scholarly journals Technology-Enhanced Consultations in Diabetes, Cancer, and Heart Failure: Protocol for the Qualitative Analysis of Remote Consultations (QuARC) Project (Preprint)

2018 ◽  
Author(s):  
Sara E Shaw ◽  
Deborah Cameron ◽  
Joseph Wherton ◽  
Lucas M Seuren ◽  
Shanti Vijayaraghavan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Qualitative Analysis ◽  
Communication Strategies ◽  
Junior Doctors ◽  
Policy Makers ◽  
Face To Face ◽  
Close Analysis ◽  
Remote Consultations ◽  
Roll Out

BACKGROUND Remote videoconsulting is promoted by policy makers as a way of delivering health care efficiently to an aging population with rising rates of chronic illness. As a radically new service model, it brings operational and interactional challenges in using digital technologies. In-depth research on this dynamic is needed before remote consultations are introduced more widely. OBJECTIVE The objective of this study will be to identify and analyze the communication strategies through which remote consultations are accomplished and to guide patients and clinicians to improve the communicative quality of remote consultations. METHODS In previous research, we collected and analyzed two separate datasets of remote consultations in a National Institute for Health Research–funded study of clinics in East London using Skype and a Wellcome Trust–funded study of specialist community heart failure teams in Oxford using Skype or FaceTime. The Qualitative Analysis of Remote Consultations (QuARC) study will combine datasets and undertake detailed interactional microanalysis of up to 40 remote consultations undertaken by senior and junior doctors and nurse specialists, including consultations with adults with diabetes, women who have diabetes during pregnancy, people consulting for postoperative cancer surgery and community-based patients having routine heart failure reviews along with up to 25 comparable face-to-face consultations. Drawing on established techniques (eg, conversation analysis), analysis will examine the contextual features in remote consultations (eg, restricted visual field) combined with close analysis of different modes of communication (eg, speech, gesture, and gaze). RESULTS Our findings will address the current gap in knowledge about how technology shapes the fine detail of communication in remote consultations. Alongside academic outputs, findings will inform the coproduction of information and guidance about communication strategies to support successful remote consultations. CONCLUSIONS Identifying the communication strategies through which remote consultations are accomplished and producing guidance for patients and clinicians about how to use this kind of technology successfully in consultations is an important and timely goal because roll out of remote consultations is planned across the National Health Service. REGISTERED REPORT IDENTIFIER RR1-10.2196/10913

“I Can’t Go Far”: Perceptions and Experiences of Heart Failure Patients Regarding Physical Activity: A Qualitative Study Using Semistructured Face-to-Face Interviews

2021 ◽  
pp. 109019812110532
Author(s):  
Elodie Charuel ◽  
Martial Bernard ◽  
Hélène Vaillant Roussel ◽  
Benoit Cambon ◽  
Thibault Ménini ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
New York ◽  
General Practitioner ◽  
Qualitative Study ◽  
Heart Association ◽  
Enabling Factors ◽  
Face To Face ◽  
New York Heart Association

Background Participation in regular physical activity (RPA) is beneficial to the quality of life and life expectancy of patients with chronic heart failure (CHF). However, it is inadequate in many patients. Aims To determine the factors that influence the practice of RPA in patients with CHF managed in general practice. Method This was a qualitative study using semistructured, individual face-to-face interviews. Patients with CHF (New York Heart Association Stages 1–3) capable of participating in RPA were enrolled by their general practitioner. A longitudinal and transversal inductive thematic analysis was performed by two researchers. Results Five themes emerged from the 19 interviews that were conducted. Poor knowledge of the disease and the benefits of participating in RPA, as well as the lack of motivation or enjoyment, in particular due to the absence of previous participation, were considered significant obstacles. Fear associated with CHF or other comorbidities was also an obstacle. Attendance at a rehabilitation center, family and social circles, and having a pet all appeared to be beneficial. Family and friends were important for motivating the patient to participate in an activity but could also be an obstacle when they were overprotective. Conclusion This study helps highlight the difficulties for patients with CHF associated with participation in RPA. Despite the obstacles, there are enabling factors on which the general practitioner may rely to motivate their patients.

scholarly journals Survey of remote consultations in psychiatry during the SARS-CoV-2 outbreak

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S264-S265
Author(s):  
Nusra Khodabux ◽  
Satheesh Gangadharan ◽  
Samuel Tromans ◽  
Avinash Hiremath
Keyword(s):  
Mental Health ◽  
Qualitative Data ◽  
Healthcare Professionals ◽  
Mental Healthcare ◽  
Technical Quality ◽  
Face To Face ◽  
The Mean ◽  
Detrimental Impact ◽  
Remote Consultations

AimsTo compare the usage of remote consultations before and after the first wave of the SARS-CoV-2 outbreak and explore mental health workers’ views on the usage of telemedicine.MethodAn online questionnaire survey was developed, and disseminated to mental healthcare professionals via e-mail and social media. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using Braun and Clarke's six step procedure for thematic analysis.1ResultThere were 40 responses from mental healthcare professionals of varying grades from different sub-specialties, predominantly from the UK. Compared to before the SARS-CoV-2 outbreak, there was an increase in usage of telephone (9(22.5% to (29)72.5%) and video consultations (4(10%) to 17(42.5%)). Respondents reported an increase in virtual MDTs (35(87.5%) during the pandemic, 9(22.5%) pre-pandemic).Based on a 5-point Likert scale, the mean technical quality of telephone consultations was 3.56/5 (Range 2-5), with 75% rating telephone consultations as not being as good as face-to-face consultations. The mean technical quality of video consultations was 3.58/5 (Range 2-5), with 63% rating video consultations as not being as good as face-to-face consultations. 25 (62.5%) respondents felt comfortable using telephone consultations during the pandemic, 20(50%) felt comfortable using video consultations. Recurring themes identified from the qualitative data regarding reasons for the technical quality ratings were: connection issues, poor infrastructure and security concerns.Nine (23%) respondents felt that using video conferencing consultations had a detrimental impact on the mental health of patients while 14(35%) felt that telephone consultations had a detrimental impact on patients’ mental health. Recurring themes for health practitioners’ perceived effect of the use of telemedicine on patients’ mental heath were the loss of personal touch and reduced patient engagement.ConclusionThere was a substantial increase in usage of remote consultations during the first wave of the SARS-CoV-2 pandemic among mental healthcare professionals. The results reported in the present study suggest there are numerous barriers to the use of telemedicine in psychiatry, which require future exploration, ideally through interview or ethnographic studies.

scholarly journals Survey of CAMHS clinicians about their experience of remote consultation: brief report

BJPsych Open ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Anupam Bhardwaj ◽  
Anna Moore ◽  
Rudolf N. Cardinal ◽  
Carol Bradley ◽  
Lauren Cross ◽  
...  
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Remote Consultation ◽  
Face To Face ◽  
Remote Consultations ◽  
Safe Care ◽  
Roll Out

The Covid-19 crisis necessitated rapid adoption of remote consultations across National Health Service (NHS) child and adolescent mental health services (CAMHS). This study aimed to understand practitioners’ experiences of rapid implementation of remote consultations across CAMHS in one NHS trust in the east of England. Data were collected through a brief questionnaire documenting clinicians’ experiences following remote delivery of services. The questionnaire began before ‘lockdown’ and focused on assessment consultations (n = 102) as part of a planned move to virtual assessment. As the roll-out of remote consultations was extended at lockdown, we extended the questionnaire to include all remote clinical contacts (n = 202). Despite high levels of initial concern, clinicians’ reports were positive overall; importantly, however, their experiences varied by team. When restrictions on face-to-face working are lifted, a blended approach of remote and face-to-face service delivery is recommended to optimise access and capacity while retaining effective and safe care.

scholarly journals Technology-Enhanced Consultations in Diabetes, Cancer, and Heart Failure: Protocol for the Qualitative Analysis of Remote Consultations (QuARC) Project

10.2196/10913 ◽  
2018 ◽  
Vol 7 (7) ◽  
pp. e10913 ◽  
Author(s):  
Sara E Shaw ◽  
Deborah Cameron ◽  
Joseph Wherton ◽  
Lucas M Seuren ◽  
Shanti Vijayaraghavan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Qualitative Analysis ◽  
Remote Consultations

scholarly journals Inequalities in general practice remote consultations: A systematic review

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0040
Author(s):  
Ruth Parker ◽  
Emma Figures ◽  
Charlotte Paddison ◽  
James Matheson ◽  
David Blane ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
General Practice ◽  
Quality Of Care ◽  
Clinical Outcomes ◽  
The Elderly ◽  
Face To Face ◽  
The Impact ◽  
Remote Consultations

BackgroundCOVID-19 has led to rapid and widespread use of remote consultations in general practice, but the health inequalities impact remains unknown.AimTo explore the impact of remote consultations in general practice compared to face-to-face consultations on utilisation and clinical outcomes across socio-economic and disadvantaged groups.Design & settingSystematic reviewMethodWe undertook an electronic search of MEDLINE, EMBASE and Web of Science from inception to June 2020. We included studies which compared remote consultations to face-to-face consultations in primary care and reported outcomes by PROGRESS Plus criteria. Risk of bias was assessed using ROBINS-I. Data was synthesised narratively.ResultsBased on 13 studies, exploring telephone and internet-based consultations, we found that telephone consultations were used by younger working age people, the very old and non-immigrants, with internet-based consultations more likely to be used by younger people. Women consistently used more remote forms of consulting than men. Socio-economic and ethnicity findings were mixed, with weak evidence that patients from more affluent areas were more likely to use internet-based communication. Remote consultations appeared to help patients with opioid dependence remain engaged with primary care. No studies reported on the impact on quality of care or clinical outcomes.ConclusionRemote consultations in general practice are likely to be used more by younger working people, non-immigrants, the elderly and women, with internet-based consultations more by younger, affluent and educated groups. Wide-spread use of remote consultations should be treated with caution until the inequalities impact on clinical outcomes and quality of care is known.

scholarly journals China-Pakistan Economic Corridor and Its Influence on Perceived Economic and Social Goals: Implications for Social Policy Makers

2019 ◽  
Vol 11 (18) ◽  
pp. 4949 ◽  
Author(s):  
Ahmad Saad ◽  
Guan Xinping ◽  
Mariah Ijaz
Keyword(s):  
Poverty Reduction ◽  
Local Community ◽  
Industrial Sector ◽  
Government Officials ◽  
Employment Opportunities ◽  
Policy Makers ◽  
Face To Face ◽  
Initial Stage ◽  
Potential Benefits

China-Pakistan Economic Corridor (CPEC) has initiated as a mega project by China and Pakistan to benefit economic growth and free trade. CPEC is in the initial stage, and policymakers and government officials consider CPEC as a “game-changer” for both the countries, as, potentially, it will generate numerous business and employment opportunities for local citizens as well as international outreach. Recently, a plethora of research has discussed both the macro as well as micro level advantages of CPEC, but has only been focused theoretically due to the emerging term. How beneficial the CPEC for a local community, and how it is perceived by the local people is not yet discussed by prior studies. This research fills the gap and examines the potential benefits of CPEC for local citizens of Pakistan. A mixed method approach was adopted to collect the data, as survey through structured questionnaire was conducted with a total of 445 citizens (323 male and 122 female), and a face-to-face interview with 32 citizens (28 male and four female) from the communities living along the CPEC routes. The findings show that, through the development of CPEC, local citizens perceive significant improvement in their lives, particularly the quality of life, better employment opportunities, and poverty reduction, while they have an insignificant perception about environmental protection and quality of education. This research recommends policy makers to build new educational institutions, encourage investors to invest in the industrial sector, and formulate environmental strategies to unleash maximum benefits of CPEC. Moreover, government official and policy makers may create awareness of CPEC projects and their benefits among the communities to get their support.

scholarly journals Willingness to Pay for Improvement in Service Quality of Intermediate Public Transport (IPT) Modes

2021 ◽  
Vol 7 (5) ◽  
pp. 866-879
Author(s):  
Saurabh Kumar ◽  
Sanjeev Sinha
Keyword(s):  
Developing Countries ◽  
Service Quality ◽  
Willingness To Pay ◽  
Public Transport ◽  
Multinomial Logit Model ◽  
Transportation Systems ◽  
Transport Infrastructure ◽  
Policy Makers ◽  
Face To Face

The Rapid increase in urban population has put extraordinary pressure on transport infrastructure. Public transport frameworks in small and medium-sized cities in developing countries include of IPT modes. However, these midsized cities in developing countries face congestion problems and have severe environmental pollution. The paper focuses on the assessment of willingness to pay for improvement in service quality of IPT mode of transportation in urban India. A Stated Choice (SC) survey instrument was designed and data was collected from IPT users to collect respondent’s socio-economic characteristics and their attributes for the stated hypothetical scenarios. Respondents were approached randomly and face-to-face interviews were carried out. The present study aimed at finding the willingness to pay for different attributes of an IPT mode to assess the relative importance of these attributes. The multinomial logit model was developed using the econometric software NLOGIT 4.0. The results obtained from the analysis suggest that the commuters in the city perceive safety as the most important attribute of an IPT mode followed by comfort and waiting time. The findings of the study shall be useful for policy makers and operators in urban planning and improvement of the transportation systems of mid-sized cities of developing countries and any new mode incorporating high comfort and safety shall be preferred. Doi: 10.28991/cej-2021-03091696 Full Text: PDF

scholarly journals Effects of cognitive behavioral therapy on depression, anxiety, sleep and quality of life for patients with heart failure and coronary heart disease. a systematic review of clinical trials 2010 – 2020

2021 ◽  
Vol 7 (3) ◽  
pp. 123
Author(s):  
Aspasia Pizga ◽  
Panagiotis Kordoutis ◽  
Stamatoula Tsikrika ◽  
Ioannis Vasileiadis ◽  
Serafeim Nanas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Behavioral Therapy ◽  
Controlled Trials ◽  
Face To Face ◽  
Randomized Controlled ◽  
Patients With Heart Failure

Background: There is a growning evidence that CBT (Cognitive Behavioral Therapy) improves mental health of patients with chronic illnesses but its effectiveness is not well established in patients with heart diseases. The present systematic review was conducted to evaluate the effects of CBT in heart failure (HF) and coronary heart disease (CHD) patients.Methods:  Pubmed, Cohraine and Google Scholar were searched for studies with randomized controlled trials. Studies were required to assess the effectiveness of CBT in depression, anxiety, sleep and quality of life of patients suffering from heart failure and coronary heart disease. SStudies identified were independently screened by two reviewers and critically appraised using the PedroScale.Results:  Sixteen randomized controlled trials were included in the review. The majority of the studies indicated that CBT therapy was effective treatment for reducing depression and anxiety and can also be beneficial for sleeping disorders and improve quality of life of patients with heart failure and coronary heart disease. Althought face to face CBT therapy seems to be clinicaly effective, internet-based CBT therapy was not superior to a guided web-based discussion forum.Conclusions: CBT can improve psychological health and quality of life of cardiac patients and further enhance benefits of rehabilitation programs.  Findings suggest that face-to-face CBT is superior to usual care and it can be incorporated in cardiac rehabilitations programs. Future studies are needed to identify the effectiveness of internet-based CBT on cardiac patients and address the factors that will increase treatment adherence.

An Exploratory Investigation of Quality of Life in Adult Liver Transplant Recipients

2005 ◽  
Vol 15 (4) ◽  
pp. 392-396
Author(s):  
Kathy B. Bean
Keyword(s):  
Quality Of Life ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Transplant Recipients ◽  
Policy Makers ◽  
Survey Tool ◽  
Face To Face ◽  
Exploratory Investigation ◽  
Liver Transplant Recipients

Quality of life is an important outcome indicator of experiences associated with liver transplantation. Unfortunately, quality of life has been defined in many different ways, causing confusion and misconceptions among practitioners, researchers, policy makers, and patients. This exploratory qualitative study was initiated to gain greater understanding regarding the adult transplant recipients' experiences with liver transplantation in order to direct future studies with this population and to assist in selection of a relevant quality of life survey tool for quantitative investigation. Twelve informants (7 women, 5 men) shared their experiences in face-to-face interviews conducted by the researcher. Analysis of these interviews reveals the importance of physiologic, psychological, social, spiritual, family, and socioeconomic aspects of quality of life for liver transplant recipients.

scholarly journals Video Consultations Between Patients and Clinicians in Diabetes, Cancer, and Heart Failure Services: Linguistic Ethnographic Study of Video-Mediated Interaction (Preprint)

2020 ◽  
Author(s):  
Sara E Shaw ◽  
Lucas Martinus Seuren ◽  
Joseph Wherton ◽  
Deborah Cameron ◽  
Christine A'Court ◽  
...  
Keyword(s):  
Heart Failure ◽  
Communication Strategies ◽  
Ethnographic Study ◽  
Face To Face ◽  
Depth Analysis ◽  
Video Consultation ◽  
Before And After ◽  
Video Link ◽  
Uk National Health Service ◽  
The Uk

BACKGROUND Video-mediated clinical consultations offer potential benefits over conventional face-to-face in terms of access, convenience, and sometimes cost. The improved technical quality and dependability of video-mediated consultations has opened up the possibility for more widespread use. However, questions remain regarding clinical quality and safety. Video-mediated consultations are sometimes criticized for being not as good as face-to-face, but there has been little previous in-depth research on their interactional dynamics, and no agreement on what a good video consultation looks like. OBJECTIVE Using conversation analysis, this study aimed to identify and analyze the communication strategies through which video-mediated consultations are accomplished and to produce recommendations for patients and clinicians to improve the communicative quality of such consultations. METHODS We conducted an in-depth analysis of the clinician-patient interaction in a sample of video-mediated consultations and a comparison sample of face-to-face consultations drawn from 4 clinical settings across 2 trusts (1 community and 1 acute care) in the UK National Health Service. The video dataset consisted of 37 recordings of video-mediated consultations (with diabetes, antenatal diabetes, cancer, and heart failure patients), 28 matched audio recordings of face-to-face consultations, and fieldnotes from before and after each consultation. We also conducted 37 interviews with staff and 26 interviews with patients. Using linguistic ethnography (combining analysis of communication with an appreciation of the context in which it takes place), we examined in detail how video interaction was mediated by 2 software platforms (Skype and FaceTime). RESULTS Patients had been selected by their clinician as <i>appropriate</i> for video-mediated consultation. Most consultations in our sample were technically and clinically unproblematic. However, we identified 3 interactional challenges: (1) opening the video consultation, (2) dealing with disruption to conversational flow (eg, technical issues with audio and/or video), and (3) conducting an examination. Operational and technological issues were the exception rather than the norm. In all but 1 case, both clinicians and patients (deliberately or intuitively) used established communication strategies to successfully negotiate these challenges. Remote physical examinations required the patient (and, in some cases, a relative) to simultaneously follow instructions and manipulate technology (eg, camera) to make it possible for the clinician to see and hear adequately. CONCLUSIONS A remote video link alters how patients and clinicians interact and may adversely affect the flow of conversation. However, our data suggest that when such problems occur, clinicians and patients can work collaboratively to find ways to overcome them. There is potential for a limited physical examination to be undertaken remotely with some patients and in some conditions, but this appears to need complex interactional work by the patient and/or their relatives. We offer preliminary guidance for patients and clinicians on what is and is not feasible when consulting via a video link. INTERNATIONAL REGISTERED REPORT RR2-10.2196/10913

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