RESUMEN
Remotely supported myofeedback treatment (RSMT) is considered to be a potentially valuable alternative to the conventional myofeedback treatment, as it might increase efficiency of care. This study was aimed at examining the receptiveness of potential end users (patients and professionals) with respect to RSMT. By doing so, protocols of RSMT can be developed which fit to the needs of end users and enhance treatment adherence. For both end-user groups, questionnaires were developed focusing on two components of the attitude-social support-self-efficacy (ASE) model. Fifteen patients with neck-shoulder complaints previously treated with conventional myofeedback and 17 professionals participated in the study. Results showed positive attitudes toward RSMT in 53% of the patients, and 67% of them were willing to participate in RSMT. Of the 17 professionals included in the present study 43% reported a positive attitude. In addition, 40% of the patients and 100% of the professionals believed their self-efficacy level to be sufficient for RSMT. In addition to e-consultations, 40% percent of the patients suggested that the optimal frequency of structural in vivo contact with their therapist would be once per 2 weeks, which is less frequent compared to the weekly in vivo contacts in the conventional myofeedback treatment. Professionals emphasized the importance of nonverbal communication and physical interaction (as in in vivo contact) in remote treatment concepts.
Asunto(s)
Actitud del Personal de Salud , Biorretroalimentación Psicológica/instrumentación , Electromiografía/instrumentación , Enfermedades Musculoesqueléticas/terapia , Dolor de Cuello/terapia , Aceptación de la Atención de Salud/estadística & datos numéricos , Modalidades de Fisioterapia , Autoeficacia , Dolor de Hombro/terapia , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Relajación Muscular/fisiología , Dimensión del Dolor , Educación del Paciente como Asunto , Proyectos Piloto , Encuestas y CuestionariosRESUMEN
We reviewed the methodology used in telemedicine research concerning patients with postural and movement disorders. Literature searches were performed using various computerized databases through to October 2005. Twenty-two studies met the criteria for review. Two broad models of telemedicine delivery were represented in the literature: (1) telemedicine between health-care professionals at each telemedicine site (n=16) and (2) telemedicine between health-care professionals and a patient at a remote site (n=6). Disparate research methodologies were used to investigate these two models. Most studies were limited to investigating the technical feasibility and acceptability of a telemedicine service rather than focusing on the overall effect of introducing the telemedicine service into routine health care. Nonetheless, it is possible to conclude that telemedicine is acceptable for both patients and professionals when used in rehabilitation. Since the two models of telemedicine evaluation tend to explore different outcomes (diagnostic accuracy versus health status), it is recommended that separate methodologies should be used. In contrast to evaluations of telemedicine model 2, randomized controlled trials appear to be less valuable for telemedicine model 1.
Asunto(s)
Atención a la Salud/normas , Trastornos del Movimiento/terapia , Postura , Telemedicina/normas , Atención a la Salud/métodos , Humanos , Trastornos del Movimiento/diagnóstico , Evaluación de Programas y Proyectos de Salud/normas , Calidad de la Atención de Salud/normas , Ensayos Clínicos Controlados Aleatorios como Asunto , Investigación/normasRESUMEN
An application was developed to optimize information exchange in acute stroke care, with which general practitioners (GPs) could consult hospital emergency units. However, it was difficult to obtain clear preferences from GPs regarding the functional requirements of the information to be transferred or the architecture of the application. Thirteen GPs volunteered to take part in the study. The GPs used a personal digital assistant in their daily work for a period of six weeks when visiting stroke patients during their evening, night and weekend shifts. A conjoint analysis was conducted to obtain the least and most preferred characteristics of the application, to facilitate implementation on a larger scale. The main outcome was that GPs preferred the decision-support facilities and the presence of information about the patient's medical history.