Demographic Characteristics and Functional Levels of Patients With Fragility Fractures Who Accept Tele-rehabilitation as an Alternative to Face-to-face Home Rehabilitation

2021 ◽  
pp. 108482232098331
Author(s):  
Claire Morris ◽  
Maayken Van den Berg ◽  
Chris Barr ◽  
Stacey George ◽  
Maria Crotty
Keyword(s):  
Mode Of Delivery ◽  
Fragility Fractures ◽  
Demographic Characteristics ◽  
Rehabilitation Service ◽  
Cognitive Changes ◽  
Face To Face ◽  
Patient Reported ◽  
Cognitive Problems ◽  
Recent Falls ◽  
Functional Gains

There is a gap in the evidence on telerehabilitation (TR) for people with fragility fractures. It is unclear whether this group with recent falls who are often frail with cognitive changes will accept tele-rehabilitation and functional gains can be achieved using this approach. Prospective observational study of consecutive patients admitted with femoral or pelvic fracture to a hospital-based home rehabilitation service (HRS) between January and November 2017. Using tablets, multidisciplinary rehabilitation was provided via videoconferencing and use of exercise apps. Patients chose a face-to-face visit or TR. Information on demographic characteristics, functional levels, the total number of therapy sessions, TR episodes, reasons for non-acceptance of TR, and patient-reported experience using TR was collected. Fifty-two patients with hip and pelvic fractures were admitted to the HRS and 35 (67.3%) received TR. Patients who did not accept TR were older, frailer and more likely to be female than those who received TR. Of the 17 who did not receive TR, 6 were deemed unsuitable by staff due to hearing, vision or cognitive problems and 3 refused. The TR group achieved acceptable functional gains. In the TR group on average, participants had 13.63 (± 7.29) home visits however they only elected to have 3.43 (± 2.48) sessions delivered via TR. TR was acceptable to a subset of hip fracture patients but face-to-face was the preferred mode of delivery. More research is needed to understand patients’ preferences and beliefs, and the influence of clinician attitudes on uptake of TR.

scholarly journals Patient-Reported Cognitive Outcomes Following Cardiac Surgery: A Descriptive Review

2021 ◽  
Vol 8 ◽  
pp. 237437352198925
Author(s):  
Amanda Robinson ◽  
Edith Pituskin ◽  
Colleen M Norris
Keyword(s):  
Cardiac Surgery ◽  
Cognitive Function ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Cognitive Outcomes ◽  
Patient Centered ◽  
Cognitive Changes ◽  
Practice Nurses ◽  
Patient Reported ◽  
Related Quality

A descriptive review was conducted to evaluate the evidence of cognitive patient-reported outcome measures (PROMs) following cardiac surgery. The search of electronic databases resulted in 400 unique manuscripts. Nine studies met the criteria to be part of the final review. Results of the review suggest that there are few validated PROMs that assess cognitive function in the cardiac surgical population. Furthermore, PROMs have not been used to assess overall cognitive function following cardiac surgery within the past decade. However, one domain of cognitive function—memory—was described, with up to half of patients reporting a decline postoperatively. Perceived changes in cognitive function may impact health-related quality of life and a patient’s overall view of the success of their surgery. Early identification of cognitive changes measured with PROMs may encourage earlier intervention and improve patient-centered care. In clinical practice, nurses may be in the best position to administer PROMs preoperatively and postoperatively.

scholarly journals Effect of "Motivational Interviewing" and "Information, Motivation and Behavioral Skills” on Choosing Mode of Delivery in Pregnant Women: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Mahboubeh Shirzad ◽  
Elham Shakibazadeh ◽  
Abbas Rahimi Foroushani ◽  
Mehrandokht Abedini ◽  
Hamid Poursharifi
Keyword(s):  
Cesarean Section ◽  
Motivational Interviewing ◽  
Pregnant Women ◽  
Self Efficacy ◽  
Mobile Application ◽  
Controlled Trial ◽  
Mode Of Delivery ◽  
Brief Interventions ◽  
Behavioral Skills ◽  
Face To Face

Abstract Background: Cesarean section is an important surgical procedure to save mothers and/or babies’ lives. Current trends show that the rate of Cesarean section is increasing dramatically over the years. The aims of this study were to compare the effects of "motivational interviewing" and "information, motivation and behavioral skills” model on choosing mode of delivery among pregnant women.Methods: In a four-armed, parallel-design randomized controlled trial, 120 women were randomly assigned to three brief interventions and one control groups. We recruited pregnant women referring to Ebnesina hospital, Tehran- Iran from 2019-2020. The intervention groups included: 1) motivational interviewing; 2) face-to-face information, motivation and behavioural skills model; and 3) information, motivation and behavioural skills model provided using a mobile application. The inclusion criteria were being literate, gestational age 24 to 32 weeks, being able to speak Persian, having no complications in the current pregnancy, having no indications for CS, and having enough time to participate in the study. The most important outcomes of the study included women’s intentions to undergo any mode of delivery, women’s self-efficacy in choosing the mode of delivery, and mode of delivery. Data were analyzed using descriptive statistics (mean, frequency and standard deviation), inferential statistics including independent t-test, paired t-test, Chi-squared and One-way ANOVA tests and logistic regression.Results: Following the interventions, significant differences were found in the mode of delivery (P < 0.05) and women’s self-efficacy and intention (P < 0.05). Women who had used the mobile application had more improvements in the self-efficacy and intention than the face-to-face intervention groups.Conclusions: Our study showed positive significant effects of various types of brief interventions to reduce unnecessary Cesarean section rate among the participant women. Providing the intervention using mobile application showed even better results. Our findings may contribute to a rise in normal vaginal delivery; and these simple, non-expensive, tailored to women, and culture-oriented brief interventions can be considered as appropriate strategies to reduce Cesarean section rate in local, national, and/or regional levels.Trial registration: This study has been registered in Iran Randomized Clinical Trial Center (IRCT20151208025431N7). Registered October 07, 2018.

scholarly journals Sosyal Yardımlaşma ve Dayanışma Vakıflarından Sosyal Yardım Alan Kadınların Bazı Sosyo-Demografik Özellikleri ile Yoksullukla Bağlantılı Deneyim ve Görüşleri

2021 ◽  
Vol 7 (13) ◽  
pp. 259-282
Author(s):  
Melike YALÇIN
Keyword(s):  
Research Method ◽  
Quantitative Research ◽  
Social Assistance ◽  
Demographic Characteristics ◽  
Adult Women ◽  
Young Adult Women ◽  
Level Of Education ◽  
Face To Face ◽  
The Poor ◽  
Poor Women

With this research, it is aimed to reveal some socio-demographic characteristics, experiences and opinions related to poverty, and power situations of coping with poverty of poor women who receive social assistance from social assistance and solidarity foundations. The quantitative research method was used in the study, and the data were obtained by making face-to-face interviews with women who received social assistance from Ankara province Altındağ, Mamak and Keçiören Social Assistance and Solidarity Foundations and accepted to participate in the study. The poor women participating in the research are young adult women with a low level of education, married, have at least one child, are unemployed and earn their living on social assistance. They define poverty as not being able to meet their needs and state the reason for poverty as unemployment. Participants see social assistance as a strategy to cope with poverty and think that the aid given is not enough to provide for their livelihood. They think that women are affected more by poverty than men, and they define their strengths mostly as being a good mother and wife.

scholarly journals Digital patient-reported outcome measures (PROMs) for remote monitoring of patients on cancer treatment: a cross-sectional questionnaire feasibility study (Preprint)

2020 ◽  
Author(s):  
Mayuran Ananth Sivanandan ◽  
Catherine Sharma ◽  
Pippa Bullard ◽  
Judith Christian
Keyword(s):  
Cancer Treatment ◽  
Outcome Measures ◽  
Remote Monitoring ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Severe Toxicity ◽  
Cross Sectional ◽  
Treatment Pathways ◽  
Face To Face ◽  
Patient Reported

BACKGROUND Oncology has increasing outpatient activity related to increased cancer incidence, better survival rates and more treatments. Innovative technological solutions could help deal with this increasing demand and digital patient-reported outcome measures (PROMs) to identify those patients that need a face-to-face (FTF) appointment is one potential approach. OBJECTIVE Our study aimed to assess the feasibility of digital PROM questionnaires to enable remote symptom monitoring for patients on cancer treatment and their ability to determine the requirement for a FTF appointment. METHODS This study was performed at a tertiary oncology centre between December 2018 and February 2019. Target clinics covered both systemic therapy and radiotherapy cohorts. The Common Terminology Criteria for Adverse Events (CTCAE) helped form the basis for acute toxicity questionnaires which were adapted into patient-friendly language. Treatment-specific digital PROM questionnaires were answered by patients and their clinicians alongside face-to-face appointments. Patients and clinicians did not see each other’s results, which were not used for clinical decisions. Agreement between patients and clinicians was assessed through descriptive statistics. Patient and staff feedback was also obtained. RESULTS 90 patients took part in the study across 10 different treatment pathways. By comparing paired patient and clinician responses, the sensitivity of the patient-completed questionnaires in correctly determining the need for FTF review was 93.6% and no patients with severe toxicity would have been missed with the questionnaires. Digital PROMs revealed 28.9% of participating patients did not need FTF review based on their symptoms. Certain oncological treatment pathways, such as immunotherapy, were found to have a larger proportion of patients with minimal symptoms compared to others, such as conventional chemotherapy. Patient and staff feedback showed high approval with digital PROMs and their potential for use in remote monitoring. CONCLUSIONS Digital PROM questionnaires can feasibly determine the need for FTF review in ‘on treatment’ oncology clinics. Their use with specific treatments could safely reduce the requirement for FTF care and future work should evaluate their application in the remote monitoring of patients.

scholarly journals Good, bad or indifferent: a longitudinal multi-methods study comparing four modes of training for healthcare professionals in one Australian state

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e021264 ◽  
Author(s):  
Priya Martin ◽  
Saravana Kumar ◽  
LuJuana Abernathy ◽  
Matthew Browne
Keyword(s):  
Healthcare Professionals ◽  
Longitudinal Design ◽  
Mode Of Delivery ◽  
Face To Face ◽  
Supervision Training ◽  
Australian State ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Training Delivery

ObjectivesThe aim of the study was to compare the differences in learning outcomes for supervision training of healthcare professionals across four modes namely face-to-face, videoconference, online and blended modes. Furthermore, changes sustained at 3 months were examined.Design/methodsA multimethods quasi-experimental longitudinal design was used. Data were collected at three points—before training, immediately after training and at 3 months post-training. Quantitative and qualitative data were collected through anonymous surveys and reflective summaries, respectively.ResultsParticipants reported an increase in supervision knowledge and confidence immediately after training that was sustained at 3 months with all four modalities of training. Using analysis of variance, we found these changes were sustained at 3 months postcompletion (confidence p<0.01 and knowledge p<0.01). However, there was no statistically significant difference in outcomes between the four modes of training delivery (confidence, p=0.22 or knowledge, p=0.39). Reflective summary data highlighted the differences in terminology used by participant to describe their experiences across the different modes, the key role of the facilitator in training delivery and the merits and risks associated with online training.ConclusionsWhen designed and delivered carefully, training can achieve comparable outcomes across all four modes of delivery. Regardless of the mode of delivery, the facilitator in training delivery is critical in ensuring positive outcomes.

The development of the rehabilitation community transition support team as a response to COVID-19

2021 ◽  
Vol 10 (4) ◽  
pp. 1-11
Author(s):  
Kelly Fenton ◽  
Katherine Kidd ◽  
Rachel Kingman ◽  
Sara Le-Butt ◽  
Michelle Gray
Keyword(s):  
Community Setting ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Service ◽  
Structured Interviews ◽  
Face To Face ◽  
Community Transition ◽  
Support Team ◽  
Staff Experiences ◽  
Community Team ◽  
Transition Support

Background/aims The rehabilitation community transition support team was created as a response to the COVID-19 pandemic, resulting in faster discharges from the inpatient rehabilitation service. The aim of this evaluation was to explore the perspectives of staff and patients on their experience of the rehabilitation community transition support team. Methods Staff and patients in the new team were interviewed using semi-structured interviews. The data were analysed using thematic analysis. Results Staff interviews generated seven main themes: positive staff experiences; defining the ‘team’; mode of working; link role for the team; technology; relationships with patients; and support from colleagues. The patient analysis generated five themes: positive experiences of the rehabilitation community transition support team; relationship with rehabilitation community transition support team worker; mode of working; handling the hurdles of discharge; and defining the ‘team’. There were crossovers of staff and patient themes, particularly surrounding around face-to-face visits, defining the team and relationships. Patients indicated that contact with the community team helped them to overcome both practical and emotional hurdles of discharge. Conclusions The presence of a team supporting the transition from hospital to a community setting may be helpful for people who have been discharged.

scholarly journals Cancer- and Cancer Treatment–Associated Cognitive Change: An Update on the State of the Science

2012 ◽  
Vol 30 (30) ◽  
pp. 3675-3686 ◽  
Author(s):  
Tim A. Ahles ◽  
James C. Root ◽  
Elizabeth L. Ryan
Keyword(s):  
Breast Cancer ◽  
Conceptual Framework ◽  
Animal Studies ◽  
Cognitive Change ◽  
Post Treatment ◽  
Cancer Treatments ◽  
Cognitive Changes ◽  
Patients With Cancer ◽  
State Of The Science ◽  
Cognitive Problems

Cognitive changes associated with cancer and cancer treatments have become an increasing concern. Using breast cancer as the prototype, we reviewed the research from neuropsychological, imaging, genetic, and animal studies that have examined pre- and post-treatment cognitive change. An impressive body of research supports the contention that a subgroup of patients is vulnerable to post-treatment cognitive problems. We also propose that models of aging may be a useful conceptual framework for guiding research in this area and suggest that a useful perspective may be viewing cognitive change in patients with cancer within the context of factors that influence the trajectory of normal aging.

scholarly journals Development of a conceptual model and patient-reported outcome measures for assessing symptoms and functioning in patients with heart failure

2020 ◽  
Vol 29 (10) ◽  
pp. 2835-2848
Author(s):  
Olga Moshkovich ◽  
Katy Benjamin ◽  
Katie Hall ◽  
Ryan Murphy ◽  
Robyn von Maltzahn ◽  
...  
Keyword(s):  
Heart Failure ◽  
Literature Review ◽  
Conceptual Model ◽  
Phase 1 ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Cognitive Testing ◽  
Expert Interviews ◽  
Cognitive Changes ◽  
Patient Reported

Abstract Purpose Heart failure (HF) is a common condition that places considerable burden on patients. We aimed to develop a patient-reported outcome (PRO) measure to assess the symptoms and impacts of HF. Methods Phase 1: a targeted literature review, expert interviews, and concept elicitation (CE) interviews with patients with HF (n = 26) were used to develop a conceptual model of the core symptoms and impacts of HF. To capture these concepts, three new fit-for-purpose PRO questionnaires were constructed in accordance with US Food and Drug Administration PRO guidance. Phase 2: three ‘waves’ of cognitive interviews were conducted with patients with HF (n = 28) to validate and refine the questionnaires. Results Three key symptoms—shortness of breath, oedema, and fatigue—were identified across the literature review, expert interviews and CE interviews. Several additional symptoms, cognitive changes and impacts of HF were reported in the CE interviews and included in the conceptual model. A 10-item symptom questionnaire (Heart Failure-Daily Symptom Diary) was constructed; cognitive testing showed that the final PRO measure was easy to understand/complete and relevant to patients with HF, confirming content validity. Two HF impact questionnaires were developed (Assessing Dyspnoea’s Impact on Mobility and Sleep and Heart Failure-Functional Status Assessment), but required refinement to ensure patient understanding. Conclusions Patient input contributed to the development of a PRO instrument for assessing physical and cognitive symptoms important to patients with HF using novel measurement strategies. Inclusion of daily metrics offers differentiation from other qualified instruments and may provide clinical insight for improving lifestyles. Additionally, two draft PRO measures may, after further validation, be useful to assess the impacts of HF.

scholarly journals What happens to patient experience when you want to see a doctor and you get to speak to a nurse? Observational study using data from the English General Practice Patient Survey

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018690 ◽  
Author(s):  
Charlotte A M Paddison ◽  
Gary A Abel ◽  
Jenni Burt ◽  
John L Campbell ◽  
Marc N Elliott ◽  
...  
Keyword(s):  
General Practice ◽  
Patient Experience ◽  
Secondary Analysis ◽  
Patient Survey ◽  
Models Of Care ◽  
Unintended Consequences ◽  
Multidisciplinary Teams ◽  
Face To Face ◽  
Patient Reported ◽  
Practice Patient

ObjectivesTo examine patient consultation preferences for seeing or speaking to a general practitioner (GP) or nurse; to estimate associations between patient-reported experiences and the type of consultation patients actually received (phone or face-to-face, GP or nurse).DesignSecondary analysis of data from the 2013 to 2014 General Practice Patient Survey.Setting and participants870 085 patients from 8005 English general practices.OutcomesPatient ratings of communication and ‘trust and confidence’ with the clinician they saw.Results77.7% of patients reported wanting to see or speak to a GP, while 14.5% reported asking to see or speak to a nurse the last time they tried to make an appointment (weighted percentages). Being unable to see or speak to the practitioner type of the patients’ choice was associated with lower ratings of trust and confidence and patient-rated communication. Smaller differences were found if patients wanted a face-to-face consultation and received a phone consultation instead. The greatest difference was for patients who asked to see a GP and instead spoke to a nurse for whom the adjusted mean difference in confidence and trust compared with those who wanted to see a nurse and did see a nurse was −15.8 points (95% CI −17.6 to −14.0) for confidence and trust in the practitioner and −10.5 points (95% CI −11.7 to −9.3) for net communication score, both on a 0–100 scale.ConclusionsPatients’ evaluation of their care is worse if they do not receive the type of consultation they expect, especially if they prefer a doctor but are unable to see one. New models of care should consider the potential unintended consequences for patient experience of the widespread introduction of multidisciplinary teams in general practice.

Effectiveness of Three Training Delivery Methods in a Voluntary Program

2009 ◽  
Vol 53 (26) ◽  
pp. 1959-1963 ◽  
Author(s):  
Arash Salehi ◽  
Lesley Strawderman ◽  
Yunchen Huang ◽  
Shaheen Ahmed ◽  
Kari Babski-Reeves
Keyword(s):  
Demographic Characteristics ◽  
Online Video ◽  
Delivery Method ◽  
Delivery Methods ◽  
Voluntary Programs ◽  
Volunteer Training ◽  
Face To Face ◽  
Advantages And Disadvantages ◽  
Voluntary Program ◽  
Training Delivery

Different training delivery methods each have their own advantages and disadvantages. Method effectiveness is based on the characteristics of the trainees and the program itself. Voluntary programs require extra consideration as there is no direct obligation for volunteers to participate and interact with the system. This paper studies and compares three methods (online, video, and face-to-face) for delivering training in a voluntary program. Demographic characteristics affected trainees' preference for training delivery method. Also, the training delivery method significantly impacts trainees' performance, participation in the program, and trainees' perceptions regarding re-training. These issues should be considered when a volunteer training program is designed.

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