that digital MBPs can be successful in delivering at least some of the benefits characteristic of face-to-face MBPs.

scholarly journals Post-adoption Contact and Relationships with Birth Family Members

2021 ◽  
pp. 151-197
Author(s):  
Harriet Ward ◽  
Lynne Moggach ◽  
Susan Tregeagle ◽  
Helen Trivedi
Keyword(s):  
Online Survey ◽  
Family Members ◽  
Adoptive Parents ◽  
Adult Adoptees ◽  
Adoptive Families ◽  
Birth Parents ◽  
Face To Face ◽  
Birth Family ◽  
Children's Identity

AbstractThe chapter draws on data collected through responses to an online survey concerning 93 adoptees (44% of the cohort), completed on average 18 years after placement, and interviews focusing on 24 adult adoptees. Face-to-face post-adoption contact was a legal requirement. After placement with adoptive families, 93% of adoptees had contact with birth family members; at follow-up, 56% still saw at least one member of their birth family; 69% of both adoptees and adoptive parents thought contact was ultimately beneficial. There was minimal evidence of contact with birth parents destabilising placements. However, it introduced a ‘painful transparency’ for all parties and could be problematic. Over time, contact supported children’s identity needs by incorporating knowledge of their antecedents and could mitigate their difficulties with attachment, separation and loss. It forced all parties to engage with one another and helped adoptees achieve closure.

scholarly journals VA Video Telehealth and Training Programs During the COVID-19 Response

2021 ◽  
Author(s):  
Rhonda Johnston ◽  
Rita F. Kobb ◽  
Claire Marty ◽  
Padraic McVeigh
Keyword(s):  
Online Survey ◽  
Surgical Care ◽  
Office Visits ◽  
Face To Face ◽  
Patient Interaction ◽  
Telemedicine Consultation ◽  
Physician Patient ◽  
And Training

Study Design: An online survey modeled after the TeleENT Satisfaction Questionnaire and the Medical Communication Competence Scale (MCCS) were administered to gauge patient experience with electronic medical record-based telemedicine visits. Results: Participants noted several advantages of telemedicine visits over traditional in-office visits: shorter visits, saving money, and avoiding potential exposure during the pandemic. Thirty-six percent of the patients agreed that the quality of care was hindered by the lack of a physical exam, and 61.7% of the patients agreed that they prefer a face-to-face visit rather than telemedicine consultation. Most patients were satisfied with the care they received via telemedicine (Likert 6.19/7), and 95.8% of the patients would use telemedicine again. Participants self-reported an average saving of $108.70 when using telemedicine. When comparing the telemedicine cohort to the in-office control, the telemedicine patients noted an improved ability to communicate with their physician in 5 out of 8 domains of the MCCS. Conclusion: Surgical preoperative consultation, postoperative follow-up, and routine visits were conducted via telemedicine during the COVID-19 pandemic, representing a new direction for surgical appointments and consultations. This study shows that telehealth provides satisfactory care and increases access to surgical care for patients when external factors prevent the traditional physician–patient interaction. With better-perceived communication via telemedicine appointments, patients may subjectively feel that they can express their symptoms and gather information from the doctor regarding their diagnosis more efficiently.

Neuropsychological Outcome and its Predictors Across the First Year after Ischaemic Stroke

2016 ◽  
Vol 17 (2) ◽  
pp. 111-122 ◽  
Author(s):  
Suzanne Barker-Collo ◽  
Rita Krishnamurthi ◽  
Valery Feigin ◽  
Amy Jones ◽  
Alice Theadom ◽  
...  
Keyword(s):  
Ischaemic Stroke ◽  
Verbal Memory ◽  
Vital Signs ◽  
Population Based ◽  
Neurological Deficits ◽  
First Year ◽  
Psychomotor Speed ◽  
Post Stroke

Background: Neuropsychological deficits occur in over half of the stroke survivors and are associated with the reduced functioning and a decline in quality of life. However, the trajectory of recovery and predictors of neuropsychological outcomes over the first year post stroke are poorly understood.Method: Neuropsychological performance, assessed using the CNS-Vital signs, was examined at 1 month, 6 months and 12 months after ischaemic stroke (IS) in a sample drawn from a population-based study (N = 198).Results: While mean scores across neuropsychological domains at each time-point fell in the average range, one in five individuals produced very low-range scores for verbal memory, attention and psychomotor speed. Significant improvements were seen for executive functioning, psychomotor speed and cognitive flexibility within 6 months post stroke, but no gains were noted from 6 to 12 months. Stroke-related neurological deficits and depression at baseline significantly contributed to the prediction of neuropsychological function at 12 month follow-up.Conclusions: In a significant minority of IS survivors, focal deficits are evident in psychomotor speed, verbal memory, executive functions and attention. Significant improvements in these domains were only evident in the first 6 months post stroke. Initial stroke-related neurological deficits and concurrent depression may be the best predictors of later cognitive functioning.

scholarly journals Return to work after stroke – Feasibility of 6-year follow-up

2018 ◽  
Vol 82 (1) ◽  
pp. 27-37 ◽  
Author(s):  
Julie Phillips ◽  
Kathryn Gaffney ◽  
Margaret Phillips ◽  
Kate Radford
Keyword(s):  
Quality Of Life ◽  
Functional Ability ◽  
Feasibility Trial ◽  
Stroke Survivors ◽  
Full Time ◽  
Voluntary Work ◽  
Post Stroke

Introduction Little is known about long-term work sustainability of stroke survivors. A feasibility trial of early stroke specialist vocational rehabilitation had 32/46 (69.5%) participants available for follow-up at 12 months post stroke. Of these, 19/32 (59.4%) were in work. This study aims to determine the feasibility of longer-term follow-up and explore work status 6 years post stroke. Method Forty-eight participants fitting criteria for the feasibility trial were sent postal questionnaires measuring employment, income, mood, functional ability and quality of life, and were invited for interview to explore working 6 years after stroke. Ethical approval was obtained. Results Of the 48 participants, five (10.4%) had died; 19/43 (44.2%) responded. Fourteen were men; mean age 62 (24–78) years. Fourteen (74%) reported working (paid work n = 10, voluntary work n = 3, full-time education n = 1). Five had retired. Most (11/13) remained with preinjury employers. Half (8/15, 53%) reported decreased income since stroke. Compared to one year, median functional ability was marginally higher (extended activities of daily living 63 (IQR 8, range 32–66) to 60 (IQR 9, range 17–66)), but health-related quality of life was lower (EuroQuol Visual Analogue Scale mean 77.4 [SD 11] to 70.7 [SD14]). Six interviewees felt returning to work was the correct decision but struggled with invisible impairments. Conclusion This study suggests that long-term follow-up is feasible and that those who made a good recovery were more likely to respond. Work remains important to stroke survivors 6 years post stroke.

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