Feasibility, Satisfaction With, and Attitude Toward Telerehabilitation During COVID-19 Pandemic: Experience of Iranian Rehabilitation Professionals

Objectives: COVID-19 pandemic and its consequences highlighted the importance of using telerehabilitation systems and affected the professional’s attitude toward it. This study aimed to investigate the feasibility, satisfaction, and attitude of rehabilitation professionals toward telerehabilitation during the COVID-19 pandemic in Iran. Methods: A web-based cross-sectional study was conducted to assess the feasibility, satisfaction, and attitude of rehabilitation professionals toward virtual training and telerehabilitation during the COVID-19 pandemic. A total of 118 occupational therapists, speech therapists, audiologists, psychologists, and educators completed the study questionnaires. Results: The findings indicate that the correlations among satisfaction, feasibility, advantages, and compatibility were significant (r ranging from 0.418 to 0.717). There were significant but weak positive correlations between years of working experience and scores of feasibility and advantages. In addition, the mean scores of feasibility, advantages, compatibility, and complexity in participants who provided telerehabilitation before the COVID-19 pandemic were higher than other respondents. Discussion: Because of the positive role of telerehabilitation in a situation such as the COVID-19 pandemic, health care systems should create mechanisms for its optimal use, protocol preparation, health professionals training, and infrastructure acquisition.

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A Cross-sectional Study on Challenges Faced and Strategies Adopted in Responding to Corona Virus Disease (COVID-19) by Hospital Administrators in Kaski District

Journal of Biomedical Research & Environmental Sciences ◽

10.37871/jbres1221 ◽

2021 ◽

Vol 2 (4) ◽

pp. 256-260

Author(s):

KC Deepti ◽

S Poudel ◽

SB Hamal Thakuri ◽

S Shrestha

Keyword(s):

Virus Disease ◽

Health Care Systems ◽

Structured Interview ◽

Cross Sectional Study ◽

Public Hospitals ◽

Cross Sectional ◽

Hospital Administrators ◽

Corona Virus ◽

Care Systems ◽

Private And Public

Background: Following the outbreak of Coronavirus disease in 2019, the year 2020/21 has been an incredibly challenging one for all global health-care systems. Methods: A cross sectional descriptive research design was used to conduct the study. The study was carried out in all general private and public hospitals of Kaski district of Nepal. Data were collected from 25th October to 5th December, 2020 from the Hospital administrators using a semi structured interview schedule. Descriptive statistics were used for data analysis. Results: Most (96.3%) of the hospitals reported that increased cost or expenses of the hospitals creating financial threat is the most challenging situation that hospitals are facing in this pandemic. In addition shortages of ventilators creating ethical dilemma for patient allocation and changing guidelines from authorities have been reported as a challenge by 88.9 percent of the hospitals respectively. All of the surveyed hospitals had developed the use of thermometers for screening at the hospital entrances to minimize the risk. Conclusion: Hospitals in this pandemic are facing a lot of challenges with regard to staff management, PPE management and so on. Hence they need to adopt best strategies in responding to the corona virus.

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A NOVEL TOOL FOR THE EARLY IDENTIFICATION OF FRAILTY IN ELDERLY PEOPLE: THE APPLICATION IN PRIMARY CARE SETTINGS

Journal of Frailty & Aging ◽

10.14283/jfa.2019.41 ◽

2019 ◽

pp. 1-6

Author(s):

M. Maggio ◽

M. Barbolini ◽

Y. Longobucco ◽

L. Barbieri ◽

C. Benedetti ◽

...

Keyword(s):

Primary Care ◽

Construct Validity ◽

Predictive Value ◽

Community Health Centers ◽

Health Care Systems ◽

Cross Sectional Study ◽

Criterion Validity ◽

Cross Sectional ◽

Care Systems ◽

The One

Objectives: Frailty is a pre-disability condition in older persons providing a challenge to Health-Care Systems. Systematic reviews highlight the absence of a gold-standard for its identification. However, an approach based on initial screening by the General Practitioner (GP) seems particularly useful. On these premises, a 9-item Sunfrail Checklist (SC), was developed by a multidisciplinary group, in the context of European Sunfrail Project, and tested in the Community. Objectives: – to measure the concordance between the judgments of frailty (criterion-validity): the one formulated by the GP, using the SC, and the one subsequently expressed by a Comprehensive Geriatric Assessment Team (CGA-Team); – to determine the construct-validity through the correspondence between some checklist items related to the 3 domains (physical, cognitive and social) and the three tools used by the CGA-Team; – to measure the instrument’s performance in terms of positive predictive value (PPV) and negative predictive value (NPV). Design: Cross-sectional study, with a final sample-size of 95 subjects. Setting: Two Community-Health Centers of Parma, Italy. Participants: Subjects aged 75 years old or more, with no disability and living in the community. Measurements: We compared the screening capacity of the GP using the SC to that one of CGA-Team based on three tests: 4-meter Gait-Speed, Mini-Mental State Examination and Loneliness Scale. Results: 95 subjects (51 women), with a mean age of 81±4 years were enrolled. According to GPs 34 subjects were frail; the CGA-Team expressed a frailty judgment on 26 subjects. The criterion-validity presented a Cohen’s k of 0.353. Construct-validity was also low, with a maximum contingency-coefficient of 0.19. The analysis showed a PPV of 58.1% and a NPV equal to 84.6%. Conclusions: Our data showed a low agreement between the judgements of GP performed by SC and CGA-Team. However, the good NPV suggests the applicability of SC for screening activities in primary-care.

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PREVALENCE AND RISK FACTORS FOR OCCURRENCE OF CONGENITAL ANOMALIES IN NEONATES AT HOSPITAL FOR CHILD AND MATERNITY IN MISAN PROVINCE

Periódico Tchê Química ◽

10.52571/ptq.v17.n36.2020.1192_periodico36_pgs_1176_1185.pdf ◽

2020 ◽

Vol 17 (36) ◽

pp. 1176-1185

Author(s):

Esraa Abd Almuhsen ALI ◽

Hussein Fadhil ALJAWADI

Keyword(s):

Risk Factors ◽

Birth Defects ◽

Health Care Systems ◽

Action Plan ◽

Central Nervous System Involvement ◽

Cross Sectional Study ◽

Considerable Effect ◽

Cross Sectional ◽

Care Systems ◽

Congenital Disabilities

Congenital disabilities affect a remarkable proportion of neonates and have a significant role in hospital admission, morbidity, and pediatrics mortality. Besides, the long-term morbidity and disability caused by birth defects may have a considerable effect on the development of the child and family and health care systems. In Misan, congenital disabilities are considered a third common cause of neonatal mortality. This study aimed to estimate the prevalence, types, and risk factors of congenital disabilities to have an action plan toward preventing the occurrence of these defects. A cross-sectional study performed in the neonatal care unit in Misan Hospital for Child and Maternity during the period of two years (2018 and 2019). Misan province is located in the South East of Iraq. The information was collected from the files of patients and registration records. Any delivered a live neonate with birth defects was enrolled in this study. These cases were diagnosed depending on history, clinical examination supported by other investigations, and radiographic studies whenever needed. The prevalence rates of congenital disabilities were 7.1/1000 and 6.6/1000 live birth in 2018 and 2019, respectively. Central nervous system involvement was the most typical pattern. Congenital disabilities were more frequent in male, single, and term babies of maternal age 18-35 years living in an urban area with a consanguinity history. Thus, the prevalence rate of congenital disabilities was notably high in Misan. Efforts toward prevention, as well as improving the prenatal diagnosis, would be essential.

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Intra articular hyaluronic acid versus intra articular triamcinolone hexacetonide in primary osteoarthritis of knee: a comparative study

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20175074 ◽

2017 ◽

Vol 6 (12) ◽

pp. 2794

Author(s):

Sabeena Kizhedath ◽

Gopesh Valoth ◽

Bindhu Vasudevan

Keyword(s):

Hyaluronic Acid ◽

Chronic Disease ◽

Health Care Systems ◽

Disease Process ◽

Cross Sectional Study ◽

Cross Sectional ◽

Primary Osteoarthritis ◽

Care Systems ◽

Efficacy Assessment ◽

Joint Line Tenderness

Background: Osteoarthritis (OA) is a painful, chronic disease with widespread burden on patients, communities, social and health care systems. Intraarticular (IA) Hyaluronic acid (HA) and corticosteroids are established treatments for OA knee. However, concerns exist regarding effect, duration, safety, effectiveness across population and heterogeneity. Aim of the study is to compare the efficacy and safety of IA HA with THA in the treatment of primary osteoarthritis knee.Methods: A descriptive cross-sectional study was done among 30 patients. One group (n=15) received IA THA 20mg/2mL on day 0 and other group (n=15) received IA HA 20mg/2 mL on day 0, 7 and 14 under aseptic precautions. The efficacy assessment using VAS for overall pain, joint line tenderness and 15m walking time in seconds were recorded. Side effects if any were noted.Results: Comparing both treatments IA THA provided superior short-term pain relief. But HA showed sustained benefit up to six months.Conclusions: OA being a chronic disease process, we need a drug which has a long-lasting effect. Additive effect of HA and THA can be considered for better efficacy.

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Understanding the Factors that Affect the Appropriateness of Rheumatology Referrals

10.21203/rs.3.rs-360246/v1 ◽

2021 ◽

Author(s):

Eline Van Den Broek-Altenburg ◽

Adam Atherly ◽

Nick Cheney ◽

Teresa Fama

Keyword(s):

Health Care Systems ◽

Cross Sectional Study ◽

Cross Sectional ◽

Factors Affecting ◽

Innovative Strategies ◽

Inappropriate Care ◽

Care Systems ◽

Value Based Care ◽

Near Future ◽

Severe Shortage

Abstract Background: Reducing inappropriate referrals to specialists is a challenge for the healthcare system as it seeks to transition from volume to value-based healthcare. Given the projection of a severe shortage of rheumatologists in the near future, innovative strategies to decrease demand for rheumatology services may prove more fruitful than increasing the supply of rheumatologists. Efforts to increase appropriate utilization through reductions in capacity may have the unintended consequence of reducing appropriate care as well. This highlights the challenges in increasing the appropriate use of high cost services as the health system transitions to value based care. The objective of this study was to analyze factors affecting appropriateness of rheumatology services.Methods: This was a cross-sectional study of patients receiving Rheumatology services between November 2013 and October 2019. We used a proxy for “appropriateness”: whether or not there was any follow-up care after the first appointment. Results from regression analysis and physicians’ chart reviews were compared using an inter-rater reliability measure (kappa). Data was drawn from the EHR 2013-2019. Results: We found that inappropriate referrals increased 14.3% when a new rheumatologist was hired, which increased to 14.8% after wash-out period of 6 months; 15.7% after 12 months; 15.5% after 18 months and 16.7% after 18 months. Other factors influencing appropriateness of referrals included severity of disease, gender and insurance type, but not specialty of referring provider. Conclusions: Given the projection of a severe shortage of rheumatologists in the near future, innovative strategies to decrease demand for rheumatology services may prove more fruitful than increasing the supply of rheumatologists. Innovative strategies to decrease demand for rheumatology services may prove more fruitful than increasing the supply of rheumatologists. These findings may apply to other specialties as well. This study is relevant for health care systems that are implementing value-based payment models aimed at reducing inappropriate care.

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Partisan Differences in Twitter Language Among US Legislators During the COVID-19 Pandemic: Cross-sectional Study (Preprint)

10.2196/preprints.27300 ◽

2021 ◽

Author(s):

Sharath Chandra Guntuku ◽

Jonathan Purtle ◽

Zachary F Meisel ◽

Raina M Merchant ◽

Anish Agarwal

Keyword(s):

Public Health ◽

Health Care ◽

Vaccine Development ◽

Health Care Systems ◽

Cross Sectional Study ◽

Party Affiliation ◽

Cross Sectional ◽

Health Crisis ◽

Care Systems ◽

Town Halls

BACKGROUND As policy makers continue to shape the national and local responses to the COVID-19 pandemic, the information they choose to share and how they frame their content provide key insights into the public and health care systems. OBJECTIVE We examined the language used by the members of the US House and Senate during the first 10 months of the COVID-19 pandemic and measured content and sentiment based on the tweets that they shared. METHODS We used Quorum (Quorum Analytics Inc) to access more than 300,000 tweets posted by US legislators from January 1 to October 10, 2020. We used differential language analyses to compare the content and sentiment of tweets posted by legislators based on their party affiliation. RESULTS We found that health care–related themes in Democratic legislators’ tweets focused on racial disparities in care (odds ratio [OR] 2.24, 95% CI 2.22-2.27; P<.001), health care and insurance (OR 1.74, 95% CI 1.7-1.77; P<.001), COVID-19 testing (OR 1.15, 95% CI 1.12-1.19; P<.001), and public health guidelines (OR 1.25, 95% CI 1.22-1.29; P<.001). The dominant themes in the Republican legislators’ discourse included vaccine development (OR 1.51, 95% CI 1.47-1.55; P<.001) and hospital resources and equipment (OR 1.22, 95% CI 1.18-1.25). Nonhealth care–related topics associated with a Democratic affiliation included protections for essential workers (OR 1.55, 95% CI 1.52-1.59), the 2020 election and voting (OR 1.31, 95% CI 1.27-1.35), unemployment and housing (OR 1.27, 95% CI 1.24-1.31), crime and racism (OR 1.22, 95% CI 1.18-1.26), public town halls (OR 1.2, 95% CI 1.16-1.23), the Trump Administration (OR 1.22, 95% CI 1.19-1.26), immigration (OR 1.16, 95% CI 1.12-1.19), and the loss of life (OR 1.38, 95% CI 1.35-1.42). The themes associated with the Republican affiliation included China (OR 1.89, 95% CI 1.85-1.92), small business assistance (OR 1.27, 95% CI 1.23-1.3), congressional relief bills (OR 1.23, 95% CI 1.2-1.27), press briefings (OR 1.22, 95% CI 1.19-1.26), and economic recovery (OR 1.2, 95% CI 1.16-1.23). CONCLUSIONS Divergent language use on social media corresponds to the partisan divide in the first several months of the course of the COVID-19 public health crisis.

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Understanding the factors that affect the appropriateness of rheumatology referrals

BMC Health Services Research ◽

10.1186/s12913-021-07036-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Eline van den Broek-Altenburg ◽

Adam Atherly ◽

Nick Cheney ◽

Teresa Fama

Keyword(s):

Health Care Systems ◽

Cross Sectional Study ◽

Cross Sectional ◽

Factors Affecting ◽

Innovative Strategies ◽

Inappropriate Care ◽

Care Systems ◽

Value Based Care ◽

Near Future ◽

Severe Shortage

Abstract Background Reducing inappropriate referrals to specialists is a challenge for the healthcare system as it seeks to transition from volume to value-based healthcare. Given the projection of a severe shortage of rheumatologists in the near future, innovative strategies to decrease demand for rheumatology services may prove more fruitful than increasing the supply of rheumatologists. Efforts to increase appropriate utilization through reductions in capacity may have the unintended consequence of reducing appropriate care as well. This highlights the challenges in increasing the appropriate use of high cost services as the health system transitions to value based care. The objective of this study was to analyze factors affecting appropriateness of rheumatology services. Methods This was a cross-sectional study of patients receiving Rheumatology services between November 2013 and October 2019. We used a proxy for “appropriateness”: whether or not there was any follow-up care after the first appointment. Results from regression analysis and physicians’ chart reviews were compared using an inter-rater reliability measure (kappa). Data was drawn from the EHR 2013–2019. Results We found that inappropriate referrals increased 14.3% when a new rheumatologist was hired, which increased to 14.8% after wash-out period of 6 months; 15.7% after 12 months; 15.5% after 18 months and 16.7% after 18 months. Other factors influencing appropriateness of referrals included severity of disease, gender and insurance type, but not specialty of referring provider. Conclusions Given the projection of a severe shortage of rheumatologists in the near future, innovative strategies to decrease demand for rheumatology services may prove more fruitful than increasing the supply of rheumatologists. Innovative strategies to decrease demand for rheumatology services may prove more fruitful than increasing the supply of rheumatologists. These findings may apply to other specialties as well. This study is relevant for health care systems that are implementing value-based payment models aimed at reducing inappropriate care.

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A population-based study of the prevalence of COVID-19 infection in Espírito Santo, Brazil: methodology and results of the first stage

10.1101/2020.06.13.20130559 ◽

2020 ◽

Cited By ~ 2

Author(s):

Cristiana Costa Gomes ◽

Crispim Cerutti ◽

Eliana Zandonade ◽

Ethel Leonor Noia Maciel ◽

Filomena Euridice Carvalho de Alencar ◽

...

Keyword(s):

Health Care Systems ◽

Large Population ◽

Population Based ◽

Cross Sectional Study ◽

Antibody Detection ◽

Infection Prevalence ◽

Cross Sectional ◽

Population Based Study ◽

Care Systems ◽

Rapid Tests

AbstractBACKGROUNDCOVID-19 is affecting almost the entire world, causing more than four hundred thousand deaths and undermining the health care systems, as much as the economy, of the afflicted countries. The strategies for prevention depend on largely lacking information, as infection prevalence and virus pathogenicity. This study aimed to determine the prevalence, the pathogenicity, and the speed of infection spreading in a large population in Brazil.MATERIALS AND METHODSThis is a serial cross-sectional study designed on a population basis and structured over houses as the sampling units. The sampling consisted of four visits at 15 days intervals in randomly selected census-designated sectors of the State major municipalities (reference municipalities) and two visits at 30 days intervals in smaller municipalities of the same regions of those of reference. At each visit, the investigators sampled houses and sampled one individual in each house for data collection. After the informed consent, the investigators performed a rapid antibody detection test (Celer Technology, Inc) and applied a questionnaire containing clinical and demographic questions.RESULTSFrom May 13th to 15th, the investigators performed 6,393 rapid tests in 4,612 individuals of the reference municipalities, 1,163 individuals of the smaller municipalities, and 166 contacts of the positive individuals. Ninety-seven dwellers were positive in the reference municipalities, giving a prevalence of 2.1% (CI 95%: 1.67-2.52%). In the smaller municipalities, the figure was 0.26% (CI 95%: 0.05%-0.75%) (three positives). There was an association of the positive result with female sex (p = 0.013) and houses with five dwellers or more (p = 0.003). Seventy-eight positive individuals reported symptoms in the previous 15 days (80.4%), being anosmia (45.4%), cough (40.2%), and myalgia (38.1%) the more frequent. About one-third of them reported fever (28.9%).CONCLUSIONSThe results reveal a still small prevalence of infection in the study area, despite the significant number of sick people overloading the health system. The figures indicate an important underreporting in the area and a frequency that still can grow, making necessary public health actions for the containment of the transmission.

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Evaluation of communication between physicians and patients in Astana City Hospital №1

Central Asian Journal of Global Health ◽

10.5195/cajgh.2013.82 ◽

2014 ◽

Vol 2 ◽

Cited By ~ 1

Author(s):

Anara Zhumadilova ◽

Brett J. Craig ◽

Alexey Tsoy ◽

Alla Gabdrakhmanova ◽

Martin Bobak

Keyword(s):

Job Satisfaction ◽

Health Care ◽

Health Care Providers ◽

Healthcare Professionals ◽

Health Care Systems ◽

Cross Sectional Study ◽

City Hospital ◽

Care Providers ◽

Cross Sectional ◽

Care Systems

Introduction: Communication between patients and health care providers is important for the effective functioning of health care systems. Miscommunication often stems from discrepancies in expectations of both healthcare professionals and patients due to cultural and historical influences. We investigated the degree to which health care providers (doctors and nurses) and patients in Kazakhstan believe that interaction between doctors and patients should be doctor- or patient-oriented.Material and methods: We conducted a cross-sectional study of 163 patients and 176 health care providers (71 doctors and 105 nurses) in a general hospital in Astana, Kazakhstan. The subjects completed a structured questionnaire containing the Patient-Practitioner Orientation Scale (PPOS), and scales assessing life and job satisfaction, effort-reward balance of healthcare professionals, and the patients’ perceptions of communication practices.Results: An overwhelming majority of doctors (81.7%), nurses (88.1%), and patients (92.3%) were doctor-oriented. Among health care providers, PPOS was not associated with age, sex, life and job satisfaction, or effort-reward imbalance. Among patients, PPOS was not associated with age, sex, or specialty of health care provider. However, higher PPOS among patients (indicating preference for patient-oriented interaction) was associated with higher satisfaction with communication with health care providers and, less strongly, with their life satisfaction.Conclusion: The main finding of this study is the very small proportion of doctors, nurses and patients who believe that interaction should be patient-oriented. These results highlight the necessity of improvement of communication among health care providers towards patient-oriented approach in order to decrease miscommunication with patients. The fact that most patients prefer doctor-oriented interaction may reflect historical stereotypes; educational/information interventions among patients may also be needed.

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Control and Support Models of Help-Seeking Behavior in Women Experiencing Domestic Violence in India

Violence and Victims ◽

10.1891/0886-6708.vv-d-12-00045 ◽

2014 ◽

Vol 29 (3) ◽

pp. 464-475 ◽

Cited By ~ 10

Author(s):

Meerambika Mahapatro ◽

R.N. Gupta ◽

Vinay K. Gupta

Keyword(s):

Domestic Violence ◽

Partner Violence ◽

Help Seeking ◽

Health Care Systems ◽

Sampling Strategy ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Indian States ◽

Care Systems

In India, there is limited prioritization of domestic violence, which is seen as a private and family matter, and handled as a social responsibility rather than a complaint or crime. Despite the Domestic Violence Act, implemented in 2006, the widespread phenomenon of domestic violence across Indian states goes unreported. Using control and support models, this article aims to examine women’s behavior in seeking help while dealing with partner violence. It is a population-based analytical cross-sectional study covering 14,507 married women from 18 states of India, selected through a systematic multistage sampling strategy. Both quantitative and qualitative methods were used to generate data.It was observed that legal complexities combined with social realities make the life of an average Indian woman insecure and miserable. Most women surveyed preferred the social-support model and opined that if they face domestic violence, they would seek help from their parents as the first option in the order of preference. The responses of women while dealing with domestic violence are often spontaneous and determined by the pressing need to resolve matters within the home/community, rather than addressing them in the public domain of state institutions where procedures are cumbersome and lengthy. A new integrated development model proposed by several communities aims to prevent domestic violence through the intervention of health care systems.

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