ABSTRACT
Objective: The impact of the COVID-19 pandemic on perceived stress, anxiety, depression, and eating behaviors of university students in Barbados was investigated. Design and Methods: Students completed an online survey between June and July 2021 including the Patient Health Questionnaire (PHQ-4), SCOFF Questionnaire, and Salzburg Stress Eating Scale. We used bivariate and multivariable logistic regression to assess factors associated with eating behaviour and eating disorders. Result(s): Of 506 respondents (mean age 26 years, 81.4% female, 85.2% undergraduates), 7.23% were underweight, 52.34% normal weight, 20.85% overweight, and 19.57% obese. PHQ-4 screening suggested anxiety prevalence of 46% (95% CI 42% to 51%) with 22% (95% CI 17% to 25%) severe anxiety, and 43% (95% CI 39% to 47%) depression prevalence. 22.5 % of students screened positive for eating disorders on the SCOFF;positive screen for eating disorder was more likely positive in obese (36%) vs underweight (15%) students (p Conclusion(s): The screening instruments indicated concerning levels of anxiety, depression, and eating disorders associated with the COVID-19 pandemic among university students in Barbados. These conditions may remain undetected unless students seek help or are referred. Proactive health services and educational outreach are needed. Prevalence estimates should be viewed with caution until cut-off scores are empirically established for students in Barbados.
ABSTRACT
BACKGROUND: The delivery of physiotherapy via telehealth could provide more equitable access to services for patients. Videoconference-based telehealth has been shown to be an effective and acceptable mode of service delivery for exercise-based interventions for chronic knee pain;however, specific training in telehealth is required for physiotherapists to effectively and consistently deliver care using telehealth. The development and evaluation of training programs to upskill health care professionals in the management of osteoarthritis (OA) has also been identified as an important priority to improve OA care delivery. OBJECTIVE: This study aims to explore physiotherapists' experiences with and perceptions of an e-learning program about best practice knee OA management (focused on a structured program of education, exercise, and physical activity) that includes telehealth delivery via videoconferencing. METHODS: We conducted a qualitative study using individual semistructured telephone interviews, nested within the Physiotherapy Exercise and Physical Activity for Knee Osteoarthritis randomized controlled trial, referred to as the PEAK trial. A total of 15 Australian physiotherapists from metropolitan and regional private practices were interviewed following the completion of an e-learning program. The PEAK trial e-learning program involved self-directed learning modules, a mock video consultation with a researcher (simulated patient), and 4 audited practice video consultations with pilot patients with chronic knee pain. Interviews were audio recorded and transcribed verbatim. Data were thematically analyzed. RESULTS: A total of five themes (with associated subthemes) were identified: the experience of self-directed e-learning (physiotherapists were more familiar with in-person learning;however, they valued the comprehensive, self-paced web-based modules. Unwieldy technological features could be frustrating);practice makes perfect (physiotherapists benefited from the mock consultation with the researcher and practice sessions with pilot patients alongside individualized performance feedback, resulting in confidence and preparedness to implement new skills);the telehealth journey (although inexperienced with telehealth before training, physiotherapists were confident and able to deliver remote care following training;however, they still experienced some technological challenges);the whole package (the combination of self-directed learning modules, mock consultation, and practice consultations with pilot patients was felt to be an effective learning approach, and patient information booklets supported the training package);and impact on broader clinical practice (training consolidated and refined existing OA management skills and enabled a switch to telehealth when the COVID-19 pandemic affected in-person clinical care). CONCLUSIONS: Findings provide evidence for the perceived effectiveness and acceptability of an e-learning program to train physiotherapists (in the context of a clinical trial) on best practice knee OA management, including telehealth delivery via videoconferencing. The implementation of e-learning programs to upskill physiotherapists in telehealth appears to be warranted, given the increasing adoption of telehealth service models for the delivery of clinical care.