Conducting a Qualitative Document Analysis

Document analysis has been an underused approach to qualitative research. This approach can be valuable for various reasons. When used to analyze pre-existing texts, this method allows researchers to conduct studies they might otherwise not be able to complete. Some researchers may not have the resources or time needed to do field research. Although videoconferencing technology and other types of software can be used to reduce some of the obstacles qualitative researchers sometimes encounter, these tools are associated with various problems. Participants might be unskillful in using technology or may not be able to afford it. Conducting a document analysis can also reduce some of the ethical concerns associated with other qualitative methods. Since document analysis is a valuable research method, one would expect to find a wide variety of literature on this topic. Unfortunately, the literature on documentary research is scant. This paper is designed to close the gap in the literature on conducting a qualitative document analysis by focusing on the advantages and limitations of using documents as a source of data and providing strategies for selecting documents. It also offers reasons for using reflexive thematic analysis and includes a hypothetical example of how a researcher might conduct a document analysis.

iCOPE with COVID-19: A Brief Telemental Health Intervention for Children and Adolescents during the COVID-19 Pandemic

The COVID-19 pandemic has prompted unprecedented disruptions to the daily lives of children and adolescents worldwide, which has been associated with an increase of anxiety and depressive symptoms in youth. However, due to public health measures, in-person psychosocial care has been affected causing barriers to mental health care access. This study investigated the feasibility, acceptability and preliminary effectiveness of iCOPE with COVID-19, a brief telemental health intervention for children and adolescents to address anxiety symptoms. Sessions were provided exclusively using videoconferencing technology. Feasibility and acceptability were measured with client satisfaction data. The main outcome measure for effectiveness was anxiety symptom severity measured using the Screen for Child Anxiety and Related Disorders (SCARED). Results indicated that the treatment was well accepted by participants. Significant reductions in anxiety were noted for social anxiety, and were observed to be trending towards a mean decrease for total anxiety. The findings suggest that this brief telemental health intervention focused on reducing anxiety related to COVID-19 is acceptable and feasible to children and adolescents. Future research using a large sample and with a longer follow-up period could inform whether symptom decreases are sustained over time.

iCOPE with COVID-19: A Brief Telemental Health Intervention for Children and Adolescents during the COVID-19 Pandemic

The COVID-19 pandemic has prompted unprecedented disruptions to the daily lives of children and adolescents worldwide, which has been associated with an increase of anxiety and depressive symptoms in youth. However, due to public health measures, in-person psychosocial care has been affected causing barriers to mental health care access. This study investigated the feasibility, acceptability and preliminary effectiveness of iCOPE with COVID-19, a brief telemental health intervention for children and adolescents to address anxiety symptoms. Sessions were provided exclusively using videoconferencing technology. Feasibility and acceptability were measured with client satisfaction data. The main outcome measure for effectiveness was anxiety symptom severity measured using the Screen for Child Anxiety and Related Disorders (SCARED). Results indicated that the treatment was well accepted by participants. Significant reductions in anxiety were noted for social anxiety, and were observed to be trending towards a mean decrease for total anxiety. The findings suggest that this brief telemental health intervention focused on reducing anxiety related to COVID-19 is acceptable and feasible to children and adolescents. Future research using a large sample and with a longer follow-up period could inform whether symptom decreases are sustained over time.

Preliminary Experience of Video Conferences in Pediatrics in Covid-19 Pandemic

A video conference enables real-time exchange between two or more participants at different locations via audio and video communication. In terms of the visualization of the discussion partners, a videoconference thus differs from a classic telephone conference and expands it to include the visual component. The term videoconferencing system refers to the technological setup or infrastructure behind such a videoconference, the videoconferencing technology. This refers to the hardware and software components that are required to carry out a videoconference technically.

A-189 Survey Findings of Challenges with Teleneuropsychological Assessment and Advice in Mitigating these Challenges

Objective Teleneuropsychology (TeleNP) has experienced tremendous uptake during the coronavirus pandemic, and there is a need to document the challenges and practical advice for conducting remote cognitive assessments. Method 87 respondents (licensed neuropsychologists = 56; others [e.g., trainees] = 31) conducting TeleNP evaluations with adult populations in the United States completed an online survey which was distributed via social media and list-servs in winter 2020–2021. Respondents were asked about their TeleNP experiences, including issues encountered and solutions to TeleNP challenges. Frequency analyses were conducted to examine the proportion of respondents endorsing specific TeleNP challenges. TeleNP advice was thematically coded to identify the most common suggestions to overcome/navigate these challenges. Results The most frequently reported TeleNP challenges included: poor internet connectivity (examinee’s home: 82.8%; an unknown source 58.6%); environmental distractions in the examinee’s location (78.2%); poor audio quality (55.2%); examinee’s unfamiliarity with the videoconferencing technology (52.9%); inability to easily conduct visuoconstructional tasks (52.9%) or adapt tests/find TeleNP norms (47.1%); and examinees’ limited access to technology (57.5%) or complete lack of access (35.6%). The most common responses to mitigate these challenges included: providing detailed instructions about the TeleNP visit and examinee expectations in advance; having a clear back-up or assistive plan (e.g., telephone call); and using TeleNP sparingly (e.g., for interview only). Conclusion These survey results reflect widely-encountered challenges with remote cognitive assessment and identify priority targets for increasing the feasibility and reliability of TeleNP. Findings can be incorporated into discussion about formalized TeleNP competencies.

Intersections of power: videoconferenced debriefing of a rural interprofessional simulation team by an urban interprofessional debriefing team

Introduction Simulation as an educational tool is known to have benefits. Moreover, the use of simulation in continuing interprofessional development is vital in rural and remote communities with limited case volumes and resources. This study explored power dynamics between rural simulation participants and urban expert co-debriefers during a simulated operating room crisis and debriefing. The aim is to gain a rich understanding of rural/urban relational dynamics embedded within the constraints and affordances of videoconferencing technology. Methods In situ observations of a videoconference-enabled simulation and debriefing were conducted, followed by seven semi-structured interviews, in this qualitative case study. A sociomateriality lens with additional sensitizing concepts of power from critical theory was employed to explore human and nonhuman interactions between rural learners, urban co-debriefers, and videoconferencing technology. Results The interviews exposed subtle expressions of power dynamics at play that were curiously not observable in the enactment of the exercise. Rural learners appreciated the objectivity of the urban debriefers as well as the nurse/physician dyad. However, rural participants appeared to quietly dismiss feedback when it was incongruent with their context. Videoconference technology added both benefits and constraints to these relational dynamics. Discussion Awareness of power relationships, and insights into affordances and constraints of videoconferencing may enhance operationalization of interprofessional simulation-based education (SBE) in rural and remote contexts.

Implementation and evaluation of the virtual Graded Repetitive Arm Supplementary Program (GRASP) for individuals with stroke during the COVID-19 pandemic and beyond

Objective Given the uncertainty with the COVID-19 pandemic, implementing telerehabilitation that enables the remote delivery of rehabilitation services is needed to mitigate the spread of COVID-19. We studied the implementation and the effectiveness of the virtual Graded Repetitive Arm Supplementary (GRASP) Program delivered and evaluated via videoconferencing in individuals with stroke. Methods The RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework with mixed methods was used to evaluate the implementation of the two iterations of the program delivered by a nonprofit organization during the pandemic. Results REACH: Seventeen people were screened, 13 people were eligible, and 11 consented to participate in the study. EFFECTIVENESS: Between baseline and post-test, participants with stroke demonstrated significant improvement in upper extremity function (Arm Capacity and Movement Test) and self-perceived UE function (Stroke Impact Scale). ADOPTION: Factors that facilitate program uptake by the staff were well-planned implementation, appropriate screening procedure, and helpful feedback from the audits. All staff felt comfortable using videoconferencing technology to deliver the program despite some technical difficulties. Factors contributing to ongoing participation included that the participants liked the group, they perceived improvements, and the instructor was encouraging. Only one participant with stroke was not comfortable using videoconferencing technology. IMPLEMENTAION: The program was implemented as intended as evaluated by a fidelity checklist. Participants’ adherence was high, as verified by the average attendance and practice time. MAINTENANCE: The organization continued to offer the program. Conclusion The virtual GRASP program was successfully implemented. Although the program was effective in improving both measured and perceived UE function in a small sample of individuals with stroke, caution should be taken in generalizing the results. Impact Implementing telerehabilitation is crucial to optimize patient outcomes and reduce the spread of COVID-19. Our findings provide guidance on the process of delivering a UE rehabilitation program remotely via videoconferencing for stroke. Moreover, insights that arise from this study also inform the implementation of other telerehabilitation services.