An Investigation of the Usability Issues of Home-based Video Telemedicine Systems with Geriatric Patients

Telemedicine is the use of technology to provide and support healthcare when distance separates the clinical service and the patient. This system is rapidly replacing the conventional method of in-person clinical visits. More than seventy percent of the geriatric population is predicted to need long-term healthcare; telemedicine could potentially support their increased healthcare needs. However, for increased user acceptance, it is important to investigate the usability of telemedicine systems. This study aims to investigate the usability issues associated with geriatric patients using home-based video telemedicine systems. Four home-based video telemedicine systems were chosen for this study: (1) Doxy.me, (2) Polycom, (3) Vidyo and (4) VSee. Using a between-subjects experimental design, 20 participants were randomly assigned to one of these four conditions. They were asked to complete a demographic questionnaire, followed by the completion of representative tasks on the telemedicine platform. This is followed by a retrospective think-aloud session at the end of which, the participants completed a NASA-TLX workload survey, an IBM Computer System Usability Questionnaire (IBM-CSUQ), and a post-test subjective questionnaire. Issues faced by the participants include downloading application plug-ins, locating icons and the size of the icons.

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Home-Based Cardiac Rehabilitation During COVID-19: A Qualitative Study

10.21203/rs.3.rs-500145/v1 ◽

2021 ◽

Author(s):

Smitha Ganeshan ◽

Crystal Tse ◽

Alexis Beatty

Keyword(s):

Cardiac Rehabilitation ◽

Organizational Factors ◽

Structured Interviews ◽

Ongoing Research ◽

Staff Members ◽

Use Of Technology ◽

Home Based ◽

Mobile Phone Applications ◽

Delivery Models

Abstract Background: Cardiac rehabilitation (CR) has been shown to reduce mortality, morbidity, and hospitalizations. Increasingly, digital tools have augmented the ease of delivering programs outside of the traditional rehabilitation center setting. Because of the need for distancing during the COVID-19 pandemic, many cardiac rehabilitation (CR) centers suspended in-person services and pivoted to home-based CR (HBCR). In this study, we qualitatively evaluated implementation of HBCR, which included weekly phone or video visits for individualized exercise plans, nutrition and health education counseling, wellness sessions, and optional mobile phone applications.Methods: Patient participants and staff members (physician, nurses, exercise physiologists, dietician, administrative staff) participated in semi-structured interviews. Two independent reviewers coded interview transcripts for emergent themes and pre-specified themes from the Theory of Planned Behavior, Unified Theory of Acceptance and Use of Technology, and the Consolidated Framework for Implementation Research.Results: A total of 12 patients and 7 staff were interviewed. Narrative descriptions highlighted the isolation, fear, and disruption of life activities during COVID-19. Key facilitators of the HBCR patient experience included strong relationships with staff who served as coaches and sources of accountability and the ability of HBCR to deliver an individually tailored experience within a patient’s home. Important organizational factors for implementation included leadership buy-in, culture of change, and support for staff. Though technology tools facilitated communication and accountability, not all participants embraced technology and some reported challenges with use.Conclusions: Individually tailored HBCR can facilitate access for patients to participate outside of a CR center. Ongoing research is needed to understand the long-term outcomes of flexible delivery models that may include both in-person and remote visits, and the role of technology in these models.

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A Qualitative Study of Home-Based and Hybrid Cardiac Rehabilitation During COVID-19

10.21203/rs.3.rs-151295/v1 ◽

2021 ◽

Author(s):

Smitha Ganeshan ◽

Crystal Tse ◽

Alexis Beatty

Keyword(s):

Cardiac Rehabilitation ◽

Organizational Factors ◽

Structured Interviews ◽

Ongoing Research ◽

Staff Members ◽

Use Of Technology ◽

Home Based ◽

Mobile Phone Applications ◽

Delivery Models

Abstract Background: Because of the need for distancing during the COVID-19 pandemic, many cardiac rehabilitation (CR) centers suspended in-person services and pivoted to home-based CR (HBCR). In this study, we qualitatively evaluated implementation of HBCR, which included weekly phone or video visits for individualized exercise plans, nutrition and health education counseling, wellness sessions, and optional mobile phone applications.Methods: Patient participants and staff members (physician, nurses, exercise physiologists, dietician, administrative staff) participated in semi-structured interviews. Two independent reviewers coded interview transcripts for emergent themes and pre-specified themes from the Theory of Planned Behavior, Unified Theory of Acceptance and Use of Technology, and the Consolidated Framework for Implementation Research. Results: A total of 12 patients and 7 staff were interviewed. Narrative descriptions highlighted the isolation, fear, and disruption of life activities during COVID-19. Key facilitators of the HBCR patient experience included strong relationships with staff who served as coaches and sources of accountability and the ability of HBCR to deliver an individually tailored experience within a patient’s home. Important organizational factors for implementation included leadership buy-in, culture of change, and support for staff. Though technology tools facilitated communication and accountability, not all participants embraced technology and some reported challenges with use.Conclusions: Individually tailored HBCR or hybrid CR can facilitate access for patients to participate outside of a CR center. Ongoing research is needed to understand the long-term outcomes of flexible delivery models that may include both in-person and remote visits, and the role of technology in these models.

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Home-Based and Hybrid Cardiac Rehabilitation During COVID-19: A Qualitative Study (Preprint)

10.2196/preprints.28665 ◽

2021 ◽

Author(s):

Smitha Ganeshan ◽

Crystal Tse ◽

Alexis Beatty

Keyword(s):

Cardiac Rehabilitation ◽

Organizational Factors ◽

Structured Interviews ◽

Ongoing Research ◽

Staff Members ◽

Use Of Technology ◽

Home Based ◽

Mobile Phone Applications ◽

Delivery Models

BACKGROUND Cardiac rehabilitation (CR) has been shown to reduce mortality, morbidity, and hospitalizations. Increasingly, digital tools have augmented the ease of delivering programs outside of the traditional rehabilitation center setting. Because of the need for distancing during the COVID-19 pandemic, many cardiac rehabilitation (CR) centers suspended in-person services and pivoted to home-based CR (HBCR). OBJECTIVE In this study, we qualitatively evaluated implementation of HBCR, which included weekly phone or video visits for individualized exercise plans, nutrition and health education counseling, wellness sessions, and optional mobile phone applications. METHODS Patient participants and staff members (physician, nurses, exercise physiologists, dietician, administrative staff) participated in semi-structured interviews. Two independent reviewers coded interview transcripts for emergent themes and pre-specified themes from the Theory of Planned Behavior, Unified Theory of Acceptance and Use of Technology, and the Consolidated Framework for Implementation Research. RESULTS A total of 12 patients and 7 staff were interviewed. Narrative descriptions highlighted the isolation, fear, and disruption of life activities during COVID-19. Key facilitators of the HBCR patient experience included strong relationships with staff who served as coaches and sources of accountability and the ability of HBCR to deliver an individually tailored experience within a patient’s home. Important organizational factors for implementation included leadership buy-in, culture of change, and support for staff. Though technology tools facilitated communication and accountability, not all participants embraced technology and some reported challenges with use. CONCLUSIONS Individually tailored HBCR can facilitate access for patients to participate outside of a CR center. Ongoing research is needed to understand the long-term outcomes of flexible delivery models that may include both in-person and remote visits, and the role of technology in these models.

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The Impact of COVID-19 on Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.2738 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 742-742

Author(s):

Rachel Ungar ◽

Rifky Tkatch ◽

Jane Huang ◽

Sandra Kraemer ◽

James Schaeffer ◽

...

Keyword(s):

Older Adults ◽

Well Being ◽

National Sample ◽

Comfort Level ◽

Healthcare Needs ◽

Use Of Technology ◽

The Impact ◽

Communication Habits ◽

Lifestyle Patterns

Abstract Background The onset of the COVID-19 pandemic has dramatically influenced the health and well-being of older adults. Changes in lifestyle patterns has required reframing communication habits and learning new skills to maintain social connections and access healthcare. Objectives: To assess 1) well-being measured prior to and during the COVID-19 era; and 2) use and comfort level of technology for social interactions and telehealth visits during this time. Methods A mailed survey to a randomly selected national sample (>65) during the summers of 2018, 2019, and 2020. Measures included mental and physical well-being and various psychosocial measures. For 2020, questions related to COVID-19 and the use of technology were included. Results A total of 4,696 (2018), 3,976 (2019) and 2,726 (2020) responded to these surveys (response rate ~27%). Overall, most constructs remained stable despite the ongoing pandemic. Most respondents reported average or high resilience (90%), high purpose (48%), stable social networks (76%), and low stress (55%). However, loneliness increased during 2020 (57%). Respondents who used technology were more likely to connect with family and friends. Only 43% reported high comfort with using technology, with older age (>75) less comfortable. At the time of the survey 37% had not seen a healthcare provider through telehealth services, and 15% felt their healthcare needs were not met by a telehealth experience. Conclusion Results demonstrate that respondents were doing well during COVID-19. Yet increases in loneliness and greater technology needs to stay socially connected and to access healthcare may result in negative long-term health outcomes.

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Maximizing Outcomes in Group Treatment of Aphasia: Lessons Learned From a Community-Based Center

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld24.3.100 ◽

2014 ◽

Vol 24 (3) ◽

pp. 100-105 ◽

Cited By ~ 1

Author(s):

Darlene Williamson

Keyword(s):

Group Treatment ◽

Treatment Protocol ◽

Lessons Learned ◽

Group Program ◽

Community Based ◽

Multiple Treatment ◽

Use Of Technology ◽

Communication Impairments ◽

Treatment Settings

Given the potential of long term intervention to positively influence speech/language and psychosocial domains, a treatment protocol was developed at the Stroke Comeback Center which addresses communication impairments arising from chronic aphasia. This article presents the details of this program including the group purposes and principles, the use of technology in groups, and the applicability of a group program across multiple treatment settings.

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COVID-19 era in long-term cardiac rehabilitation programs: how was muscle strenght and lean mass affected in cardiovascular patients?

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.362 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

M Borges ◽

M Lemos Pires ◽

R Pinto ◽

G De Sa ◽

I Ricardo ◽

...

Keyword(s):

Muscle Strength ◽

Cardiac Rehabilitation ◽

Lean Mass ◽

Lower Limb ◽

Lower Limbs ◽

Phase Iii ◽

Face To Face ◽

Home Based ◽

Lower Limb Strength

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Exercise prescription is one of the main components of phase III Cardiac Rehabilitation (CR) programs due to its documented prognostic benefits. It has been well established that, when added to aerobic training, resistance training (RT) leads to greater improvements in peripheral muscle strength and muscle mass in patients with cardiovascular disease (CVD). With COVID-19, most centre-based CR programs had to be suspended and CR patients had to readjust their RT program to a home-based model where weight training was more difficult to perform. How COVID-19 Era impacted lean mass and muscle strength in trained CVD patients who were attending long-term CR programs has yet to be discussed. Purpose To assess upper and lower limb muscle strength and lean mass in CVD patients who had their centre-based CR program suspended due to COVID-19 and compare it with previous assessments. Methods 87 CVD patients (mean age 62.9 ± 9.1, 82.8% male), before COVID-19, were attending a phase III centre-based CR program 3x/week and were evaluated annually. After 7 months of suspension, 57.5% (n = 50) patients returned to the face-to-face CR program. Despite all constraints caused by COVID-19, body composition and muscle strength of 35 participants (mean age 64.7 ± 7.9, 88.6% male) were assessed. We compared this assessment with previous years and established three assessment time points: M1) one year before COVID-19 (2018); M2) last assessment before COVID-19 (2019); M3) the assessment 7 months after CR program suspension (last trimester of 2020). Upper limbs strength was measured using a JAMAR dynamometer, 30 second chair stand test (number of repetitions – reps) was used to measure lower limbs strength and dual energy x-ray absorptiometry was used to measure upper and lower limbs lean mass. Repeated measures ANOVA were used. Results Intention to treat analysis showed that upper and lower limbs lean mass did not change from M1 to M2 but decreased significantly from M2 to M3 (arms lean mass in M2: 5.68 ± 1.00kg vs M3: 5.52 ± 1.06kg, p = 0.004; legs lean mass in M2: 17.40 ± 2.46kg vs M3: 16.77 ± 2.61kg, p = 0.040). Lower limb strength also decreased significantly from M2 to M3 (M2: 23.31 ± 5.76 reps vs M3: 21.11 ± 5.31 reps, p = 0.014) after remaining stable in the year prior to COVID-19. Upper limb strength improved significantly from M1 to M2 (M1: 39.00 ± 8.64kg vs M2: 40.53 ± 8.77kg, p = 0.034) but did not change significantly from M2 to M3 (M2 vs M3: 41.29 ± 9.13kg, p = 0.517). Conclusion After CR centre-based suspension due to COVID-19, we observed a decrease in upper and lower limbs lean mass and lower limb strength in previously trained CVD patients. These results should emphasize the need to promote all efforts to maintain physical activity and RT through alternative effective home-based CR programs when face-to-face models are not available or possible to be implemented.

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