A non-randomized clinical trial to examine patients’ experiences and communication during telemonitoring of pacemakers after five years follow-up

Patients with pacemakers need regular follow-ups which are demanding. Telemonitoring for pacemaker can provide a new opportunity to avoid follow-up visits. On the other hand, in-person visits could help patients with pacemakers to cope better with the anxiety linked to their condition and maintain better communication with their doctors than simple remote control of their device status. Therefore, our objective was to analyze the experiences and communication comparing telemonitoring (TM) versus conventional monitoring (CM) of patients with pacemakers. A single-center, controlled, non-randomized, non-blinded clinical trial was designed. Data were collected five years after implantation in a cohort of 89 consecutive patients assigned to two different groups: TM and CM. The ‘Generic Short Patient Experiences Questionnaire’ (GS-PEQ) was used to assess patients’ experiences, and the Healthcare Communication Questionnaire (HCCQ) was used to measure the communication of patients with healthcare professionals. Additionally, an ad-hoc survey including items from the ‘Telehealth Patient Satisfaction Survey’ and a ‘costs survey’ was used. After five years, 55 patients completed the study (TM = 21; CM = 34). Participants’ mean (±SD) age was 81 (±6.47), and 31% were females. No differences in baseline characteristics between groups were found. The comparative analyses TM versus CM showed some significant differences. According to GS-PEQ, TM users received adequate information about their diagnosis or afflictions (p = .035) and the treatment was better adapted to their situation (p = .009). Both groups reported negative experiences regarding their involvement in their treatment decisions, the waiting time before admission, and perceived a low-benefit. According to HCCQ, the TM group experienced poorer consultation management by the healthcare provider (p = .041). Participants reported positive overall communication experiences. The study provides insights into the experiences and communication in PM monitoring services as well as specific areas where users reported negative experiences such as the consultation management by clinicians. Trial registration: ClinicalTrials.gov NCT02234245.

The Association Between Older Adult Technology Use and Mental Health During the COVID-19 Pandemic

Physical distancing during the COVID-19 pandemic may impact the mental health of older adults, but technology use may buffer this impact. This study aimed to 1) examine changes in older adult technology use during the COVID-19 pandemic and 2) determine if technology use moderates the relationships between decreased in-person communication/activity and the mental health of older adults during the pandemic. Data were taken from the NHATS COVID-19 Round 10 (n= 3,188). Older adults engaged in more technology-based activity (b= .237, p<0.001), technology-based healthcare communication (b=.112, p<0.001), and technology-based food acquisition (b= .214, p<0.001) during the COVID-19 pandemic, compared to before. Technology use did not moderate the relationship between decreased in person personal communication (b= .021, p= 0.662)/activity (b= .045, p= 0.749) and mental health during the pandemic. Although older adults are utilizing technology more during the pandemic, it might not be protective against negative mental health outcomes from physical distancing.

Public perception of NHS general practice during the first six months of the COVID-19 pandemic in England

Background: In March 2020, the delivery of NHS general practice consultations was rapidly modified to mitigate the spread of COVID-19. Remote triage and consultations became the default, with adapted models for face-to-face contact if clinically required. This study aimed to gain insight into public perception of these adaptations. Methods: Two online surveys were developed, and conducted in August and September 2020. Survey A, open to adults (>18 years) receiving the link to it, considered respondents’ perspectives on healthcare contacts since March 2020, and their understanding of the adapted delivery. Survey B, open to survey A respondents only, then considered how healthcare communication had been received and individual preferences for this. Survey participation was voluntary. Results: The perceptions of 150 members of the public were obtained. 105 had considered contacting general practice, although half avoided this or delayed doing so for longer than usual. While some patients did so ‘to help the NHS’, others experienced reduced access for reasons including concerns about telephone consultations and about COVID-19 safety. Some however reported benefitting from remote consultation availability and regular texts/emails from their practice. 68% (102/150) of respondents were unaware that patients with COVID-19 were seen separately from other patients during general practice appointments. 27% in survey B who had avoided or delayed contact said they would have felt more comfortable contacting general practice had they known this. Conclusions: Experience and use of the adapted general practice models varied. Some patients felt their access to healthcare was reduced, often due to technological requirements. For some who found attending face-to-face appointments difficult however, remote contact was advantageous. Most of those surveyed were unaware of the COVID-19 control measures in place during face-to-face general practice consultations. Assessment of adapted delivery model accessibility and clearer public messaging about the changes may help reduce inequalities.

Measuring quality and patient satisfaction in healthcare communication with foreign-language speakers

Healthcare services face increasing challenges to provide accessible care to an equally increasing diversity ofpatient populations. This is clearly reflected in the linguistic diversity ofpeople living in Switzerland and can be seen mostplainly in the country ’s public hospitals. After a literature review on language barriers in clinical services and the potential impact that interpreters can have in clinical outcomes, we describe how interpreters can be introduced in a primary care setting and how the quality of communication with foreign-language-speaking patients as well as their satisfaction with communication can be improved. Changes in the quality of inter - preter-mediated communication, as rated by the patients themselves, can be monitored and have a beneficial impact on the quality of care. This is important at a time of growing cultural and linguistic diversity in Switzerland and other countries, which requires healthcare systems to implement highquality professional interpreter services that ensure effective communication withforeign-language-speakingpatients.

Healthcare Communication Role in the Detection of Unhealthy Behavior in University Students

The current study aims to identify unhealthy behaviors among university students, establish means of detection of unhealthy behavior, identify obstacles to digital volunteering, and explore the relationship between volunteer preferred style of volunteering and the obstacles to volunteering. Data for the study was gathered by administering an unstructured, anonymous questionnaire to 207 female university students and staff. The survey design included questions about sociodemographic characteristics, views on different facets of volunteering, unhealthy behaviors, and correlation between volunteering and unhealthy behaviors. The results revealed unhealthy behavior detected by the respondents (51.7%). Twenty-eight (13.5%) of the 207 respondents reported using social media in detecting women with offending behavior. The value of Pearson’s R is 0.245; thus, it is considered as weak or no correlation. There is hence no correlation between how respondents preferred volunteer work and the obstacle to volunteering. There is not much difference in the obstacles to volunteering faced by respondents despite their preferred style of volunteering. The findings reveal that digital volunteering effectively gains ground in detecting and managing unhealthy behaviors among university students. Much more could be achieved through digital volunteering if more awareness is created and volunteering programs are designed to be more interesting and less time-consuming to allow more students to participate.

Platformization of healthcare communication: Insights from the early stage of the COVID-19 pandemic in Italy

Over the past few years, public health organizations have adopted new communication practices, such as social media communication, framed by the concepts of Health 2.0 and Medicine 2.0. These concepts need to be reconsidered in the light of the transformation of social media as digital platforms. This article aims to define and critically discuss the concept of the platformization of healthcare communication, investigating the impact of social media incorporation on the local health authorities’ Facebook communication during the early phase of the COVID-19 emergency in Italy. Findings show the progressive incorporation of the mechanisms of platformization by local health authorities and the progressive shift of their Facebook pages from connectors to complementors of healthcare communication and services during the early phase of the pandemic. Conclusions critically discuss the incorporation of social media into the communication strategies of the public healthcare sector.

Decision-Making Ethics with Regard to Life-Sustaining Interventions: Summoning what other Patients Chose

"Health decisions occur in a rich context in which social influences are omnipresent. The tendency to compare oneself with others has been described as one of the critical social factors influencing decision making. Based on a collection of 43 audio-recordings of hospital admission encounters which were analyzed though a conversation analytic methodology, we present findings and reflections in regard to how patients and physicians discuss cardio-pulmonary resuscitation. The phenomena of interest concerns how and when patients and physicians refer to what other people decide (for example: “Often the patients tell us: No futile care”). This practice is encountered in 6 of the conversations recorded. Reference to other people’s decisions is a way to talk about options, but it does much more than just enumerating them. As a resource in interaction, this reference is employed when the patient can’t or doesn’t express a preference (thereby clarifying options) or when the preference the patient expressed is problematic (because contrary to expectations). By using this reference, decision making is projected as a matter of membership to a group of individuals, and not as a matter of individual prognostic.The ethical implications of referring to other people’s choices are significant, since it can influence the patient and pose a serious threat to autonomous decisions. We argue that findings such as ours, stemming from data-driven studies of healthcare communication, are pivotal for informing ethics education in its effort to address the biases that physicians impose upon patients during decision making. "

Context, Cognition, and Communication: Understanding how the Psychology of Location Affects Health and Medical Communication

Prior research reveals that cognition – or how the mind processes information – often guides human behavior in familiar settings (St.Amant, 2018). Such factors can affect the communication practices persons use to convey information about health concepts or medical processes (Hamm, 2003; St.Amant, 2021). The challenge becomes anticipating such connections in order to create texts and visuals audiences can understand and use to meet healthcare needs. This article presents an approach to meeting this need by applying the concept of cognitive scripts to understand and address the communication expectations audiences often associated with health and medical settings. In presenting these ideas, the article begins with an explanation of how cognitive scripts can affect communication processes. From there, the author advocates applying script dynamics to health and medical communication practices. To do so, the author expands upon ideas in the literature on cognitive scripts to create a script-based approach for researching an audience’s expectations of healthcare situations. The author then describes how to apply the information collected from this research to create communication materials audiences can more easily use in healthcare contexts. The result is a three-factor method that focuses on applying cognitive scripts to identify and address an audience’s expectations for healthcare communication in a given context. Readers can then use this approach to design healthcare communication materials that audiences can easily and effectively use.