scholarly journals Introducing Videoconferencing on Tablet Computers in Nurse–Patient Communication: Technical and Training Challenges

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Lisbeth O. Rygg ◽  
Hildfrid V. Brataas ◽  
Bente Nordtug
Keyword(s):  
Pilot Study ◽  
Network Connectivity ◽  
Internet Access ◽  
Care Quality ◽  
Tablet Computers ◽  
Network Access ◽  
Individual Interviews ◽  
Patients With Cancer ◽  
And Training ◽  
At Home

Background. This article examines personnel and patient experiences of videoconferencing (VC) trials on tablet computers between oncology certified nurses (OCNs) and patients with cancer who live at home. The study points to organizational pitfalls during the introduction process. In many different arenas, the use of VC has increased recently owing to improved Internet access and capacity. This creates new opportunities for contact between patients living at home and their nurses. Video conferencing presupposes knowledge about Internet access, training, and usability of technological equipment. The aim of this pilot study was to illuminate patients’ and nurses’ experiences of the technical functionality, usability, and training of tablet use in VC in primary cancer care. The results point to the drawbacks concerning the introduction of VC. Method. A pilot study with an explorative design was used to describe patients’ and OCNs’ experiences of technical functionality and usability of VC on tablet computers. After a three-month trial, data were gathered, focusing on both patients’ and nurses’ perspectives. Individual interviews with four female OCNs, aged 32–65 (mean 46), and six patients with cancer, two men and four women aged 49–78 (mean 69), were content-analyzed. Results. The analysis revealed two main categories: network connectivity and tablet usability and training and educational pitfalls. Conclusion. When planning VC implementation, the organizational leadership should consider network access and stability, as well as individualized VC training on tablets. Ensuring patient safety should also be a priority. Further research should provide knowledge of technological and educational pitfalls, and possible implications of VC on the care quality of nursing.

scholarly journals Palliative Care Skills and New Resources for Oncology Practices: Meeting the Palliative Care Needs of Patients With Cancer and Their Families

2020 ◽  
pp. 14-22 ◽  
Author(s):  
Anthony Back ◽  
Tara Friedman ◽  
Janet Abrahm
Keyword(s):  
Palliative Care ◽  
Communication Skills ◽  
Language Processing ◽  
Symptom Control ◽  
Care Quality ◽  
Community Based ◽  
Patients With Cancer ◽  
Patient Reported ◽  
The Impact ◽  
At Home

In its 2017 guideline, ASCO challenged members to integrate palliative care into their standard oncology practices for all patients, throughout their cancer trajectory. However, partnering with palliative care experts alone will not be enough to achieve that goal; there are too few experts now, and there will not be enough in the future to meet the needs of patients with cancer and their families. Other strategies are required. Oncologists can develop new communication skills that were not included in their fellowship curricula, skills that integrate into their visits the subjects that palliative care clinicians discuss routinely with patients referred to them. In this review, Dr. Back offers three questions matched to communication skills that can help oncologists explore key areas: (1) What is happening? (2) How do you (and I) feel? and (3) What is important? and discusses the “REMAP” strategy for making urgent medical decisions. Dr. Friedman reviews the impact of community-based palliative care resources and telehealth on care quality, patient centeredness, and reducing costs. Community-based palliative care services and telehealth are available to patients and families at home, during active treatment. Dr. Abrahm reviews how patient-reported outcomes (PROs) completed at home can enhance patients’ symptom control, quality of life, and toleration of treatment and decrease unplanned emergency visits by alerting clinicians to patients’ severe symptoms, making appropriate referrals, or suggesting patients contact their oncology team. She also provides an update on using PROs and natural language processing with clinical decision support to create sophisticated palliative care assessments and treatment options in the electronic health record during patients’ office visits.

scholarly journals Causes of Cancer Re-Admissions: A Patient-Centered Approach

2020 ◽  
Vol 16 (8) ◽  
pp. e734-e740
Author(s):  
Allison Zibelli ◽  
Katie Holland ◽  
Emily Wei
Keyword(s):  
Discharge Planning ◽  
Outpatient Setting ◽  
Care Quality ◽  
Care Team ◽  
Teaching Hospitals ◽  
Semistructured Interview ◽  
Limited Information ◽  
Patient Centered ◽  
Patients With Cancer ◽  
At Home

PURPOSE: Patients with a cancer diagnosis have a high risk of re-admission during the 30 days after discharge. Clinicians, payers, and patients consider this to be an indicator of care quality. The causes of re-admission remain poorly understood. Retrospective chart reviews, used in most re-admission research, provide limited information regarding the causes of, and methods to reduce, re-admissions. This project sought to elicit the insights of those most affected by re-admission: the patients themselves. METHODS: We interviewed patients with cancer who were re-admitted to 2 urban teaching hospitals when they were hospitalized during their second admission. Trained interviewers used a semistructured interview guide to gather information on events just before the second admission, the patients’ understanding of the cause of re-admission, and the patients’ views about their readiness for discharge at the previous admission. Interviews were transcribed and analyzed, and themes were identified and explored. RESULTS: Three major themes were identified. First, most patients saw their re-admission as caused by problems that could not be treated in an outpatient setting. Second, the patients felt that they did not have sufficient resources at home to manage their care. Furthermore, the patients did not see the outpatient care team as a resource that they could call on for assistance. As a result, most of the decisions to return to the hospital were made by the patients themselves. CONCLUSION: The decision that leads to re-admission often happens at home, in response to unmanageable needs. Strengthening the bond between the care team and the patient, with the aim of providing care in the most appropriate setting, could decrease re-admissions in patients with cancer. Possible interventions include home visits, enhanced discharge planning, and telehealth services.

scholarly journals Plasma Exosomal miRNA Levels after Radiotherapy Are Associated with Early Progression and Metastasis of Cervical Cancer: A Pilot Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2110
Author(s):  
Oyeon Cho ◽  
Do-Wan Kim ◽  
Jae-Youn Cheong
Keyword(s):  
Cervical Cancer ◽  
Pilot Study ◽  
Biological Functions ◽  
Patients With Cancer ◽  
Initial Stage ◽  
Exosomal Mirnas ◽  
Early Progression ◽  
Before And After ◽  
Microenvironmental Factors ◽  
Exosomal Mirna

Plasma exosomal miRNAs are key regulators of cell-cell interactions associated with several biological functions in patients with cancer. This pilot study aimed to investigate the log2 fold change (log2FC) of the expression of exosomal miRNAs and related mRNAs in the blood of patients with cervical cancer to identify prognostic markers better than those currently available. We sequenced plasma exosomal RNA from 56 blood samples collected from 28 patients with cervical cancer, who had been treated with concurrent chemoradiotherapy (CCRT). Changes in the expression of miRNAs and mRNAs before and after CCRT were represented as log2FC. Their biological functions were studied by miRNA-mRNA network analysis, using ingenuity pathway analysis, after the selection of two groups of miRNAs, each associated with early progression (EP) and metastasis, also described as initial stage. Seven patients experienced EP, three of whom died within four months after progression. Reduced levels of miR-1228-5p, miR-33a-5p, miR-3200-3p, and miR-6815-5p and increased levels of miR-146a-3p in patients with EP revealed unresolved inflammation, with accompanying increased expression of PCK1 and decreased expression of FCGR1A. Increased levels of miR-605-5p, miR-6791-5p, miR-6780a-5p, and miR-6826-5p and decreased levels of miR-16-1-3p (or 15a-3p) were associated with the degree of metastasis and led to the systemic activation of myeloid, endothelial, and epithelial cells, as well as neurons, phagocytes, and platelets. Log2FCs in the expression of miRNAs and mRNAs from plasma exosomes after CCRT are associated with EP and metastasis, reflecting unresolved inflammation and systemic microenvironmental factors, respectively. However, this study, supported by preliminary data insufficient to reach clear conclusions, should be verified in larger prospective cohorts.

scholarly journals Piloting the Play Cycle Observation Method in ‘real time’: Recording children’s Play Cycles in pre-school provision

2020 ◽  
pp. 1476718X2096985
Author(s):  
Pete King ◽  
LaDonna Atkins ◽  
Brandon Burr
Keyword(s):  
Pilot Study ◽  
Real Time ◽  
School Setting ◽  
Early Years ◽  
Good Reliability ◽  
Rater Reliability ◽  
Children's Play ◽  
Observational Tool ◽  
Observation Method ◽  
And Training

The Play Cycle Observation Method (PCOM) is an observational tool developed to focus on the process of play and has shown good reliability when watching videos of children playing. This study piloted use of the PCOM in ‘real time’ in a pre-school setting where 3-year-old children play. The results from two independent observers not familiar with the concept of the Play Cycle or the PCOM found good inter-rater reliability using Cohen Kappa (k) when observing play cues to form play cycles, as well as observing play cues within established play cycles. In addition, the recording of the nature of the play cues and play returns, the play frame and how the play cycle finishes (annihilation) were shown to be consistent between the two inter-rater observers. The results of this pilot study indicate the PCOM can be used as an observational tool to record the process of play by both students and practitioners working in a range of contexts including playwork, childcare, early years and statutory education. The PCOM can also be used as a teaching and training aid for trainers and lecturers.

Comparison of simulation observer tools on engagement and maximising learning: a pilot study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Sandra Johnston ◽  
Naomi Tutticci ◽  
Karen Theobald ◽  
Joanne Ramsbotham
Keyword(s):  
Pilot Study ◽  
Nursing Students ◽  
Learning Outcomes ◽  
Clinical Reasoning ◽  
Preliminary Evidence ◽  
Reasoning Ability ◽  
Main Study ◽  
Standard Observer ◽  
Learning Behaviours ◽  
And Training

Abstract Objectives This pilot study examined if the Clinical Reasoning Observer Worksheet (CROW) compared to a standard observer worksheet used during simulation, would enhance nursing students active learning behaviours and perceptions of clinical reasoning ability. Methods This pilot study was undertaken to test the design and processes for a future larger study and reports on preliminary evidence of efficacy of recruitment procedures and instrumentation in addition to student’s learning outcomes. Results There was little overall difference in outcomes between groups who used either simulation observer worksheet. Overall, participants who used either worksheet perceived their ability to apply clinical reasoning to an episode of patient care increased. Conclusions Modifications were identified as necessary for a larger study including changes to instrumentation, method of survey delivery and training of simulation facilitators. A more definitive evaluation will be achievable with a larger group of students in a main study with the suggested modifications.

scholarly journals Acceptability, Feasibility and Preliminary Evaluation of a Novel, Personalised, Home-Based Physical Activity Intervention for Chronic Heart Failure (Active-at-Home-HF): a Pilot Study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Nduka C. Okwose ◽  
Leah Avery ◽  
Nicola O’Brien ◽  
Sophie Cassidy ◽  
Sarah J. Charman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Heart Failure ◽  
Pilot Study ◽  
Chronic Heart Failure ◽  
Physical Activity Intervention ◽  
Step Count ◽  
Home Based ◽  
At Home

Abstract Purpose Less than 10% of heart failure patients in the UK participate in cardiac rehabilitation programmes. The present pilot study evaluated feasibility, acceptability and physiological effects of a novel, personalised, home-based physical activity intervention in chronic heart failure. Methods Twenty patients (68 ± 7 years old, 20% females) with stable chronic heart failure due to reduced left ventricular ejection fraction (31 ± 8 %) participated in a single-group, pilot study assessing the feasibility and acceptability of a 12-week personalised home-based physical activity intervention aiming to increase daily number of steps by 2000 from baseline (Active-at-Home-HF). Patients completed cardiopulmonary exercise testing with non-invasive gas exchange and haemodynamic measurements and quality of life questionnaire pre- and post-intervention. Patients were supported weekly via telephone and average weekly step count data collected using pedometers. Results Forty-three patients were screened and 20 recruited into the study. Seventeen patients (85%) completed the intervention, and 15 (75%) achieved the target step count. Average step count per day increased significantly from baseline to 3 weeks by 2546 (5108 ± 3064 to 7654 ± 3849, P = 0.03, n = 17) and was maintained until week 12 (9022 ± 3942). Following completion of the intervention, no adverse events were recorded and quality of life improved by 4 points (26 ± 18 vs. 22 ± 19). Peak exercise stroke volume increased by 19% (127 ± 34 vs. 151 ± 34 m/beat, P = 0.05), while cardiac index increased by 12% (6.8 ± 1.5 vs. 7.6 ± 2.0 L/min/m2, P = 0.19). Workload and oxygen consumption at anaerobic threshold also increased by 16% (49 ± 16 vs. 59 ± 14 watts, P = 0.01) and 10% (11.5 ± 2.9 vs. 12.8 ± 2.2 ml/kg/min, P = 0.39). Conclusion The Active-at-Home-HF intervention is feasible, acceptable and effective for increasing physical activity in CHF. It may lead to improvements in quality of life, exercise tolerance and haemodynamic function. Trial Registration www.clinicaltrials.gov NCT0367727. Retrospectively registered on 17 September 2018.

Feasibility and convenience of immunotherapy at home for patients with cancer : a single-centre audit

Lung Cancer ◽  
2021 ◽  
Vol 156 ◽  
pp. S41
Author(s):  
Harliana Mohd Yusof ◽  
Giuseppe Banna ◽  
Julia Fullerton ◽  
Rebecca Broomfield ◽  
Chit Cheng Yeoh ◽  
...  
Keyword(s):  
Single Centre ◽  
Patients With Cancer ◽  
At Home

scholarly journals Computer-aided self-help for phobia/panic via internet at home: A pilot study

2004 ◽  
Vol 184 (5) ◽  
pp. 448-449 ◽  
Author(s):  
Mark Kenwright ◽  
Isaac M. Marks ◽  
Lina Gega ◽  
David Mataix-Cols
Keyword(s):  
Pilot Study ◽  
Panic Disorder ◽  
Open Study ◽  
The Internet ◽  
Face To Face ◽  
Self Help ◽  
Computer Aided ◽  
Therapist Support ◽  
At Home ◽  
Help System

SummaryIn an open study, ten people with phobia or panic disorder who could not travel repeatedly to a therapist accessed a computer-aided exposure self-help system (Fear Fighter) at home on the internet with brief therapist support by telephone. They improved significantly, and their outcome and satisfaction resembled those in patients with similar disorders who used Fear Fighter in clinics with brief face-to-face therapist support.

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