This research report contains the findings of an international study consisting of three online ‘living’ surveys. The surveys focused on how the COVID-19 pandemic has impacted sign language interpreters’ working practices, how this was experienced by them, and how digital disruption caused by the pandemic is impacting and innovating the sign language interpreting profession. The study was carried out between April 2020 and July 2020; the largest contingent of respondents over all three surveys were from the U.S., followed by the UK, the Netherlands, Germany, Finland and Belgium. Respondents commented that the crisis will probably accelerate the need for remote interpreting training in interpreter training programs. Another resurfacing issue was the perceived need for sign language interpreting students to have face-to-face practice and live mentoring. Respondents commented on what benefits they thought remote interpreting might bring to the table, both for themselves and for deaf people. In general, the most significant benefits that were mentioned were flexibility and the possibility to improve efficiency and availability of sign language interpreting services. Notwithstanding these benefits, a significant number of respondents claimed that remote interpreting is more stressful than face-to-face interpreting and requires a heavier cognitive load.
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Background: The COVID-19 pandemic taught us how to rethink care delivery. It catalyzed creative solutions to amplify the potential of personnel and facilities. This paper presents and evaluates a promptly introduced triaging solution that evolved into a tool to tackle the ever-growing waiting lists at an academic ophthalmology department, the TeleTriageTeam (TTT). A team of undergraduate optometry students, tutor optometrists, and ophthalmologists collaborate to maintain continuity of eye care. In this ongoing project, we combine innovative interprofessional task allocation, teaching, and remote care delivery. Objective: In this paper, we described a novel approach, the TTT; reported its clinical effectiveness and impact on waiting lists; and discussed its transformation to a sustainable method for delivering remote eye care. Methods: Real-world clinical data of all patients assessed by the TTT between April 16, 2020, and December 31, 2021, are covered in this paper. Business data on waiting lists and patient portal access were collected from the capacity management team and IT department of our hospital. Interim analyses were performed at different time points during the project, and this study presents a synthesis of these analyses. Results: A total of 3658 cases were assessed by the TTT. For approximately half (1789/3658, 48.91%) of the assessed cases, an alternative to a conventional face-to-face consultation was found. The waiting lists that had built up during the first months of the pandemic diminished and have been stable since the end of 2020, even during periods of imposed lockdown restrictions and reduced capacity. Patient portal access decreased with age, and patients who were invited to perform a remote, web-based eye test at home were on average younger than patients who were not invited. Conclusions: Our promptly introduced approach to remotely review cases and prioritize urgency has been successful in maintaining continuity of care and education throughout the pandemic and has evolved into a telemedicine service that is of great interest for future purposes, especially in the routine follow-up of patients with chronic diseases. TTT appears to be a potentially preferred practice in other clinics and medical specialties. The paradox is that judicious clinical decision-making based on remotely collected data is possible, only if we as caregivers are willing to change our routines and cognitions regarding face-to-face care delivery.
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New Virtual Care Centers (VCCs) within hospitals utilize information technology to remotely monitor and support patients with chronic diseases living at home. Nurses play a crucial role by providing remote coaching and guidance to help patients manage their conditions. Currently, there is a growing understanding regarding the evolving roles and responsibilities of nurses in VCCs, however studies have yet to establish connections with educational frameworks, which poses a challenge for nursing education programs to prepare students for this emerging professional role effectively. Our study aimed to provide insights into the evolving roles, tasks, and responsibilities of nurses providing remote care as per the CanMEDS framework. We conducted a qualitative content analysis of 15 interviews. Nursing work within VCCs is represented by the seven CanMEDS roles. Most tasks align with the roles of Leader and Collaborator, while Quality Promotor has the fewest. Our study maps the responsibilities and tasks of VCCs' care delivery to the core roles of nurses.
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Virtual care centres (VCCs) are novel wards of hospitals and facilitate the provision of remote monitoring and home-based patient care by virtual care nurses. Whereas since the COVID-19 pandemic VCCs have rapidly emerged, there is a lack of insight in virtual care nurses’ work and the associated work load. Therefore, the aim of this study was to identify the nursing activities performed in Virtual Care Centers (VCCs) and assess nurses’ perceived workload associated with these activities. A multicentre descriptive, observational cross-sectional study was performed.
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Through a qualitative examination, the moral evaluations of Dutch care professionals regarding healthcare robots for eldercare in terms of biomedical ethical principles and non-utility are researched. Results showed that care professionals primarily focused on maleficence (potential harm done by the robot), deriving from diminishing human contact. Worries about potential maleficence were more pronounced from intermediate compared to higher educated professionals. However, both groups deemed companion robots more beneficiary than devices that monitor and assist, which were deemed potentially harmful physically and psychologically. The perceived utility was not related to the professionals' moral stances, countering prevailing views. Increasing patient's autonomy by applying robot care was not part of the discussion and justice as a moral evaluation was rarely mentioned. Awareness of the care professionals' point of view is important for policymakers, educational institutes, and for developers of healthcare robots to tailor designs to the wants of older adults along with the needs of the much-undervalued eldercare professionals.
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1 Maternity services across Europe during the pandemic has undergone changes to limit virus transmission; however, many changes are not evidence-based. 2 Although these changes were introduced to keep women, babies and healthcare staff safe, the exclusion of companions and the separation of mothers and babies is particularly antithetical to a human rights-based approach to quality care. 3 A poll of COST Action 18211 network members showed that inconsistency in the application of restrictions was high, and there were significant deviations from the recommendations of authoritative bodies. 4 Concerns have emerged that restrictions in practice may have longer term negative impacts on mothers and their families and, in particular, may impact on the long-term health of babies. 5 When practice changes deviate from evidence-based frameworks that underpin quality care, they must be monitored, appraised and evaluated to minimise unintended iatrogenic effects.
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Background: Recent technological developments such as wearable sensors and tablets with a mobile internet connection hold promise for providing electronic health home-based programs with remote coaching for patients following total hip arthroplasty. It can be hypothesized that such a home-based rehabilitation program can offer an effective alternative to usual care.Objective: The aim of this study was to determine the effectiveness of a home-based rehabilitation program driven by a tablet app and remote coaching for patients following total hip arthroplasty.Methods: Existing data of two studies were combined, in which patients of a single-arm intervention study were matched with historical controls of an observational study. Patients aged 18-65 years who had undergone total hip arthroplasty as a treatment for primary or secondary osteoarthritis were included. The intervention consisted of a 12-week home-based rehabilitation program with video instructions on a tablet and remote coaching (intervention group). Patients were asked to do strengthening and walking exercises at least 5 days a week. Data of the intervention group were compared with those of patients who received usual care (control group). Effectiveness was measured at four moments (preoperatively, and 4 weeks, 12 weeks, and 6 months postoperatively) by means of functional tests (Timed Up & Go test and the Five Times Sit-to Stand Test) and self-reported questionnaires (Hip disability and Osteoarthritis Outcome Score [HOOS] and Short Form 36 [SF-36]). Each patient of the intervention group was matched with two patients of the control group. Patient characteristics were summarized with descriptive statistics. The 1:2 matching situation was analyzed with a conditional logistic regression. Effect sizes were calculated by Cohen d.Results: Overall, 15 patients of the intervention group were included in this study, and 15 and 12 subjects from the control group were matched to the intervention group, respectively. The intervention group performed functional tests significantly faster at 12 weeks and 6 months postoperatively. The intervention group also scored significantly higher on the subscales "function in sport and recreational activities" and "hip-related quality of life" of HOOS, and on the subscale "physical role limitations" of SF-36 at 12 weeks and 6 months postoperatively. Large effect sizes were found on functional tests at 12 weeks and at 6 months (Cohen d=0.5-1.2), endorsed by effect sizes on the self-reported outcomes.Conclusions: Our results clearly demonstrate larger effects in the intervention group compared to the historical controls. These results imply that a home-based rehabilitation program delivered by means of internet technology after total hip arthroplasty can be more effective than usual care.Keywords: home-based rehabilitation program; internet; osteoarthritis; physiotherapy; rehabilitation; remote coaching; tablet app; total hip arthroplasty; total hip replacement; usual care.
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This article examines the impact of the COVID-19 pandemic on the sign language interpreting profession drawing on data from a fourth and final survey conducted in June 2021 as part of a series of online “living surveys” during the pandemic. The survey, featuring 331 respondents, highlights significant changes in the occupational conditions and practices of sign language interpreters due to the sudden shift towards remote video-mediated interpreting. The findings reveal a range of challenges faced by interpreters, including the complexities of audience design, lack of backchanneling from deaf consumers, the need for heightened self-monitoring, nuanced conversation management, and team work. Moreover, the study highlights the physical and mental health concerns that have emerged among interpreters as a result of the shift in working conditions, and a need for interpreters to acquire new skills such as coping with the multimodal nature of online interpreting. While the blend of remote, hybrid, and on-site work has introduced certain advantages, it also poses new challenges encompassing workload management, online etiquette, and occupational health concerns. The survey’s findings underscore the resilience and adaptability of SLIs in navigating the shift to remote interpreting, suggesting a lasting transformation in the profession with implications for future practice, training, and research in the post-pandemic era.
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Physical activity monitoring with wearable technology has the potential to support stroke rehabilitation. Little is known about how physical therapists use and value the use of wearable activity monitors. This cross-sectional study explores the use, perspectives, and barriers to wearable activity monitoring in day-to-day stroke care routines amongst physical therapists. Over 300 physical therapists in primary and geriatric care and rehabilitation centers in the Netherlands were invited to fill in an online survey that was developed based on previous studies and interviews with experts. In total, 103 complete surveys were analyzed. Out of the 103 surveys, 27% of the respondents were already using activity monitoring. Of the suggested treatment purposes of activity monitoring, 86% were perceived as useful by more than 55% of the therapists. The most recognized barriers to clinical implementation were lack of skills and knowledge of patients (65%) and not knowing what brand and type of monitor to choose (54%). Of the non-users, 79% were willing to use it in the future. In conclusion, although the concept of remote activity monitoring was perceived as useful, it was not widely adopted by physical therapists involved in stroke care. To date, skills, beliefs, and attitudes of individual therapists determine the current use of wearable technology.
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Transitions in health care and the increasing pace at which technological innovations emerge, have led to new professional approach at the crossroads of health care and technology. In order to adequately deal with these transition processes and challenges before future professionals access the labour market, Fontys University of Applied Sciences is in a transition to combining education with interdisciplinary practice-based research. Fontys UAS is launching a new centre of expertise in Health Care and Technology, which is a new approach compared to existing educational structures. The new centre is presented as an example of how new initiatives in the field of education and research at the intersection of care and technology can be shaped.
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