ABSTRACT
BACKGROUND: Preoperative medical evaluation serves to identify risk factors and optimize patients before surgery. Providing a telehealth option in the perioperative setting has played a significant role in reducing barriers to quality perioperative health care. OBJECTIVE: We aimed to evaluate how telemedicine preoperative evaluations using Clinical Video Telehealth (CVT) impact hospital length of stay. METHODS: We performed a retrospective chart review between 2016 and 2017 of adult patients who underwent evaluations in our hospitalist-run preoperative medicine clinic. Patients seen in our preoperative CVT program were compared to patients seen in person to evaluate the association of visit type (preoperative CVT versus in-person evaluation) with hospital length of stay, defined as hospital stay from postoperative day 0 to discharge. There were 62 patients included in this retrospective study. RESULTS: The adjusted incidence rate ratio (IRR) for hospital length of stay was significantly shorter in patients who underwent preoperative CVT compared to an in-person visit (IRR 0.52, 95% CI 0.29-0.92, P=.02). CONCLUSIONS: After adjusting for age and comorbidities, we show that preoperative telemedicine in the perioperative setting is associated with a shorter hospital length of stay compared to in-person visits. This suggests that telemedicine can play a viable role in this clinical setting.
ABSTRACT
Telesupervision is an increasingly common practice in health service psychology training, particularly due to the COVID-19 pandemic. However, little is known about important considerations that may inform the long-term adoption of telesupervision, including its acceptability among trainees, the impact of technology-mediated supervision on critical variables such as the supervisory working alliance, and whether established supervisory best practices can be effectively employed in a telehealth format. The present study provides qualitative and quantitative data on trainee perceptions of telesupervision among a sample of 144 health service psychology students engaged in either telesupervision or hybrid supervision combining telesupervision with in-person meetings within university training clinics in the United States. Trainees completed questionnaires rating supervisory working alliance, metacommunication, quality of supervision, the identified supervisor's use of best practices, and perceptions of COVID-19 danger as well as provided qualitative responses to three open-ended questions exploring expectations around telesupervision as well as perceived advantages and disadvantages. Findings suggest that trainees find telesupervision to be highly acceptable, with over 90% of participants reporting that it met or exceeded their expectations. Ratings of critical variables such as supervisory working alliance, metacommunication, and engagement in best practices generally did not differ between the hybrid and telesupervision groups, nor were these results affected by supervision format (i.e., individual vs. group) or trainee developmental level. Unique benefits and limitations of telesupervision were highlighted. Overall, results suggest that telesupervision is a highly acceptable and beneficial tool in health service psychology training. Considerations for the ongoing use of telesupervision are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement Health service psychology trainees find telesupervision to be highly acceptable and report strong supervisory alliances, effective engagement in metacommunication, and utilization of supervisory best practices via telehealth. The widely recommended practice of incorporating at least some in-person meetings was not associated with higher trainee ratings of supervision. Findings suggest that trainees across developmental levels may benefit from telesupervision as an alternative to in-person supervision, which may ultimately increase access to high-quality clinical supervision. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
Background: The study aims to explore the mental health of the hotline callers during the COVID-19 pandemic in China. Methods: Callers (N = 10,490) from the Beijing Psychological Support Hotline from January 21st to June 30th in 2019 and 2020 were enrolled and divided into two groups (during (2020) and before (2019) COVID-19 pandemic). The severity of depressive symptoms, psychological distress, hopefulness, and suicidal ideation (SI) was assessed. Demographic characteristics and major concerns were also collected. Mann-Whitney U and chi-square test were used to compare the differences in mental health conditions and major concerns between two years and between different age groups. The multivariable logistic regression was used to explore whether mental health conditions were associated with pandemic and demographic factors. Results: Results from multivariable logistic regression analysis indicated that the change in suicidal ideation (OR = 1.52, 95% CI: 1.21-1.92) was significantly different across age groups. Callers during the pandemic reported a higher level of hopefulness (OR = 1.13, 95% CI [1.03-1.24]), a lower level of depressive symptoms (OR = 0.81, 95% CI [0.74-0.89]) and psychological distress (OR = 0.89, 95% CI [0.81-0.98]), and were less likely to report SI (OR = 0.69, 95% CI [0.61-0.77]) compared with callers before the pandemic. Conclusions: Compared with callers before the pandemic, hotline callers during the early stage of COVID-19 pandemic did not present significant mental health problems. Younger callers during the pandemic were more vulnerable for the presence of suicidal ideation. Hotline-based crisis interventions might provide specific psychological support to cope with troubles during the pandemic.
ABSTRACT
Background: To compare the characteristics between hotline callers with and without the Coronavirus Disease 2019 (COVID-19) related psychological problems. Methods: From January 25 to March 31, 2020, 581 callers with COVID-19 related psychological problems (COVID-19 callers) and 695 callers without COVID-19 related psychological problems (non-COVID-19 callers) to the Beijing Psychological Support Hotline were recruited. The demographic characteristics, primary concerns, suicidal ideation, depression and other psychological problems were compared between the two groups of callers. Results: Both groups of the callers were predominantly female and highly educated. The primary concerns reported by the COVID-19 callers were depression (38.4%) and family relationship problems (26.0%). As compared to the non-COVID-19 callers, COVID-19 callers reported more financial (7.4%) and work related problems (4.1%), but revealed lower prevalence of suicidal ideation (47.9% v 71.3%), lower degrees of psychological distress (74.3 v 79.1), intensity of suicidal ideation (0 v 50), severity of depression (57.9 v 65.1), and higher degree of hopefulness (41.1 v 33.6) (all p values < 0.01). Additionally, a lower proportion of COVID-19 callers met the criteria of depressed mood (51.6% v 61.4%) and other 4 symptoms than the non-COVID-19 callers (p values < 0.01). Conclusions: Based on the content of the primary concerns and the relatively low level of depression of the COVID-19 callers, the psychological intervention for them during the pandemic should focus on "psychological supports." Coping strategies for daily life stressors and promotion of scientific knowledge about the pandemic should also be included in the hotline-related interventions.