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2.
J Med Internet Res ; 22(9): e21561, 2020 09 30.
Article in English | MEDLINE | ID: covidwho-862666

ABSTRACT

BACKGROUND: The COVID-19 pandemic has accelerated the need for telehealth at home. Although the Department of Veterans Affairs is a leading provider of telehealth, disparities may exist in reaching older veterans living in rural areas. VA Video Connect (VVC) is a video conferencing app that enables veterans to connect with their health care provider via a secure and private session. OBJECTIVE: The aim of this study was to examine the capability and willingness of older veterans to participate in a VVC visit during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted on older veterans (N=118) at the Central Arkansas Veterans Healthcare System. Participants were interviewed over the phone and responses to the following items were recorded: availability of internet, email, and an electronic device with a camera; veterans' willingness to complete an appointment via a VVC visit; and availability of assistance from a caregiver for those who were unable to participate in a VVC visit alone. RESULTS: Participants' mean age was 72.6 (SD 8.3) years, 92% (n=108) were male, 69% (n=81) were Caucasian, 30% (n=35) were African Americans, and 36% (n=42) lived in a rural location. The majority reported having access to the internet (n=93, 77%) and email service (n=83, 70%), but only 56% (n=67) had a camera-equipped device. Overall, 53% (n=63) were willing and capable of participating in a VVC visit. The availability of internet access was significantly lower in rural compared to nonrural participants (P=.045) and in those with or less than a high school education compared to those who pursued higher education (P=.02). Willingness to participate in the VVC visit was significantly lower in rural compared to nonrural participants (P=.03). Of the participants who reported they were able and willing to partake in a VVC visit (n=54), 65% (n=35) opted for VVC and 35% (n=19) preferred a phone visit. In total, 77% (n=27) of the scheduled VVC visits were successful. CONCLUSIONS: Despite advances in technology, and willingness on the part of health care systems, there are some lingering issues with capability and willingness to participate in video telehealth visits, particularly among older adults residing in rural areas.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Rural Health/statistics & numerical data , Telemedicine , Veterans/psychology , Veterans/statistics & numerical data , Videoconferencing , Aged , Appointments and Schedules , Arkansas/epidemiology , Caregivers , Cross-Sectional Studies , Delivery of Health Care , Electronic Mail , Female , Humans , Male , Middle Aged , Pandemics
3.
Orthopedics ; 43(5): 292-294, 2020 Sep 01.
Article in English | MEDLINE | ID: covidwho-693528

ABSTRACT

The COVID-19 pandemic has had a strong impact on the care of orthopedic patients. This impact has been particularly difficult in New York State, which experienced the largest number of COVID-19 cases and led to a state- mandated pause on all elective surgeries. As a result, physical and occupational therapists became the principal providers of care and had to adjust their workflow to ensure quality care. Understanding the perspectives and needs of therapists relative to the circumstances created by COVID-19 is critical to safe and effective care. The goal of this study was to define the perspectives of therapists in New York State regarding the impact of COVID-19 on their work. An email-based 20-question survey was distributed to 250 therapists from all 10 regions of New York State who treated outpatient orthopedic patients during the peak of the pandemic in early April 2020. The survey collected demographic and practice information as well as responses regarding several clinical practice issues. The results provide insight into the concerns of therapists regarding the delivery of care, and responses clarify indications for therapy and for the use of telemedicine to achieve goals during the pandemic. The COVID-19 pandemic is profoundly impacting the work of therapists worldwide. Therapists responded to this survey expressing concerns about the safe delivery of care, access to personal protective equipment, use of telemedicine, and their role within health care during the pandemic. The results of this study can be used to establish guidelines for safe, effective, and efficient therapy during the pandemic. [Orthopedics. 2020;43(5):292-294.].


Subject(s)
Attitude of Health Personnel , Coronavirus Infections/epidemiology , Orthopedic Procedures/rehabilitation , Orthopedics/trends , Outpatients , Physical Therapy Specialty/trends , Pneumonia, Viral/epidemiology , Telerehabilitation/trends , Betacoronavirus , Elective Surgical Procedures/rehabilitation , Electronic Mail , Humans , New York/epidemiology , Occupational Exposure , Occupational Therapy , Pandemics , Personal Protective Equipment , Surveys and Questionnaires , Telerehabilitation/statistics & numerical data
4.
Am J Geriatr Psychiatry ; 28(10): 1020-1024, 2020 10.
Article in English | MEDLINE | ID: covidwho-664900

ABSTRACT

OBJECTIVE: To explore older people's use of the Internet for coping with stress posed by the COVID-19 pandemic. METHODS: An online survey with a random sample of 407 Internet users aged 60 years and over (Mean = 69.14). RESULTS: Participants reported a significant increase in 7 of 12 Internet-based functions following the pandemic onset. Stress levels were moderate-to-high and participants appeared more worried about others than about themselves. Significant positive associations were found between stress and increase in Internet use for interpersonal communication and online errands. Linear regression analysis revealed a significant negative association between stress and subjective wellbeing, but it was only increased Internet use for leisure that associated significantly with enhanced wellbeing. CONCLUSION: The changes in Internet use clearly reflected coping efforts that were apparently ineffective in enhancing wellbeing. Paradoxically, the only online functions that could improve wellbeing, Internet use for leisure, are precisely those whose use hardly increased.


Subject(s)
Adaptation, Psychological , Commerce , Communication , Coronavirus Infections/epidemiology , Internet/statistics & numerical data , Leisure Activities , Pneumonia, Viral/epidemiology , Stress, Psychological , Aged , Aged, 80 and over , Betacoronavirus , Electronic Mail , Female , Humans , Israel/epidemiology , Linear Models , Male , Middle Aged , Online Social Networking , Pandemics , Surveys and Questionnaires
5.
Recenti Prog Med ; 111(6): 357-367, 2020 06.
Article in Italian | MEDLINE | ID: covidwho-612961

ABSTRACT

The global emergency caused by the SARS-CoV-2 pandemic has suddenly changed how we communicate with families in all the CoViD-19 care settings, due to the obligation to maintain complete social isolation. Healthcare workers are isolated from their families, and must manage the consequences of this isolation just like the patients. They and their families perceive the personal attitudes, closeness and psychological support from the care teams. This perception of genuine participation by the healthcare workers during isolation is especially important when a patient dies, and it may influence the process of grief. This document is intended for all healthcare professionals caring for CoViD-19 patients, particularly those in more severe clinical conditions and it is aimed to help the care team to communicate with families distanced from the patient. The document consists of three parts: 1) presentation of the statements for communicating with patients family members during isolation; 2) discussion of key points as a theoretical framework for the statements; 3) instructions for telephone communication, with a checklist and a worksheet. The document was written by authors from different disciplines (doctors, nurses, psychologists, legal experts) and was then reviewed by a group of experts comprising professionals, people who have experienced ICU hospitalization, and their families. Finally, the document was approved by the National Boards of the Italian Society of Anesthesia and Intensive Care (SIAARTI), Italian Association of Critical Care Nurses (Aniarti), Italian Society of Emergency Medicine (SIMEU), and Italian Society of Palliative Care (SICP).


Subject(s)
Betacoronavirus , Communication , Coronavirus Infections , Pandemics , Patient Isolation , Pneumonia, Viral , Professional-Patient Relations , Social Isolation , Attitude of Health Personnel , Checklist , Communication Barriers , Confidentiality , Electronic Mail , Family Relations , Health Personnel/psychology , Humans , Interdisciplinary Communication , Patient Care Team , Patient Preference , Professional-Family Relations , Social Isolation/psychology , Social Support , Telephone , Truth Disclosure
6.
J Med Internet Res ; 22(5): e19128, 2020 05 06.
Article in English | MEDLINE | ID: covidwho-186485

ABSTRACT

BACKGROUND: During the coronavirus disease (COVID-19) pandemic, governments issued movement restrictions and placed areas into quarantine to combat the spread of the disease. In addition, individuals were encouraged to adopt personal health measures such as social isolation. Information regarding the disease and recommended avoidance measures were distributed through a variety of channels including social media, news websites, and emails. Previous research suggests that the vast amount of available information can be confusing, potentially resulting in overconcern and information overload. OBJECTIVE: This study investigates the impact of online information on the individual-level intention to voluntarily self-isolate during the pandemic. Using the protection-motivation theory as a framework, we propose a model outlining the effects of cyberchondria and information overload on individuals' perceptions and motivations. METHODS: To test the proposed model, we collected data with an online survey (N=225) and analyzed it using partial least square-structural equation modeling. The effects of social media and living situation were tested through multigroup analysis. RESULTS: Cyberchondria and information overload had a significant impact on individuals' threat and coping perceptions, and through them on self-isolation intention. Among the appraisal constructs, perceived severity (P=.002) and self-efficacy (P=.003) positively impacted self-isolation intention, while response cost (P<.001) affected the intention negatively. Cyberchondria (P=.003) and information overload (P=.003) indirectly affected self-isolation intention through the aforementioned perceptions. Using social media as an information source increased both cyberchondria and information overload. No differences in perceptions were found between people living alone and those living with their families. CONCLUSIONS: During COVID-19, frequent use of social media contributed to information overload and overconcern among individuals. To boost individuals' motivation to adopt preventive measures such as self-isolation, actions should focus on lowering individuals' perceived response costs in addition to informing them about the severity of the situation.


Subject(s)
Communicable Disease Control , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Health Education , Internet , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Self Efficacy , Social Media , Adaptation, Psychological , Betacoronavirus , Coronavirus Infections/psychology , Coronavirus Infections/transmission , Cross-Sectional Studies , Electronic Mail/supply & distribution , Humans , Intention , Motivation , Pneumonia, Viral/psychology , Pneumonia, Viral/transmission , Quarantine/psychology , Self Care/psychology , Social Media/supply & distribution , Surveys and Questionnaires
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