RATIONALE
There is a growing demand for comprehensive, evidence-based, and accessible clinical practice guidelines (CPGs) to address virtual service delivery. This demand was particularly evident within the field of hearing healthcare during the COVID-19 pandemic, when providers were faced with an immediate need to offer services at a distance. Considering the recent advancement in information and communication technologies, the slow uptake of virtual care, and the lack of knowledge tools to support clinical integration in hearing healthcare, a Knowledge-to-Action Framework was used to address the virtual care delivery research-to-practice gap.


AIMS AND OBJECTIVES
This paper outlines the development of a CPG specific to provider-directed virtual hearing aid care. Clinical integration of the guideline took place during the COVID-19 pandemic and in alignment with an umbrella project aimed at implementing and evaluating virtual hearing aid care incorporating many different stakeholders.


METHOD
Evidence from two systematic literature reviews guided the CPG development. Collaborative actions around knowledge creation resulted in the development of a draft CPG (v1.9) and the mobilisation of the guideline into participating clinical sites.


RESULTS AND CONCLUSION
Literature review findings are discussed along with the co-creation process that included 13 team members, from various research and clinical backgrounds, who participated in the writing, revising, and finalising of the draft version of the guideline.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/jep.13846

Phase 1 of collaborative action around the implementation of virtual hearing aid care: Development of a clinical practice guideline.

This article describes the development and administration of the Caregiver Insights of Pediatric Speech and Language Services Delivered via Telepractice During COVID-19 survey. Caregivers of children who began receiving speech and/or language services delivered via telepractice during COVID-19 were recruited to participate in this study. Participants were invited to share their impressions of telepractice during COVID-19 and why they chose to continue or discontinue this service delivery model when a return to in-person therapy became possible. This survey was developed using procedures outlined by the commonly accepted stages of questionnaire development. This process establishes content validity through: (a) identification of the survey purpose, (b) creation of an item blueprint, (c) expert panel review, and (d) interviews with end-users (i.e., parents, caregivers). Dissemination of the survey occurred through social media and field-specific forums. Sixty caregivers participated. Findings from the 35 items were analyzed using descriptive statistics and consensual qualitative research. We found that caregivers' levels of satisfaction regarding telepractice services varied. When given the option to return to in person services post-pandemic, some participants continued telepractice due to convenience and the expertise of the therapist, while others discontinued due to their child's lack of engagement. Caregivers identified successes as the presence and participation of a family member, comfortability in one's own home, and accessibility; whereas barriers such as lack of session materials, technology, and difficulty understanding directions led some to return to in-person services. These findings identify advantages and disadvantages of this service delivery model when selecting the best therapy environment for a child, as well as training topics for ongoing advancements. 

Learning from caregivers: Insights into pediatric speech and language services delivered via telepractice during COVID-19

This study aimed to elicit the preferences and willingness-to-pay for blood pressure (BP) telemonitoring programs. This study also investigated the different factors or participant characteristics that could influence preferences and choice behaviors. Participants with hypertension were identified from an online survey panel demographically representative of Singapore's general population. Participants completed a discrete choice experiment (DCE) with 12 choice sets, selecting their preferred BP monitoring program differing on five attributes: mode of consultation, BP machine type (with Bluetooth or not), BP machine price, monthly fee, and program duration. The base reference population (male, married, higher income, more formal education years, full-time worker, aged 55 to <65 years, and digital skills score of 36) preferred teleconsultation over in-person consultation, Bluetooth feature, lower machine price, lower monthly fee, and shorter program duration. A subgroup of participants can be considered teleconsultation-resistant, and three demographic factors were associated with lower preference for teleconsultation: female, fewer formal education years, and lower income. Considering the reference population and Bluetooth attribute, participants were willing to pay 66 SGD (~49 USD) additional for the machine to obtain the Bluetooth feature. Considering the reference population and teleconsultation attribute, participants were willing to pay 6.80 SGD (~5.10 USD) extra monthly fee for a program using teleconsultation. Here we report that amongst participants with hypertension, there is strong preference for the use of teleconsultation and a BP machine with Bluetooth feature in a BP monitoring program. However, a subgroup of participants are teleconsultation-resistant and would prefer in-person consultation. 

Preferences and willingness-to-pay for a blood pressure telemonitoring program using a discrete choice experiment

Wie können Roboter bei ambulanten Pflege- und Therapiemaßnahmen nach einem Schlaganfall helfen? Die Beiträger*innen fassen die Ergebnisse des Forschungsprojekts »DeinHaus 4.0 Oberpfalz« zusammen, bei dem interdisziplinäre Forscher*innen im Rahmen einer Längsschnittstudie den Einsatz von Telepräsenzrobotern empirisch untersuchen. Die unterschiedlichen Perspektiven der angewandten Ethik, E-Health, Logopädie, Physiotherapie, Pflegewissenschaft, Soziologie und Technikfolgenabschätzung legen nahe: Die Digitalisierung lässt sich gewinnbringend zur Unterstützung der Gesundheitsversorgung einsetzen. 

Digitale Technik für ambulante Pflege und Therapie III

Pfingsten, Schedel und Michel widmen sich in diesem Beitrag der Frage nach der Machbarkeit und Wirkung teletherapeutischer Physiotherapie bei Schlaganfallpatienten. Diese prospektive, nicht kontrollierte Interventionsstudie nutzt Telepräsenzroboter und app-basiertes Training, um die Intensität und Frequenz der Therapie zu erhöhen und funktionelle Verbesserungen der betroffenen oberen Extremität zu fördern. Ein Mixed-Methods-Design mit quantitativen Assessments und qualitativen Interviews zeigt, dass teletherapeutische Maßnahmen die Rehabilitation unterstützen, Versorgungslücken schließen und die Selbstständigkeit der Patienten fördern können. Die interdisziplinäre Tele-Therapie mit regelmäßigen, intensiven Übungen führt zu signifikanten Verbesserungen der Lebensqualität, der Teilhabe und Partizipation, der Alltagsfähigkeit und der Funktion der oberen Extremität. 

Physiotherapeutische Tele-Intervention - Machbarkeit und funktionelle Veränderungen bei Schlaganfallbetroffenen

Background The use of telepractice as an alternate method of delivering healthcare to people increased significantly after COVID-19 became a global pandemic. Objectives This study aimed to identify factors contributing to the accelerated adoption of telepractice during COVID-19 in Singapore. It also sought to examine whether there are differences in the perspectives of staff in nursing facilities and caregivers in personal homes towards telepractice. Methods A cross-sectional mixed method design was used. A survey with 20 items was adapted from the Telehealth Usability Questionnaire and translated into Mandarin. Anonymous responses were obtained from 70 patients and caregivers who had received speech therapy services via telepractice from a restructured hospital before and/or during Singapore’s Circuit Breaker period. Analyses were conducted using descriptive statistics and content analysis. Results Sociodemographic variables of age, gender, education level and language preference did not impact user satisfaction and the likelihood of using telepractice again. Service-related factors were more influential. Participants chose to use telepractice as it saved travelling time (24.0%), was easy to use (19.3%), improved healthcare access (17.5%) and reduced waiting time (17.5%). Although all respondents expressed satisfaction in telepractice, 35.5% from personal homes and 37.5% from nursing facilities were not keen to use it again. Amongst caregivers, 26.7% from personal homes and 37.5% from nursing facilities preferred not to continue telepractice use. Technical and logistical disruptions and the lack of ‘personal touch’ were contributing factors. Conclusion Improving technological infrastructure, providing training for users and developing guidelines would help sustain telepractice as a form of service delivery beyond COVID-19.

https://journals.sagepub.com/doi/pdf/10.1177/20101058221074120

Factors affecting telepractice use in COVID-19

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Factors affecting telepractice use in COVID-19