ABSTRACT
Background: Due to the coronavirus disease 2019 (COVID-19) pandemic the importance of videoconferencing psychotherapy (VCP) has considerably increased. Although the effectiveness of VCP is well documented by numerous therapy outcome studies, reservations from clinicians’ perspectives are still common. They relate in particular to the limited possibilities for the formation of a relationship and the absence of a physical co-presence in the video setting. Objective: This article provides an overview of the empirical findings on the quality of the therapeutic relationship as well as on the nature of nonverbal interaction in VCP. Methods: The MEDLINE, APA PsycArticles, APA PsycInfo, and PSYNDEX databases were searched for controlled studies that examined the therapeutic relationship in VCP compared to face-to-face therapy. Another literature search was conducted for studies of nonverbal interaction in VCP. Results: The results show that the quality of the therapeutic relationship in VCP is comparable to that in face-to-face therapy. The interaction in VCP has so far only been described in qualitative studies. In interviews patients and therapists report an increase in verbal and nonverbal activity in VCP. For therapeutic work, changes with respect to being silent and understanding of body language are highlighted. Conclusion: To the best of our knowledge no studies exist that explain why a comparatively successful relationship structure can be established, despite the changes and limitations associated with the mediation of interaction in VCP.
ABSTRACT
Coronavirus-19 outbreak caused concern of lowering performance of clinical trials, including delays in initiation, lower enrollment, or more frequent deviations related with visit schedule change. Korea, with the sixth largest number of industry-sponsored interventional drug trials in the world, has been controlling COVID-19 outbreak rather successfully and maintaining daily medical practice in most areas of the country. We investigated performance of oncology clinical trials before and after COVID-19 in Korea. We retrospectively identified and reviewed the files, notes, and source documents of ongoing breast cancer clinical trials during January to May 2019 and January to May 2020 in a single cancer center conducting oncology trials in Korea. Number of enrolled patients, drop-outs, protocol deviations including study visit delay or visit omission were measured. We investigated 77 ongoing studies from January to May 2020, and 67 from the same period in 2019. The numbers of newly initiated trials and new enrollment were not decreased during COVID-19 outbreak period. After outbreak of COVID-19, number of onsite monitoring was decreased, however total number of monitoring was maintained as remote monitoring was increased. Remote monitoring comprised 44% of all monitoring visit in 2020, and found 30%(15/50) of protocol deviations detected by all monitoring visit. Of the 26 study visit related protocol deviations during February to May 2020, 10(38%) cases were COVID-19 related. Thirteen percent(3/24) of study drop out cases were COVID-19 related, from subjects' demand due to fear of visiting hospital. Although monitoring access was limited, vigorous countermeasures successfully maintained performance of oncology clinical trials during COVID-19 outbreak in Korea. Remote monitoring visits successfully complemented restricted onsite monitoring. COVID-19 related protocol deviations and drop-out cases were noted, mostly from subjects' concerns about travel. Future regulations and guidelines should pursue developing alternatives of face-to-face contact visit as needed.