Patient's perspectives of treatment satisfaction and efficiency of the 2:1 clinical education model in physical therapy rehabilitation

Managing clinical education placements in physical therapy and physical therapy assistant programs continue to evolve to meet the needs of accredited programs (Commission on Accreditation in Physical Therapy Education [CAPTE], 2021b). The onset of COVID-19, the increased market demand, and the rise of more universities' program growth in physical therapy created a need for increased clinical placements. The 2:1 model has the potential to increase available placements. However, the implementation is slow due to resistance and obstacles. The 2:1 clinical model differs from the 1:1 model because it adds another student in the clinical experience for the clinical instructor;therefore, one clinical instructor mentors two students simultaneously. Research on the 2:1 model explored the viewpoints of clinical instructors, students,academia, and clinical site coordinators and lacked patient perspectives. This qualitative multiplecase study included an exploration of the patient's perspective of treatment satisfaction and efficiency of the 2:1 clinical education model. Reflexive thematic analysis, RA, was the method applied to the data obtained through semi-structured interviews. RA uses an inductive approach in qualitative studies for healthcare research without a predetermined set of codes or a codebook(Braun et al., 2021, 2014). Kotter's Change Management Model, KCMM, was the theoretical framework for this study. The first step is to create a sense of urgency, accomplished by the COVID-19 pandemic, market demand, and an increase in physical therapy and physical therapist university programs. This study focused on the second step, which is to create a guiding coalition of all the stakeholders. Obtaining patient perspectives was essential, as it was missing from previous research. Patients are the stakeholders who are usually the primary stakeholder for quality control in healthcare. The positive results of this study about satisfaction and effectiveness of the 2:1 model were from seven participants of diverse ages, locations, treatment settings, and diagnoses and supported 2:1 model in physical therapy and physical therapist assistant clinical education. By gaining insight from a primary stakeholder contributed to the gap in the literature and supported implementing a change initiative for the 2:1 model. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Telehealth satisfaction amidst the COVID-19 pandemic

The COVID-19 pandemic caused substantial disruptions and changes in mental health service delivery as community mental health clinics had to scramble to implement telehealth services to provide continuity of care under quarantine. For the current study, I conducted in-depth video interviews with ten clients from a community mental health training clinic who transitioned from in-person services to telehealth services. Twenty-one factors related to clients' satisfaction with telehealth services and their perceived barriers to the treatment modality using a grounded theory framework. The majority of participants reported they were satisfied with telehealth but preferred to return to in-person therapy sessions with supplemental telehealth services as needed. Various benefits of telehealth were noted throughout the interviews, including increased ease of access, convenience, and having means of personal comfort during session (e.g., pets, musical instruments, etc.). Participants also identified ways in which telehealth can create barriers to effective therapy, such as privacy concerns, distractions, and technology challenges. Nine guidelines to enhance the effectiveness of telehealth services in the future are provided based on data collected in these interviews. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Older adults access to mental health and social care services during COVID-19 restrictions in Western Australia

Objective: This study aimed to understand the impact of COVID-19 on access to mental health and social services among older adults in Western Australia. Method: A cross-sectional study was conducted with 194 adults aged >=70 years or >=60 years with chronic conditions. A questionnaire co-developed by a consumer reference group was used to collect data on social networks and service access. Frequency analyses were used to assess quantitative data. Qualitative data were assessed using thematic analyses. Results: 62.7% of participants reported being not at all/slightly affected by COVID-19;40.7% reported having three/four people to chat with. 76.3% of participants did not access mental health or social services during the 2020 COVID-19 restrictions. The remaining 23.7% mostly accessed mental health-related services, with GPs the most common source of support. 18.0% of the total sample reported choosing not to access services even though they would have liked to. Conclusions: Most older adults in this sample did not access mental health or social care services. 18.0% of all participants felt they needed services but did not access them. This suggests there were some unmet needs within the community. Strengthening social networks may help protect older adults against psychosocial declines during and post-COVID-19. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Patient and professional experiences with virtual antenatal clinics during the COVID-19 pandemic in a UK tertiary obstetric hospital: Questionnaire study

Background: The COVID-19 pandemic required rapid implementation of virtual antenatal care to keep pregnant women safe. This transition from face-to-face usual care had to be embraced by patients and professionals alike. Objective: We evaluated patients'and professionals' experiences with virtual antenatal clinic appointments during the COVID-19 pandemic to determine satisfaction and inquire into the safety and quality of care received. Methods: A total of 148 women who attended a virtual antenatal clinic appointment at our UK tertiary obstetric care center over a 2-week period provided feedback (n=92, 62% response rate). A further 37 health care professionals (HCPs) delivering care in the virtual antenatal clinics participated in another questionnaire study (37/45, 82% response rate). Results: We showed that women were highly satisfied with the virtual clinics, with 86% (127/148) rating their experience as good or very good, and this was not associated with any statistically significant differences in age (P = .23), ethnicity (P = .95), number of previous births (P = .65), or pregnancy losses (P = .94). Even though 56% (83/148) preferred face-to-face appointments, 44% (65/148) either expressed no preference or preferred virtual, and these preferences were not associated with significant differences in patient demographics. For HCPs, 67% (18/27) rated their experience of virtual clinics as good or very good, 78% (21/27) described their experience as the same or better than face-to-face clinics, 15% (4/27) preferred virtual clinics, and 44% (12/27) had no preference. Importantly, 67% (18/27) found it easy or very easy to adapt to virtual clinics. Over 90% of HCPs agreed virtual clinics should be implemented long-term. Conclusions: Our study demonstrates high satisfaction with telephone antenatal clinics during the pandemic, which supports the transition toward widespread digitalization of antenatal care suited to 21st-century patients and professionals. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Exploring the association among provider-patient relationship, communication, accessibility and convenience, and perceived quality of care from the perspective of patients living with HIV before and during SARS-CoV-2 pandemic

Globally, 37.8 million people were living with human immunodeficiency virus and acquire immunodeficiency syndrome (HIV/AIDS) in 2018, with 1.7 million new cases reported and 57% receiving antiretroviral therapies. Nearly 76,000,000 people have been diagnosed with HIV and an estimated 33,000,000 people have died of HIV/AIDS since the beginning of the epidemic. The focus of this research was to investigate the perspective of persons living with HIV in respect to their relationship with their provider, provider communication, accessibility, and their perceived quality of care before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic using a cross-sectional quantitative analysis. This cross-sectional quantitative study was conducted to ascertain whether a relationship exists between provider patient relationship, communication, accessibility and convenience, and perceived quality of care from the perspective of patients living with HIV before and during the SARS-CoV-2 pandemic using a regression analysis. Fifty-eight individuals participated in the study and their responses were anonymous. The study was guided by a patient-centered care model as an approach to inform health care providers who are providing services in HIV care. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Perceptions and experiences toward extended-release buprenorphine among persons leaving jail with opioid use disorders before and during COVID-19: An in-depth qualitative study

Background: Extended-release buprenorphine (XRB) offers a novel approach to sustained monthly treatment for people who use opioids in criminal justice settings (CJS). This study explores the experiences of adults receiving XRB as a jail-to-community treatment. Methods and findings: In-depth qualitative interviews were conducted among adult participants with opioid use disorder (OUD;n = 16) who were recently released from NYC jails and maintained on XRB after switching from daily sublingual buprenorphine (SLB). Interviews elaborated on the acceptability and barriers and facilitators of XRB treatment pre- and post-release. Interviews were audio recorded, transcribed, and analyzed for content related to factors influencing XRB treatment uptake and community reentry. Important themes were grouped into systems, medication, and patient-level factors. Key systems-level factors influencing initiation of XRB in jail included an alternative to perceived stigmatization and privacy concerns associated with daily in-jail SLB administration and less concerns with buprenorphine diversion. In-jail peer networks positively influenced participant adoption of XRB. XRB satisfaction was attributed to reduced in-jail clinic and medication administration visits, perceived efficacy and blockade effects upon the use of heroin/fentanyl following release, and averting the risk of criminal activities to fund opioid use. Barriers to retention included post-injection withdrawal symptoms and cravings attributed to perceived suboptimal medication dosing, injection site pain, and lack of in-jail provider information about the medication. Conclusion: Participants were generally favorable to XRB initiation in jail and retention post-release. Further studies are needed to address factors influencing access to XRB in criminal justice settings, including stigma, ensuring patient privacy following initiation on XRB, and patient-, provider-, and correctional staff education pertaining to XRB. Trial Registration: ClinicalTrials.gov Identified: NCT03604159. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Telemental health uptake in an outpatient clinic for veterans during the COVID-19 pandemic and assessment of patient and provider attitudes

This study aimed to (a) describe the process of rapid uptake of telemental health in an outpatient mental health clinic for veterans and their family members during the coronavirus disease 2019 (COVID-19) pandemic and (b) present patient and provider attitudes about telemental health. Virtual visit (video and phone) trends for this clinic are described over the 8 weeks pre- and post-COVID-19 closure. As part of a quality improvement initiative over a subsequent 2-week period, 147 patient visits (127 unique individuals), and 24 mental health providers who were part of a multidisciplinary team were eligible to complete an anonymous self-report satisfaction survey immediately after a telehealth session. Prior to the COVID-19 closure, the clinic averaged 112.75 completed visits per week, with virtual visits accounting for less than 5% of all appointments. In the second month after closure, the clinic averaged 153.75 completed visits per week (36.36% increase in volume), with virtual visits accounting for 100% of visits (42% phone, 58% video). The proportion of video compared to telephone visits increased pre to postclosure. The no-show rate significantly decreased pre to postclosure (10.87% vs. 15.01%, resp., chi2 = 17.81, p < .001). Patient and provider satisfaction with telemental health were high. Prospectively, most patients (83.56%) expressed preference for televisits-only or televisits combined with in-person visits. Patients and providers were satisfied with telemental health. Convenience was an oft-cited advantage by both patients and providers. Telemental health may represent a cost-effective solution to mental health care access during and beyond COVID-19. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement Rapid and wide-spread uptake of telemental health in an outpatient clinic serving veterans and military service members was feasible and deemed satisfactory to patients and providers. Telemental health was associated with lower no-show rates. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The empowering role of hospitable telemedicine experience in reducing isolation and anxiety: Evidence from the COVID-19 pandemic

Purpose: This paper aims to explore how hospitable telemedicine services empowered patients during the COVID-19. Expanding from the technology aspect, this research integrated the philosophy of hospitality organizational culture by including factors related to human-human interaction as significant predictors for patients' sense of empowerment (perceived competence and control) in coping with their emotional stress (anxiety and isolation). Design/methodology/approach: Survey data were obtained from 409 general consumers who have used video-based virtual consultation since February 2020. Stepwise multiple regression and simple linear regression analyses were used for hypotheses testing. Findings: The results reveal that the doctors' reliability, responsiveness and empathy significantly predict patients' perceived competence and control. Perceived usefulness and convenience of telemedicine technology enhance patients' perceived competence and control. Patients' sense of empowerment significantly reduces their anxiety and sense of isolation. Research limitations/implications: To fully understand the role of hospitality in people's telemedicine experiences, future studies are encouraged to not only examine the patients-clinicians interactions but also explore the patients-support staff interactions. Practical implications: Health care providers' "bed-side" manners empower patients in managing their emotional stress. Health care providers should be trained for their empathetic ability and communication skills. Strategies such as collaborating with hospitality schools and business schools can be implemented to help build medical student's patient-centric attitudes and skills. Originality/value: This paper provided empirical evidence for the value of hospitality in health care and offered useful suggestions for health care providers, especially by empowering vulnerable people during catastrophic events such as COVID-19. (PsycInfo Database Record (c) 2021 APA, all rights reserved)