Video Consultations Research Articles

Video consultations among registered nurses in public sector and associated factors

Abstract Background In digital health services, including services for older people, video consultations can enhance access to care while enabling interaction through audio and visual means. Registered nurses are pivotal in digital care delivery and there is a need for more understanding regarding the use of video consultations in nursing. This study aims to examine factors associated with nurses’ video consultations in the public sector. Methods The Finnish ‘Survey on information systems for registered nurses’ was delivered for registered nurses in March 2023. The respondents were asked whether their work had included video consultations in the past six months. Binary logistic regression was used to examine if career stage and digital skills (basic IT-skills, proficiency in data security, skills in digital working environments) were associated with nurses’ video consultations, adjusted for working unit and location of employment. Results The study included 2,525 public sector nurses (92.7% female, mean age 47.34, SD 10.47). Of them, twelve percent had used video consultations with patients. Most nurses used video consultations in outpatient units (63.3%), whereas they were less used among those working in acute care (3.3%), housing services (3.3%) and home-based services (8.2%). Early-career nurses had lower odds (OR .38, 95% CI .19-.73) of video consultations compared to mid-career nurses. Nurses who had good skills in working in digital environments (OR 2.07, 95% CI 1.26-3.39) had greater odds of video consultations than those with poorer skills. Conclusions The study suggests a limited adoption of video consultations among public sector nurses, particularly among early-career professionals. Increasing targeted support and training, and the availability of tools for various patient service needs in video consultations, are needed. By recognizing the importance of nurses’ digital skills, digital care delivery could be enhanced and potential public health benefits promoted. Key messages • Relatively few registered nurses used video consultations in the public sector. More research is needed to explore if their usage could be increased safely for patients, also in early nursing careers. • Proficiency in digital work environments is imperative for ensuring the quality of care in video consultations. Therefore, collaborative efforts are required to enhance professionals’ digital skills.

STI/HIV care in times of COVID-19 according to Dutch healthcare professionals: A mixed methods study

Abstract Background Surveillance data from the Netherlands show that STI/HIV testing decreased at the start of the COVID-19 pandemic, suggesting barriers in access to STI/HIV care. However, the impact of the pandemic on STI/HIV care may be more complex, and key populations could be differentially affected. The aim of this study was to gain more insight into the impact of COVID-19 on STI/HIV care in the Netherlands from the perspective of STI/HIV care providers. Methods We investigated whether professionals in STI/HIV care experienced changes compared to pre-COVID in access to care, demand and provision of care, shifts online care, and quality of care. An online survey was completed by 192 STI/HIV care professionals. Additionally, semi-structured interviews were held with 23 STI/HIV care professionals. Results According to participants, specific subgroups of priority populations may have had difficulties accessing STI/HIV care during the pandemic especially during lockdowns and at public sexual health services. Professionals were concerned to have lost sight of subpopulations in vulnerable circumstances and that the pandemic may have magnified inequalities in access to STI/HIV care, which may be related to different levels of health and digital literacy required for telephone and video consultations. Furthermore, participants found online care provision was not up to standards and were concerned about follow-up care for patients using private online providers of remote tests. Conclusions Professionals experienced that COVID-19 measures may have compounded existing disparities. To minimize inequalities in access to STI/HIV care during a pandemic, it is recommended to prioritize services for people in vulnerable circumstances such as recent migrants and people with low health or digital literacy. More collaboration between and within sectors may help in better organizing healthcare and prevent overburdening of specific sectors. Key messages • According to STI/HIV care providers, the COVID-19 pandemic differentially impacted different STI/HIV care sectors, but also increased existing inequalities in access to care for vulnerable groups. • Professionals experienced that COVID-19 measures impacted the provision of STI/HIV care, access to care for vulnerable populations, and quality of care.

Engagement of adults with congenital heart disease in research: overcoming barriers relating to social deprivation

Abstract Background In adult congenital heart disease (ACHD), social deprivation is associated with adverse health outcomes, such as increased inpatient admissions and major adverse cardiovascular events (1). Research studies on this topic often rely on patients engaging with surveys, and the characteristics of non-respondents in relation to social deprivation remain unknown. Purpose We assessed the association between social deprivation and response to a research survey in the ACHD population. Methods We included all individuals in the UK who were invited to participate in the APPROACH-IS II study (2), which assessed patient-reported outcomes in ACHD. A validated index of relative deprivation was derived from household postcodes, based on the 2019 Index of Multiple Deprivation (IMD) scores for geographic units in England (3). A lower IMD decile indicates a greater degree of deprivation. We compared patient engagement rates between 2 centres utilising different recruitment approaches: a Southern centre (South) relying on recruitment during mainly telephone or video consultations, and a Northern centre (North) recruiting patients during face-to-face clinic appointment, with the help of an ACHD clinical and research nurse specialist. Results In total, 593 patients were asked to take part in APPROACH-IS II in the UK: 324 patients from the Southern centre and 269 patients from the Northern centre, of whom 130(40.1%) and 209(77.7%) responded, respectively (p<0.0001). In the South, patients approached were homogeneously spread amongst IMD deciles (6.0[4.0-9.0]) and respondents were significantly less deprived (higher IMD decile) than non-respondents (7.0[5.0-9.0] vs 6.0[4.0-8.0], p=0.02). Indeed, the response rate in areas of higher deprivation (IMD decile<=4) was significantly lower than in the least deprived areas (IMD >=8) (31.3% vs 47.0%, p=0.03). In the North, the distribution of deprivation in patients was skewed towards lower IMD deciles, with a significantly higher proportion of patients from areas of higher deprivation (Figure A, 26 vs 99(30.6%) in the South, p<0.0001). There was no difference in IMD decile between respondents and non-respondents in the North (Figure B, 5.0[2.0-7.0] vs 4.0[2.0-7.0], p=0.26). When comparing patients living in the most deprived areas (IMD <=4), there was a large and significant difference in response rate between centres (p<0.0001). Conclusions In our population, deprivation appears to have a significant impact on the likelihood of patients engaging with clinical research. An enhanced approach, involving face-to-face contact and the involvement of a dedicated clinical nurse specialist, can improve recruitment to research studies and abolish the effect of socioeconomic status on patient engagement.Figure 1A and B

The Impact of International Classification of Disease-Triggered Prescription Support on Telemedicine: Observational Analysis of Efficiency and Guideline Adherence.

Integrating decision support systems into telemedicine may optimize consultation efficiency and adherence to clinical guidelines; however, the extent of such effects remains underexplored. This study aims to evaluate the use of ICD (International Classification of Disease)-coded prescription decision support systems (PDSSs) and the effects of these systems on consultation duration and guideline adherence during telemedicine encounters. In this retrospective, single-center, observational study conducted from October 2021 to March 2022, adult patients who sought urgent digital care via direct-to-consumer video consultations were included. Physicians had access to current guidelines and could use an ICD-triggered PDSS (which was introduced in January 2022 after a preliminary test in the preceding month) for 26 guideline-based conditions. This study analyzed the impact of implementing automated prescription systems and compared these systems to manual prescription processes in terms of consultation duration and guideline adherence. This study included 10,485 telemedicine encounters involving 9644 patients, with 12,346 prescriptions issued by 290 physicians. Automated prescriptions were used in 5022 (40.67%) of the consultations following system integration. Before introducing decision support, 4497 (36.42%) prescriptions were issued, which increased to 7849 (63.57%) postimplementation. The physician's average consultation time decreased significantly to 9.5 (SD 5.5) minutes from 11.2 (SD 5.9) minutes after PDSS implementation (P<.001). Of the 12,346 prescriptions, 8683 (70.34%) were aligned with disease-specific international guidelines tailored for telemedicine encounters. Primary medication adherence in accordance with existing guidelines was significantly greater in the decision support group than in the manual group (n=4697, 93.53% vs n=1389, 49.14%; P<.001). Most of the physicians adopted the PDSS, and the results demonstrated the use of the ICD-code system in reducing consultation times and increasing guideline adherence. These systems appear to be valuable for enhancing the efficiency and quality of telemedicine consultations by supporting evidence-based clinical decision-making.

Aachen smoking cessation and harm reduction (ASCHR) trial study protocol – scientific evaluation of a psychological-telemedical counseling concept for smoking cessation in patients with vascular diseases

BackgroundSmoking is a major risk factor of cardiovascular diseases, notably peripheral arterial disease (PAD). Despite this link, research on smoking cessation interventions in PAD patients remains scarce and inconclusive regarding the efficacy of such interventions.Therefore, elucidating it is crucial and should address both individuals who smoke that are motivated to quit and individuals who smoke heavily lacking the motivation to quit.Methods/DesignThe Aachen Smoking Cessation and Harm Reduction (ASCHR) trial is a prospective randomized controlled study (RCT) on the benefits of telemedical-psychological support for smoking cessation in patients with PAD, funded by the “Innovation Fund” of the Joint Federal Committee in Germany. This trial aims to scientifically assess the efficacy, feasibility, acceptance, and efficiency of a multi-stage smoking cessation program based on the recommendations of the German guideline for smoking cessation tailored to patients with PAD, compared to a control group receiving no intervention. Central to the program is psychological counseling utilizing motivational interviewing techniques, delivered through telemedicine via video consultations. The primary endpoint of the ASCHR trial is the smoking cessation rate after 8 months of intervention, with a secondary endpoint evaluating sustained abstinence at a further 6 months follow-up. Smoking cessation is defined as a carbon monoxide level in exhaled air of less than 6 ppm. We hypothesize that the group receiving the multi-stage cessation program will yield a cessation rate at least 10 percentage points higher than that of usual care. Anticipating a dropout rate of around 35%, the planned sample size is at least N = 1032 study participants.DiscussionShould the trial demonstrate significant positive outcomes, efforts should be made to integrate the program into routine care in Germany, potentially offering a promising base for future smoking cessation support among PAD patients.

Reasons for encounter in video contacts at a Danish out-of-hours primary care service: a questionnaire study

ObjectiveTo investigate reasons for encounter in telephone triage contacts to an out-of-hours primary care service for which general practitioners (GPs) use video consultations (video contact), overall and stratified for patient...

Pharmacist-Led Video Consultation to Identify and Mitigate Drug Interactions Among Patients Initiating Oral Anticancer Drugs.

The past decade has seen an increase in oral anticancer drug (OACD) approvals. Polypharmacy and drug-drug interactions (DDIs) likely contribute to OACD toxicity. We assessed a one-time pharmacist-led video consultation to identify DDIs. We conducted a single-arm telehealth intervention of a one-time 30-minute pharmacist-led video consultation among patients initiating OACDs. The visit focused on identifying polypharmacy and DDIs. Feasibility was defined as ≥50% completion of all study interventions. We determined the prevalence, characteristics, and severity of OACD-related potential DDIs. We also assessed the prevalence of medication list inaccuracies, polypharmacy, patient satisfaction, and patient perception of intervention acceptability, appropriateness, and feasibility. Of 58 eligible patients, 43 (74%) completed the intervention and 33 (57%) completed all evaluations. Median medication per patient was nine (range 4-21), and 98% of patients had at least five prescriptions. The median number of medication list errors was two (range 0-16), with at least one error for 76% and >1 for 52%. Pharmacists identified OACD-related interactions in 18 cases (42%), including change in drug metabolism (eight), elimination (one), and absorption (three). Interactions were classified as Lexicomp categories C (13), D (five), or X (one) requiring close monitoring or a change in treatment. All patients expressed high satisfaction with the intervention and agreed or completely agreed that it was acceptable, appropriate, and feasible. Polypharmacy, medication list errors, and DDIs are prevalent among patients initiating OACDs. A one-time remote pharmacist-led video consultation can address OACD-related DDIs, which may decrease medication complexity and improve adherence.

Registered Nurses' Digital Client Work and Associating Factors: A Cross-Sectional Study.

To describe the frequency of digital client work among Finnish registered nurses, including video consultations, secured messaging and digital promotion of care without direct contact with the client. In addition, the study examines the association between various factors related to nurses' characteristics and work environment with digital client work and its frequency. A cross-sectional survey study. A total of 2970 nurses responded to a nationwide survey in spring 2023. Descriptive statistics were used to characterise the frequency of different types of digital client work. Binary logistic regression analyses were used to examine the associations. One-third of the respondents reported digital client work during the last 6 months. The majority had worked digitally with their clients daily or weekly. Secured messaging was the most frequently used type of digital client work, whereas video consultations were less frequent. Nurses working in acute care, home-based care or other environments worked more frequently digitally with their clients than those working in inpatient care. Nurses with higher digital dedication and collegial support had greater odds of digital client work than those with lower dedication. Among those who reported frequent digital client work, lower skills in information security were observed. Given the significant variation in the frequency of digital client work among nurses across different environments, assessing broader digitalisation adoption opportunities is essential. Organisations must ensure that nurses have sufficient skills for secure handling of client data, and efforts should be made in creating motivational and supportive work environments to facilitate digital client work. By understanding the factors influencing nurses' digital client work, organisations can create stronger structures to support their work. Enhancing digital service availability across different healthcare settings would offer clients more care options, thereby potentially improving their access to healthcare. This research addresses a knowledge gap regarding the current extent of nurses' digital client work in various healthcare environments and explores potential influencing factors. As governments aim to significantly expand the provision of digital healthcare services, understanding the variation in nurses' digital client work is crucial. This information can guide targeted interventions, such as continuous education, and organisational and collegial support, facilitating dedication to use digital technologies and ensuring secure and impactful advancements in digital healthcare. Our research will benefit healthcare organisations, decision-makers, nursing professionals and educational institutions. Our study adheres to the relevant EQUATOR guidelines and follows the STROBE checklist for cross-sectional studies. No patient or public contribution.

The impact of the COVID-19 pandemic on antibiotic prescription rates in out-of-hours primary care – a register-based study in Denmark

Background Antibiotic prescription rates can be affected by pandemic measures such as lockdowns, social distancing, and remote consultations in general practice. Therefore, such emergency states may negatively affect antimicrobial stewardship, specifically in out-of-hours (OOH) primary care. As contact patterns changed in the COVID-19 pandemic, it would be relevant to explore the impact on antimicrobial stewardship. Aim To study the impact of the pandemic on antibiotic prescription rates in OOH primary care, overall and per age group. Methods This cross-sectional register-based study used routine data from OOH primary care in the Central Denmark Region. We included all patient contacts in two equivalent time periods: pre-pandemic and pandemic period. The main outcome measure was defined as the number of antibiotic prescriptions per contact (antibiotic prescription rate). Results The overall antibiotic prescription rate decreased during the first year of the pandemic compared to the pre-pandemic period (RR = 0.97, 95%CI: 0.96–0.98). Likewise, the rate decreased for clinic consultations (RR = 0.63, 95%CI: 0.62–0.64). However, an increase was seen for telephone consultations (RR = 1.73, 95%CI: 1.70–1.76). The decline in clinic consultations was largest for consultations involving children aged 0–10 years (RR = 0.53, 95%CI: 0.51–0.56). Conclusion Antibiotic prescription rates in Danish OOH primary care decreased during the first year of the COVID-19 pandemic, especially for young children. Prescription rates decreased in clinic consultations, whereas the rates increased in telephone consultations. Further research should explore if antibiotic prescription rates have returned to pre-pandemic levels, and if the introduction of video consultations has affected antibiotic prescription patterns in OOH primary care.

Assessing Patient Use of and Attitudes toward eHealth Services for Communication with Primary Care Centers in Saudi Arabia and Factors Affecting Usage.

This study investigates patients' use of eHealth services, their awareness of the availability of these services, and their intention to use them in primary care. It also examines patient characteristics and factors that influence the use of these services. A cross-sectional design using questionnaires was conducted. Based on the unified theory of acceptance and use of technology (UTAUT), the participants rated the two most common services. Descriptive analyses and linear correlation analyses were performed. A simple linear regression was conducted to identify factors influencing the participants' intention to use eHealth services. In total, 1203 participants with an average age of 43.7 years were surveyed. The participants' usage rates varied, with the lowest at 2.4%, for measuring vital signs, and the highest at 47.4%, for booking appointments. The intentions to use the services ranged from 22.5%, for video consultations, to 46.6%, for prescription refill requests. Approximately 20% of the respondents were unaware of each service's availability. Positive associations were found between all the constructs and the intention to use online services, with a younger age being the most significant factor. The use of and intention to use eHealth services varied greatly. The participants were often unaware of the availability of these services. Promoting the availability and benefits of eHealth services could enhance patient engagement in primary care settings.

Shared decision-making and detection of comorbidities in an online acromegaly consultation with and without the Acromegaly Disease Activity Tool ACRODAT® using the simulated person approach

ObjectiveA patient-centered approach to the management of acromegaly includes disease activity control, shared decision-making and identification of comorbidities. The Acromegaly Disease Activity Tool (ACRODAT®) is intended to assist physicians in providing such holistic management. The present study investigated this claim using the simulated person (SP) approach.MethodsWe studied patient-doctor interaction via online video consultation in a randomized prospective study design with SPs trained to simulate a specific acromegaly profile. We analyzed the proportion of conversation time devoted to health content and the specific acromegaly and comorbidity relevant categories mentioned in the conversation. We collected physicians’ feedback on the usefulness of ACRODAT®, SPs subjective perception of the quality of the conversation and compared consultations with and without ACRODAT® using a qualitative approach.ResultsThe sample (N = 30) consisted of endocrinologists treating patients with acromegaly in Germany. For SP-physician interactions (N = 60), the proportion of time spent on conversation content (e.g. IGF-I, quality of life) was distributed according to the focus of the patient profile. Comorbidities were less well identified than the need for a change in therapy. Only 18.3% of the SPs were actively asked to participate in the decision-making process. ACRODAT® did not lead to any significant differences in the course of the discussion.ConclusionsShared decision-making was underrepresented in this SP-physician interaction in acromegaly management. Physicians adapted the content of the discussion to the SP’s needs, but did not adequately address comorbidities. According to the analysis criteria used, ACRODAT® did not contribute to a more holistic patient management in the present study.

Model of integrated mental health video consultations for people with depression or anxiety in primary care (PROVIDE-C): assessor masked, multicentre, randomised controlled trial

ObjectiveTo evaluate whether an integrated mental health video consultation approach (PROVIDE model) can improve symptoms compared with usual care in adults with depression and anxiety disorders attending primary care.DesignAssessor masked,...

Implementing Telemedicine into Clinical Training Through Pre-recorded Video Consultations

Although the contribution of real patient encounters to medical education is well known, challenges such as a lack of suitable cases, patients not consenting to student involvement, physical space limitations that prevent every student from participating, the inability to replicate the same patient encounter, and reduced patient admissions to healthcare facilities during extraordinary periods are common obstacles that need to be addressed in clinical education. To overcome these challenges, video consultation (VC) recordings, which were made with the consent of patients having a telemedicine consultation, were collected as an archive of medical interview recordings covering a wide spectrum of pulmonary diseases. These recordings were watched by students in a classroom setting during clinical clerkships, with case discussions interspersed. This article, which also discusses the results of clinical clerkship evaluations, indicates that the use of pre-recorded VC sessions can be an effective tool for teaching good clinical practices through the ideal method of medical interviews, diagnostic approaches, evaluation of test results, communication skills with patients and their relatives, and addressing the socio-psychological aspects and social impacts of diseases. As an innovative attempt, sharing this process at an early stage of development may inspire enthusiasm for implementing this approach and open the field for further development.

Evaluating video and hybrid group consultations in general practice: mixed-methods, participatory study protocol (TOGETHER 2).

General practice is facing an unprecedented challenge in managing the consequences of the pandemic. In the midst of a policy drive to balance remote and in-person service provision, substantial workload pressures remain, together with increasing prevalence of long-term conditions, and declining staff numbers and morale. To address these challenges, some practices in the UK have been delivering video and hybrid group consultations (VHGCs) providing clinical care to multiple patients at the same time. Despite positive initial findings and enthusiasm, there are still gaps in our understanding of the influence VHGCs have on patient experience, healthcare utilisation, quality, safety, equity and affordability. To generate an in-depth understanding of VHGCs for chronic conditions in general practice, surface assumptions and sociotechnical dynamics, inform practice and extend theorisation. Mixed-methods, multi-site research study using co-design and participatory methods, from qualitative, quantitative and cost-related perspectives. WP1 includes a national, cross-sectional survey on VHGC provision across the UK. In WP2 we will engage patients and general practice staff in co-design workshops to develop VHGC models with emphasis on digital inclusion and equity. In WP3 we will carry out a mixed-methods process evaluation in up to 10 GP practices across England (5 sites already running VHGCs and 5 comparison sites). Qualitative methods will include interviews, focus groups and ethnographic observation to examine the experiences of patients, carers, clinical and non-clinical NHS staff, commissioners and policy-makers. Quantitative methods will examine the impact of VHGCs on healthcare utilisation in primary and secondary care, patient satisfaction, engagement and activation. We will also assess value for money of group and individual care models from a health economics perspective. We aim to develop transferable learning on sociotechnical change in healthcare delivery, using VHGCs as an exemplar of technology-supported innovation. Findings will also inform the design of a future study.

Emergency care via video consultation: interviews on patient experiences from rural community hospitals in northern Sweden

BackgroundDelivering emergency care in rural areas can be challenging, but video consultation (VC) offers opportunities to make healthcare more accessible. The communication and relationship between professionals and patients have a significant impact on the patient’s experience of safety and inclusion. Understanding the patient perspective is crucial to developing good quality healthcare, but little is known about patient experiences of emergency care via VC in a rural context. The aim of this study was to explore patient experiences of emergency care via VC in northern rural Sweden.MethodsUsing a qualitative approach, semi- structured interviews (n = 12) were conducted with individuals aged 18—89 who had received emergency care with a registered nurse (RN) on site and VC with a general practitioner (GP). The interviews were conducted between October 2021 and March 2023 at community hospitals (n = 7) in Västerbotten County, Sweden. Interviews were analysed with content analysis.ResultsThe analysis resulted in main categories (n = 2), categories (n = 5) and subcategories (n = 20). In the main category, “We were a team of three”, patients described a sense of inclusion and ability to contribute. The patients perceived the interaction between the GP and RN to function well despite being geographically dispersed. Patients highly valued the opportunity to speak directly to the GP. In the main category, “VC was a two-sided coin”, some experienced the emergency care through VC to be effective and smooth, while some felt that they received a lower quality of care and preferred face-to-face consultation with the GP. The quality of the VC was highly dependent on the RN’s ability to function as the hub in the emergency room.ConclusionPatients in rural areas perceived being included in 'the team' during VC, however they experienced disadvantages with the system on individual basis. The nursing profession plays an important role, and a proper educational background is crucial to support RNs in their role as the hub of the visit. The GP’s presence via VC was seen as important, but to fully enable them to fulfil their commitments as medical professionals, VC needs to be further improved with education and support from technical devices.

Telemedicine in Pediatric Respiratory Care: Benefits, Challenges, and Future Directions

This study explores the impact of telemedicine on pediatric respiratory care, focusing on its benefits, challenges, and future directions. A mixed-methods approach was employed, involving 150 pediatric patients with chronic respiratory conditions such as asthma and cystic fibrosis, who were randomly assigned to either telemedicine or traditional care groups. The telemedicine group used a digital platform for video consultations, remote monitoring, and health management over a 12-month period. Quantitative data on clinical outcomes, including emergency department visits and hospitalizations, were collected from electronic health records, while patient-reported outcomes were assessed through surveys. Qualitative data were gathered via semi-structured interviews with patients and caregivers. Results indicated that the telemedicine group experienced significantly fewer emergency visits and hospitalizations, higher quality of life scores, better treatment adherence, and greater patient satisfaction compared to the traditional care group. Average oxygen saturation and peak flow rates were also higher in the telemedicine group, and more frequent monitoring alerts were noted.

Acceptability of Telepsychiatry among Overseas Filipino Workers in Kuwait

The challenges faced by overseas Filipino workers (OFWs) expose them to abuse, harming their mental wellness. Telepsychiatry offers hope by allowing prompt diagnosis, management, and treatment of mental health issues. Yet, the acceptability of this technology among OFWs has not been studied, and specialized psychiatric services for them are scarce. This study assessed telepsychiatry acceptance among OFWs in Kuwait. Using a cross-sectional design, participants with mental health concerns in a Philippine Embassy shelter were selected. Tailored telepsychiatry software facilitated secure online video consultations and psychotherapy sessions with a Philippines-based psychiatrist. Acceptance was measured with the telemedicine satisfaction and usefulness questionnaire. Fifty-five (55) female OFWs participated; most were household service workers (n = 53; 96.36%) with a median age of 35. Mental health disorders were diagnosed in 22 participants (40%) – including acute stress disorder (n = 14; 25.45%), major depressive disorder (n = 5; 9.09%), brief psychotic disorder (n = 1; 1.82%), post-traumatic stress disorder (n = 1; 1.82%), and adjustment disorder (n = 1; 1.82%). Acceptance-wise, the majority of the participants expressed satisfaction with the telepsychiatry service provided (mean = 4.77; SD=0.48). This pioneering research demonstrates the viability of telepsychiatry in providing vital psychosocial support to distressed OFWs in Kuwait. Sustaining and expanding this service across various countries is essential to ensure access to culturally sensitive and responsive mental health resources, thereby promoting mental health equity and the overall well-being of migrant workers

Patient survey on the use of video consultation in the outpatient treatment of chronic pruritus

Analyses of patient evaluations and barriers to the implementation of teledermatology procedures are still rare. The aim of this study was to determine whether administrative processes have an influence on the patient evaluation of telephone and video consultations. With the help of apatient survey, assessments of the processes and organisation surrounding the outpatient appointment were asked. These were then compared to the assessment of whether the telephone or video consultation is an alternative to on-site consultation. In all, 1538 patients took part in the survey. Significant correlations were found between the evaluation of the telephone or video consultation and the distance between the place of residence and the outpatient clinic, whether the patient had already been seen several times or for the first time, as well as the evaluation of the waiting time for the appointment, the organisation before the appointment and the waiting time in the outpatient clinic. The study shows that even after the Coronavirus pandemic, telephone and video consultations remain an important tool for patients to contact their physician. However, patients' perceptions of the processes around the outpatient appointment have an influence on their willingness to participate in adigital consultation.

Consideration of Thermal Comfort, Daylighting Comfort, and Life-Cycle Decarbonization in the Retrofit of Kindergarten Buildings in China: A Case Study

Kindergartens play a crucial role in nurturing the physical, cognitive, and social development of children. Hence, designing kindergarten buildings requires the consideration of the unique requirements and behavior of children. Considering the rapid urbanization of China and its commitment to achieving the 3060 carbon goal, in this study, we examine the retrofitting of kindergarten buildings in China and propose a retrofit optimization method for kindergarten buildings that considers thermal comfort, daylighting, and life-cycle carbon emissions. Through this method, information on the thermal and daylighting comfort of occupants, weather data, occupant scheduling, and envelope and energy system of the kindergarten building to be retrofitted can be obtained through various approaches, such as video playback, field investigation, literature research, and consult drawings. On this basis, optimization variables are selected, and a physical model is established to guide the retrofit process. Afterward, a rapid comprehensive optimization framework based on parallel computing is adopted to obtain the comprehensive optimal design scheme for the building to be retrofitted. The proposed method is applied to a kindergarten building retrofit case in Nanjing, China, and the results show that the optimal comprehensive scheme results in a reduction in carbon emissions of 34,158.3 kg, an increase in the thermal comfort period of 2.7%, and an improvement in daylighting comfort of 79.7% over the benchmark scheme. The significance of this study extends beyond its potential for widespread application in kindergarten building retrofits. It contributes to advancing sustainable building design and environmental stewardship, creating healthier and more comfortable learning environments for children while mitigating the environmental impact of buildings. Moreover, it emphasizes the importance of considering children’s unique needs and behaviors in building design, ultimately leading to better outcomes for their overall development.

Video Consultations and Environmental Sustainability - Usability's Impact on Long-Term Use.

The rapid shift to digital healthcare, accelerated by the COVID-19 pandemic, holds promise for sustainable healthcare delivery and climate change mitigation. This study evaluates the Alltid öppet application through the lens of usability and patient satisfaction and their correlation with the intention for continued use. A cross-sectional analysis of primary care patients revealed that alignment with user needs significantly predicts long-term adoption, while frustration during use discourages it. Ease of use did not significantly affect the intention to continue, suggesting that usability alone is insufficient to drive sustained engagement. These findings highlight user-centred design's importance in digital healthcare solutions, suggesting that enduring adoption hinges on value perception and reducing user frustration. As the healthcare sector navigates its digital future, this study offers crucial insights into the design and implementation strategies that could underpin the environmental sustainability and resilience of healthcare systems.