Telepsychiatry and patient-provider concordance.

CONTEXT: Telepsychiatry has become a common modality for the provision of psychiatric consultations to patients in rural regions. AIMS: The aims of this study were to assess and compare patient and provider satisfaction and perceptions of access to care with telepsychiatry. METHODS: Telepsychiatric consultations were given by providers based on an urban tertiary academic health centre to patients located in rural primary care clinics. RESULTS: Patients (n = 110) and providers (n = 10) were both highly satisfied with telepsychiatry and both believed that telepsychiatry provided patients with better access to care. Paired patient and provider survey results demonstrated a high level of concordance between patients and provider responses. CONCLUSIONS: Concordance between patient and provider satisfaction may contribute to adherence and positive treatment outcomes. These results provide support for the use of telepsychiatry consultations to improve patient access to psychiatric care in rural regions.

Contexte: La télépsychiatrie est maintenant une modalité courante de prestation de services psychiatriques aux patients vivant en régions rurales. Objectifs: Cette étude avait pour objectif d'évaluer et de comparer la satisfaction et la perception des patients et des fournisseurs de soins quant à l'accès aux soins par l'entremise de la télépsychiatrie. Méthodes: Des consultations de télépsychiatrie dans un centre universitaire de santé tertiaire en milieu urbain ont été dispensées à des patients situés dans des cliniques de première ligne en milieu rural. Résultats: Les patients (n = 110) et fournisseurs de soins (n = 10) étaient très satisfaits de la télépsychiatrie et croyaient dans les deux cas qu'elle donnait aux patients un meilleur accès aux soins. Les résultats jumelés à une enquête auprès des patients et des fournisseurs de soins ont démontré une grande concordance entre les réponses des patients et celles des fournisseurs de soins. Conclusions: La concordance entre la satisfaction des patients et celle des fournisseurs de soins pourrait favoriser l'observance et des résultats thérapeutiques positifs. Ces résultats appuient le recours aux consultations de télépsychiatrie pour améliorer l'accès aux soins psychiatriques en régions rurales. Mots-clés: Accès aux soins, satisfaction des patients, satisfaction des fournisseurs, rural, télépsychiatrie.

Using behavior change frameworks to improve healthcare worker influenza vaccination rates: A systematic review.

BACKGROUND: Influenza vaccination of healthcare workers (HCW) is important for protecting staff and patients, yet vaccine coverage among HCW remains below recommended targets. Psychological theories of behavior change may help guide interventions to improve vaccine uptake. Our objectives were to: (1) review the effectiveness of interventions based on psychological theories of behavior change to improve HCW influenza vaccination rates, and (2) determine which psychological theories have been used to predict HCW influenza vaccination uptake. METHODS: MEDLINE, EMBASE, CINAHL, PsycINFO, The Joanna Briggs Institute, SocINDEX, and Cochrane Database of Systematic Reviews were searched for studies that applied psychological theories of behavior change to improve and/or predict influenza vaccination uptake among HCW. RESULTS: The literature search yielded a total of 1810 publications; 10 articles met eligibility criteria. All studies used behavior change theories to predict HCW vaccination behavior; none evaluated interventions based on these theories. The Health Belief Model was the most frequently employed theory to predict influenza vaccination uptake among HCW. The remaining predictive studies employed the Theory of Planned Behavior, the Risk Perception Attitude, and the Triandis Model of Interpersonal Behavior. The behavior change framework constructs were successful in differentiating between vaccinated and non-vaccinated HCW. Key constructs identified included: attitudes regarding the efficacy and safety of influenza vaccination, perceptions of risk and benefit to self and others, self-efficacy, cues to action, and social-professional norms. The behavior change frameworks, along with sociodemographic variables, successfully predicted 85-95% of HCW influenza vaccination uptake. CONCLUSION: Vaccination is a complex behavior. Our results suggest that psychological theories of behavior change are promising tools to increase HCW influenza vaccination uptake. Future studies are needed to develop and evaluate novel interventions based on behavior change theories, which may help achieve recommended HCW vaccination targets.

Increasing public awareness about hepatitis C: development and validation of the brief hepatitis C knowledge scale.

Hepatitis C virus (HCV) is silently becoming a major public health problem. Currently, no validated HCV knowledge measures exist. This study aimed to develop and validate a brief measure to assess general knowledge about HCV risk factors, modes of transmissions, and treatment options. A total of 406 individuals participated in this cross-sectional study. All participants completed the proposed 19-item Brief HCV Knowledge Scale. Participants were: HCV mono-infected patients (n = 83), HCV-human immunodeficiency virus (HIV) co-infected patients (n = 24), HIV mono-infected patients (n = 128) community healthcare workers (n = 89), and college students (n = 82). Two-week test-retest data were collected for the college student sample. Psychometric evaluation of the proposed scale demonstrated high levels of validity (content and construct validity) and reliability (internal consistency and retest stability). Factor analysis indicated a one-factor solution, which accounted for 49% of the variance. HCV knowledge was positively correlated with length of time since HCV diagnosis (r = 0.29, p < 0.05). HCV treatment-experienced patients obtained significantly higher HCV knowledge scores (82% correct) than HCV treatment-naïve patients (72% correct) (p < 0.05). HCV knowledge in College students (43% correct) and HIV patients (54% correct) was significantly lower than in HCV patients (77% correct) and community healthcare workers (80% correct) (p < 0.001). Community workers' HCV knowledge was positively correlated with years of HCV work experience (r = 0.30, p < 0.01). This self-administered Brief HCV Knowledge scale has high levels of validity and reliability across patient, healthcare provider and college student populations. It has valuable applications as a clinical teaching tool with patients and healthcare providers and could be used as an outcome indicator in novel HCV educational intervention studies.