Understanding the Experience of Geriatric Care Professionals in Using Telemedicine to Care for Older Patients in Response to the COVID-19 Pandemic: Mixed Methods Study

Chen, Wenwen; Flanagan, Ashley; Nippak, Pria; Nicin, Michael; Sinha, Samir K.

doi:10.2196/34952

Cited by 12 publications

(12 citation statements)

References 35 publications

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“…Clinician's perceived virtual care advantages often described improvement to patient care and their work ow, such as increased e ciency of care [17,18,22], access to a comprehensive suite of patient information [16,20] and accessibility for disadvantaged patient groups [16, 21, 25, 26] which assisted in facilitating implementation. This is in line with international literature, where reduced transmission of contagious diseases and continuous monitoring of patients have been cited as advantages [31][32][33]. However, such perceived advantages are constrained by clinician's concerns surrounding clinical liability, and the validity and quality of care administered and received using virtual care [15,18].…”

Section: Discussionsupporting

confidence: 75%

Factors that influence the uptake of virtual care solutions in Australian primary care practice: a systematic scoping review

Delaforce,

Maddock,

Wheeler

et al. 2024

Preprint

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Background The use of virtual care solutions in primary care settings has increased exponentially. Current evidence suggests high patient satisfaction with virtual care, but it is not without limitations. Research is needed to understand what factors influence the implementation of virtual care so that it can be delivered to the right patient, in the right clinical context at the right time as business-as-usual healthcare. Implementation science offers theories and models to assist with this, but none yet comprehensively address virtual care solution delivery. Methods A systematic scoping review was undertaken to identify empirical research studies that reported factors influencing the uptake of virtual care solutions within the Australian primary care setting. Searches were undertaken in Embase, PubMed, Scopus and Web of Science. The Consolidated Framework for Implementation Research (CFIR) was used to code factors influencing the implementation of virtual care solutions. Results 14 studies were identified as eligible for inclusion. A cluster of five common influencing factors were identified. Three were from the existing CFIR framework, and two were newly developed constructs. CFIR constructs included: innovation relative advantage, capability and information technology infrastructure. New constructs included accessibility and suitability. A further six new constructs were identified (trust, privacy, governance, unintended consequences, preference and choice) but they were not prominently mentioned. Conclusions There are common influencing factors among primary care settings that implemented virtual care. The CFIR assisted in conceptualising these but was not sufficient for capturing factors unique to virtual care. Newly developed constructs are noted to be of importance in the literature, but further primary research is needed to understand if they are applicable in multiple contexts.

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Section: Discussionsupporting

confidence: 75%

Factors that influence the uptake of virtual care solutions in Australian primary care practice: a systematic scoping review

Delaforce,

Maddock,

Wheeler

et al. 2024

Preprint

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“…Observed perceptions of the needs and resources of patients in the responses of participants in this study also reflected concerns about the ‘digital gap’, which continues to be a significant barrier for older people in using telemedicine technology and its use required the assistance of carers ( 51 ). In the experience of geriatric care workers using telemedicine to care for older patients in response to the COVID-19 pandemic, the findings suggest that telemedicine can greatly facilitate much of the geriatric care that is traditionally provided in person, while being less useful in providing certain aspects of geriatric care to older patients, their carers and families ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

“…One of the main guidelines for the care of older people during the COVID-19 pandemic in home and primary health care settings is the proactive assessment by a primary care physician or nurse to identify early signs of COVID or abnormal symptoms like sudden changes in cognition, onset of behavioral disturbances, or functional deterioration that may indicate early signs of the infection ( 5 ). As a result of the above conditions, geriatric care professionals, including nursing care, have been forced to adopt new ways of working quickly to ensure continuity of care for older patients in response to the COVID-19 pandemic ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Understanding the experiences of PHC nurses in caring for older patients in the post-fifth wave of the COVID-19 pandemic: an exploratory qualitative study

Ślusarska,

Nowicki,

Chrzan-Rodak

et al. 2024

Front. Public Health

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ObjectiveTo ensure the best possible care, the perspective of PHC nurse work experience during the COVID-19 pandemic should be considered when developing nursing care protocols for older patients who receive PHC services.MethodThis exploratory qualitative study was conducted with 18 nurses working continuously in PHC between the first and fifth waves of the pandemic. Semi-structured thematic interviews were undertaken. Qualitative thematic content analysis was conducted to identify and group the themes that emerged from the discourse. Interviews were transcribed and analyzed using thematic analysis.ResultsThe first topic describes the nurses’ experiences of physical and mental suffering in caring for older patients in response to the pandemic. The second topic covers the experience of reorganizing PHC work. The third topic focuses on the difficulties of caring for older patients. The final topic includes issues of support needs for nurses in PHC work.ConclusionThe experience and understanding of PHC nurses in caring for older people during the COVID pandemic should lead to significant changes in the system of nursing care for geriatric patients and in the cooperative role within geriatric care specialist teams. Drawing on the experience of COVID-19, it is necessary to work on the weak points of PHC exposed by the pandemic in order to improve the quality of care and life for geriatric patients.

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“…Future research, including that of this team, must actively reach out to support those older adults on the underrepresented side of the digital divide [35][36][37], particularly as the United Nations calls for all nations to close these digital divides [38]. As suggested by participants in this study, support strategies should target both older adults and providers; Chen et al [39] found that training geriatric care professionals on virtual care technologies prior to the pandemic helped ease the transition to virtual care. Multiple virtual care resources have been designed for older adults in Canada, including appointment checklists (eg, [5]) and supportive liaisons to help navigate particular technologies, as implemented at Women's College Hospital [40].…”

Section: Future Directionsmentioning

confidence: 99%

The Impact of COVID-19 on Older Adults’ Perceptions of Virtual Care: Qualitative Study

Abdallah¹,

Stolee²,

Lopez³

et al. 2022

JMIR Aging

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Background In response to the COVID-19 pandemic, older adults worldwide have increasingly received health care virtually, and health care organizations and professional bodies have indicated that virtual care is “here to stay.” As older adults are the highest users of the health care system, virtual care implementation can have a significant impact on them and may pose a need for additional support. Objective This research aims to understand older adults’ perspectives and experiences of virtual care during the pandemic. Methods As part of a larger study on older adults’ technology use during the pandemic, we conducted semistructured interviews with 20 diverse older Canadians (mean age 76.9 years, SD 6.5) at 2 points: summer of 2020 and winter/early spring of 2021. Participants were asked about their technology skills, experiences with virtual appointments, and perspectives on this type of care delivery. Interviews were digitally recorded and transcribed. A combination of team-based and framework analyses was used to interpret the data. Results Participants described their experiences with both in-person and virtual care during the pandemic, including issues with accessing care and long gaps between appointments. Overall, participants were generally satisfied with the virtual care they received during the pandemic. Participants described the benefits of virtual care (eg, increased convenience, efficiency, and safety), the limitations of virtual care (eg, need for physical examination and touch, lack of nonverbal communication, difficulties using technology, and systemic barriers in access), and their perspectives on the future of virtual care. Half of our participants preferred a return to in-person care after the COVID-19 pandemic, while the other half preferred a combination of in-person and virtual services. Many participants who preferred to access in-person services were not opposed to virtual care options, as needed; however, they wanted virtual care as an option alongside in-person care. Participants emphasized a need for training and support to be meaningfully implemented to support both older adults and providers in using virtual care. Conclusions Overall, our research identified both perceived benefits and perceived limitations of virtual care, and older adult participants emphasized their wish for a hybrid model of virtual care, in which virtual care is viewed as an addendum, not a replacement for in-person care. We recognize the limitations of our sample (small, not representative of all older Canadians, and more likely to use technology); this body of literature would greatly benefit from more research with older adults who do not/cannot use technology to receive care. Findings from this study can be mobilized as part of broader efforts to support older patients and providers engaged in virtual and in-person care, particularly post–COVID-19.

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Understanding the Experience of Geriatric Care Professionals in Using Telemedicine to Care for Older Patients in Response to the COVID-19 Pandemic: Mixed Methods Study

Cited by 12 publications

References 35 publications

Factors that influence the uptake of virtual care solutions in Australian primary care practice: a systematic scoping review

Factors that influence the uptake of virtual care solutions in Australian primary care practice: a systematic scoping review

Understanding the experiences of PHC nurses in caring for older patients in the post-fifth wave of the COVID-19 pandemic: an exploratory qualitative study

The Impact of COVID-19 on Older Adults’ Perceptions of Virtual Care: Qualitative Study

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