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  1. Article ; Online: Health Care Professionals' Experiences With the Use of Video Consultation: Qualitative Study.

    Primholdt Christensen, Nina / Skou, Karen Emilie / Boe Danbjørg, Dorthe

    JMIR formative research

    2021  Volume 5, Issue 7, Page(s) e27094

    Abstract: ... knowledge about how to use gestures and body language during video consultation was obtained. ... in the outpatient clinic use and experience the use of video consultations with hematological patients, with a focus ... on relational and organizational aspects.: Methods: The study was designed as an explorative and qualitative ...

    Abstract Background: The number of remote video consultations between doctors and patients has increased during the last few years and especially during the COVID-19 pandemic. The health care service is faced with rising rates of chronic illness and many patients who are more confident in self-management of their illnesses. In addition, there is an improved long-term outlook for serious conditions, such as cancer, that might require flexibility in everyday life.
    Objective: This study aimed to investigate how medical doctors in the outpatient clinic use and experience the use of video consultations with hematological patients, with a focus on relational and organizational aspects.
    Methods: The study was designed as an explorative and qualitative study. Data were collected via participant observations and focus group interviews with medical doctors.
    Results: The study identified possibilities and barriers in relation to adapting to the alternative way of meeting patients in the clinical setting. One of the main findings in this study is that the medical doctors were afraid that they missed important observations, as they were not able to perform a physical examination, if needed. They also emphasized that handshake and eye contact were important in order to get an overall impression of the patient's situation. It also became clear that the medical doctors used body language a lot more during video consultation compared with consultation in a physical setting. The medical doctors found the contact with the patients via the screen to be good, and the fact that the technology was working well made them feel comfortable with the video consultation.
    Conclusions: In this study, we found that the medical doctors were able to maintain good contact with the patients despite the screen and were able to assess the patients in a satisfying manner. However, there were still uncertainties among some doctors about the fact that they could not examine the patients physically. New knowledge about how to use gestures and body language during video consultation was obtained.
    Language English
    Publishing date 2021-07-21
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-326X
    ISSN (online) 2561-326X
    DOI 10.2196/27094
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  2. Article ; Online: Health professionals' views of medical teleconsultation uptake in the Brazilian Unified Health System: A description using the NASSS framework.

    Catapan, Soraia de Camargo / Taylor, Alan / Calvo, Maria Cristina Marino

    International journal of medical informatics

    2022  Volume 168, Page(s) 104867

    Abstract: ... teleconsultation in Brazil. Studying the Brazilian Unified Public Health System (SUS) experiences in implementing ... teleconsultations can help to inform their sustainability. This study identifies the changes required to integrate ... conditions including instant messaging, WhatsApp, telephone calls and video consultations which were also ...

    Abstract Background: The COVID-19 pandemic accelerated efforts to deploy and regulate medical teleconsultation in Brazil. Studying the Brazilian Unified Public Health System (SUS) experiences in implementing teleconsultations can help to inform their sustainability. This study identifies the changes required to integrate specialized teleconsultation in local workflows in SUS.
    Methods: A case study of teleconsultation performed by a University Hospital and a Municipal Specialty Outpatient Clinic in the south of Brazil collected information from two focus groups with specialised doctors, two key informant interviews and associated documents. The Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework domains of condition, technology, proposal value, users and organization informed a qualitative thematic analysis of this data.
    Results: Several forms of teleconsultation were used to manage paediatrics and endocrine conditions including instant messaging, WhatsApp, telephone calls and video consultations which were also used for dermatology. In Brazil, telephone interactions are not considered teleconsultation. In contrast, video consultations were longer than face-to-face appointments, facilitate the understanding and evaluation of conditions, and offered continuity of care, comfort, and safety, without the need for patients to travel, reducing the risk of infection. Patients accepted video consultations to varying degrees but some found it difficult to use the technology. The willingness of doctors to provide any form of teleconsultation was important. Management support was key to defining workflows, coordinating care pathways, and providing technical support.
    Conclusions: This study highlights particularities of teleconsultation uptake for the included specialities. The NASSS framework provides a useful means of identifying the changes to enable teleconsultation continuity for specialised care in SUS.
    MeSH term(s) Humans ; Child ; Remote Consultation ; Pandemics ; Brazil ; COVID-19 ; Health Personnel
    Language English
    Publishing date 2022-09-23
    Publishing country Ireland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1466296-6
    ISSN 1872-8243 ; 1386-5056
    ISSN (online) 1872-8243
    ISSN 1386-5056
    DOI 10.1016/j.ijmedinf.2022.104867
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  3. Article ; Online: Online survey and interview evaluation to explore the use of video consulting among Allied Health Professionals during the COVID-19 pandemic.

    Williams, Jessica / Johns, Gemma / Phipps, Kerrie / Khalil, Sara / Ogonovsky, Mike / Ahuja, Alka

    BMJ open

    2023  Volume 13, Issue 5, Page(s) e068176

    Abstract: ... and, thus, to understand the usage and reasons for using video consultations, this study aimed ... with the use of video consultations (68.6% overall and 81.4% of clinicians reported the prevention ... the COVID-19 pandemic, there was a shift in care provision, with the increased use of online consultations ...

    Abstract Objectives: Allied Health Professionals (AHP) consist of 13 different specialty roles in Wales, sharing the responsibility of promoting and supporting the health and well-being of the population. During the COVID-19 pandemic, there was a shift in care provision, with the increased use of online consultations, such as those using video consultation platforms. However, this shift was associated with uncertainty and hesitancy, and, thus, to understand the usage and reasons for using video consultations, this study aimed to capture the experiences of both AHP and their patients, while investigating each role individually.
    Participants: A survey was distributed to and completed by n=8928 patients and n=4974 clinicians, all AHP were included except for orthoptists and paramedics due to ambiguities in the data. A further 86 clinicians participated in phone interviews.
    Results: All professions had a high prevention of face-to-face with the use of video consultations (68.6% overall and 81.4% of clinicians reported the prevention). However, this was lower for certain professions such as podiatrists, potentially due to the specific patient needs, such as physical assessments. Also, a range of different appointment types were being conducted, and there was a high acceptance of these alternative methods among participants. The interviews with clinicians revealed five important aspects of video consultations: the perceived benefits, the perceived challenges, technology issues and necessary improvements, clinician preference and the future of video consulting. Specifically, the future of video consulting evidenced clinicians' desire for a blended approach to working, selecting the appropriate modality depending on the situation and patient-specific needs.
    Conclusions: Integrating the traditional methods of service delivery (face-to-face), and novel, innovative ways, such as video consultations, can motivate positive transformations for the efficiency and efficacy of health and social care.
    MeSH term(s) Humans ; COVID-19/epidemiology ; Pandemics ; Qualitative Research ; Referral and Consultation ; Telemedicine/methods ; Allied Health Personnel
    Language English
    Publishing date 2023-05-17
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2022-068176
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  4. Article ; Online: The Perception of Health Care Practitioners Regarding Telemedicine During COVID-19 in Saudi Arabia: Mixed Methods Study.

    Alqurashi, Heba / Mohammed, Rafiuddin / AlGhanmi, Amany Shlyan / Alanazi, Farhan

    JMIR formative research

    2023  Volume 7, Page(s) e47065

    Abstract: ... health care professionals to obtain their view of telemedicine services in their hospitals.: Results: The study revealed ... and experiences of health care professionals with telemedicine during the COVID-19 pandemic ... and health care providers to communicate more efficiently and effectively.: Objective: This study ...

    Abstract Background: Telemedicine is a rapidly evolving field that uses information and communication technology to provide remote health care services, such as diagnosis, treatment, consultation, patient monitoring, and medication delivery. With advancements in technology, telemedicine has become increasingly popular during the COVID-19 lockdown and has expanded beyond remote consultations via telephone or video to include comprehensive and reliable services. The integration of telemedicine platforms can enable patients and health care providers to communicate more efficiently and effectively.
    Objective: This study aims to investigate the awareness, knowledge, requirements, and perceptions of health care practitioners in Saudi Arabia during the pandemic health crisis from the end-user perspective. The findings of this study will inform policy makers regarding the sustainability of telemedicine and how it affects the process of provision of health care and improves the patients' journey.
    Methods: This study adopted a mixed methods design with a quantitative-based cross-sectional design and qualitative interviews to assess the perceptions of various health care professionals working in outpatient departments that have a telemedicine system that was used during the COVID-19 pandemic. For both approaches, ethics approval was obtained, and informed consent forms were signed. In total, 81 completed questionnaires were used in this study. In the second phase, general interviews were conducted with managerial staff and health care professionals to obtain their view of telemedicine services in their hospitals.
    Results: The study revealed that most participants (67/81, 83%) were familiar with telemedicine technology, and the study proved to be statistically significant at P<.05 with a proportion of the participants (52/81, 64%) believing that continuous training was essential for its effective use. The study also found that consultations (55/153, 35.9%) and monitoring patients (35/153, 22.9%) were the major components of telemedicine used by health care professionals, with telephones being the most commonly used mode of interaction with patients (74/117, 63.2%). In addition, 54% (44/81) of the respondents expressed concerns about patient privacy and confidentiality, highlighting this as a major issue. Furthermore, the majority of participants (58/81, 72%) reported the necessity of implementing national standards essential for telemedicine technology in Saudi Arabia. The interviews conducted as part of the study revealed 5 major themes: culture, barriers and difficulties, communication, implementation, and evaluation. These themes highlighted the importance of a culture of acceptance and flexibility, effective communication, and ongoing evaluation of telemedicine technologies in health care systems.
    Conclusions: This study provides a crucial message with insights into the perceptions and experiences of health care professionals with telemedicine during the COVID-19 pandemic in Saudi Arabia.
    Language English
    Publishing date 2023-09-28
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-326X
    ISSN (online) 2561-326X
    DOI 10.2196/47065
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  5. Article ; Online: Acceptability of an mHealth App for Monitoring Perinatal and Postpartum Mental Health: Qualitative Study With Women and Providers.

    Varma, Deepthi S / Mualem, Maya / Goodin, Amie / Gurka, Kelly K / Wen, Tony Soo-Tung / Gurka, Matthew J / Roussos-Ross, Kay

    JMIR formative research

    2023  Volume 7, Page(s) e44500

    Abstract: ... privacy, and the security of mental health data as concerns. Health care professionals highlighted ... interviews with health care providers (n=8) were conducted to inform the acceptability of mHealth and ... for early diagnosis and intervention but not among pregnant and postpartum women.: Objective: This study aims ...

    Abstract Background: Up to 15% of pregnant and postpartum women commonly experience undiagnosed and untreated mental health conditions, such as depression and anxiety, which may result in serious health complications. Mobile health (mHealth) apps related to mental health have been previously used for early diagnosis and intervention but not among pregnant and postpartum women.
    Objective: This study aims to assess the acceptability of using mHealth to monitor and assess perinatal and postpartum depression and anxiety.
    Methods: Focus group discussions with pregnant and postpartum women (n=20) and individual interviews with health care providers (n=8) were conducted to inform the acceptability of mHealth and determine its utility for assessing perinatal and postpartum mood symptoms. Participants were recruited via purposive sampling from obstetric clinics and the surrounding community. A semistructured interview guide was developed by an epidemiologist with qualitative research training in consultation with an obstetrician. The first author conducted all focus group discussions and provider interviews either in person or via Zoom (Zoom Video Communications, Inc) depending on the COVID-19 protocol that was in place during the study period. All interviews were audio recorded with consent; transcribed; and uploaded for coding to ATLAS.ti 8 (ATLAS.ti Scientific Software Development Gmb H), a qualitative data analysis and retrieval software. Data were analyzed using the deductive content analysis method using a set of a priori codes developed based on the interview guide. Methodological rigor and quality were ensured by adopting a systematic approach during the implementation, data collection, data analysis, and reporting of the data.
    Results: Almost all women and providers had downloaded and used at least 1 health app. The respondents suggested offering short questions in layperson language that could be understood by women of all educational levels and offering no more than 2 to 3 assessments per day at preferred timings decided by the women themselves. They also suggested that the women themselves receive the alerts first, with other options being family members, spouses, or friends if the women themselves did not respond within 24 to 72 hours. Customization and snooze features were strongly endorsed by women and providers to improve acceptability and utility. Women mentioned competing demands on their time during the postpartum period, fatigue, privacy, and the security of mental health data as concerns. Health care professionals highlighted the long-term sustainability of app-based mood assessment and monitoring as an important challenge.
    Conclusions: The findings from this study show that mHealth would be acceptable to pregnant and postpartum women for monitoring mood symptoms. This could inform the development of clinically meaningful and inexpensive tools for facilitating the continuous monitoring of, the early diagnosis of, and an early intervention for mood disorders in this vulnerable population.
    Language English
    Publishing date 2023-06-07
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-326X
    ISSN (online) 2561-326X
    DOI 10.2196/44500
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  6. Article ; Online: Therapists' Experience of Video Consultation in Specialized Mental Health Services During the COVID-19 Pandemic: Qualitative Interview Study.

    Gullslett, Monika K / Kristiansen, Eli / Nilsen, Etty R

    JMIR human factors

    2021  Volume 8, Issue 3, Page(s) e23150

    Abstract: ... comprehensive knowledge about how therapists experience the use of video consultation (VC). To reach ... qualitative research is needed, and future studies should focus on service users' experiences, cocreation between ... shifting from institutional to noninstitutional care provision with increased integration of the use ...

    Abstract Background: As part of political and professional development with increased focus on including service users within mental health services, these services are being transformed. Specifically, they are shifting from institutional to noninstitutional care provision with increased integration of the use of electronic health and digitalization. In the period from March to May 2020, COVID-19 restrictions forced rapid changes in the organization and provision of mental health services through the increased use of digital solutions in therapy.
    Objective: The aim of this study was to develop and advance comprehensive knowledge about how therapists experience the use of video consultation (VC). To reach this objective, we evaluated therapists' experiences of using VC in specialized mental health services in the early phase of COVID-19 restrictions. The following questions were explored through interviews: Which opportunities and challenges appeared when using VC during the period of COVID-19 restrictions? In a short-term care pathway, for whom does VC work and for whom does it not work?
    Methods: This study employed a qualitative approach based on an abductive strategy and hermeneutic-phenomenological methodology. Therapists and managers in mental health departments in a hospital were interviewed via Skype for Business from March to May 2020, using a thematic interview guide that aimed to encourage reflections on the use of VC during COVID-19 restrictions.
    Results: Therapists included in this study experienced advantages in using VC under circumstances that did not permit face-to-face consultations. The continuity that VC offered the service users was seen as a valuable asset. Various negative aspects concerning the therapeutic environment such as lack of safety for the most vulnerable service users and topics deemed unsuitable for VC lowered the therapists' overall impression of the service. The themes that arose in the data analysis have been categorized in the following main topics: (1) VC-"it's better than nothing"; (2) VC affects therapists' work situation-opportunities and challenges in working conditions; and (3) challenges of VC when performing professional assessment and therapy on the screen.
    Conclusions: Experiences with VC in a mental health hospital during COVID-19 restrictions indicate that there are overall advantages to using VC when circumstances do not permit face-to-face consultations. Nevertheless, various negative aspects in the use of VC lowered the therapists' overall impression of VC. Further qualitative research is needed, and future studies should focus on service users' experiences, cocreation between different stakeholders, and how to scale up the use of VC while ensuring that the service provided is appropriate, safe, and available.
    Language English
    Publishing date 2021-07-15
    Publishing country Canada
    Document type Journal Article
    ISSN 2292-9495
    ISSN (online) 2292-9495
    DOI 10.2196/23150
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  7. Article ; Online: Experiences of psychiatrists and support staff providing telemental health services to Indigenous peoples of Northern Quebec

    Zhida Shang / Antonia Arnaert / Yvonne Hindle / Zoumanan Debe / Geneviève Côté-Leblanc / Amine Saadi

    BMC Health Services Research, Vol 21, Iss 1, Pp 1-

    2021  Volume 9

    Abstract: ... services. To our knowledge, there has been no qualitative study exploring the experiences of TMH staff ... to mental health care for Canada’s Indigenous peoples can be difficult. Telemental health (TMH) offers ... serving the Indigenous peoples in Northern Quebec, Canada; which is the purpose of this study. Methods ...

    Abstract Abstract Background Due to regional, professional, and resource limitations, access to mental health care for Canada’s Indigenous peoples can be difficult. Telemental health (TMH) offers the opportunity to provide care across vast distances and has been proven to be as effective as face-to-face services. To our knowledge, there has been no qualitative study exploring the experiences of TMH staff serving the Indigenous peoples in Northern Quebec, Canada; which is the purpose of this study. Methods Using a qualitative descriptive design, the entire staff of a TMH clinic was recruited, comprising of four psychiatrists and four support staff. Individual semi-structured interviews were conducted through videoconferencing, and results were thematically analyzed. Results To address the mental health gap in Northern communities, all psychiatrists believe in the necessity of in-person care and note the synergistic effect of combining in-person care and TMH services. This approach to care allows psychiatrists to maintain both an insider and outsider identity. However, if a patient’s condition requires hospitalization, then the TMH staff face a new set of information sharing and communication challenges with the inpatient staff. TMH staff believe that the provision of culturally sensitive care to Northern patients at the inpatient unit is progressing; however, more work needs to be done. Despite the strong collegial atmosphere within the clinic and collective efforts to provide quality TMH services, all participants express a sense of frustration with the paper-based and scattered documentation system. Conclusion The TMH team works in cohesion to offer TMH services to Indigenous peoples; yet, automatization is needed to improve the workflow efficiency within the clinic and collaboration with the Northern clinics. More research is needed on the functioning of TMH teams and the separate but important roles of each team member.
    Keywords Telemental health ; Telepsychiatry ; Videoconferencing ; Remote consultation ; Mental health ; Indigenous peoples ; Public aspects of medicine ; RA1-1270
    Subject code 360
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Teleoncology for indigenous patients: the responses of patients and health workers.

    Mooi, Jennifer K / Whop, Lisa J / Valery, Patricia C / Sabesan, Sabe S

    The Australian journal of rural health

    2012  Volume 20, Issue 5, Page(s) 265–269

    Abstract: Problem: Townsville Cancer Centre provides video-consultation (VC) services to patients in rural ... levels of satisfaction expressed from patients, families and HWs. Health professionals involved ... workers (HWs) to VC and such teleoncology service.: Design: Descriptive study, using semistructured ...

    Abstract Problem: Townsville Cancer Centre provides video-consultation (VC) services to patients in rural/remote regions of North Queensland in order to improve access to specialist cancer care. The experience and responses of indigenous patients using this service have not been studied. Our objective is to assess the level of satisfaction and the responses of Indigenous patients, their families and health workers (HWs) to VC and such teleoncology service.
    Design: Descriptive study, using semistructured interviews.
    Setting: Tertiary referral centre (Townsville Cancer Centre) and various rural and remote towns in Queensland.
    Key measures for improvement: Satisfaction levels of Indigenous patients, their family members and Indigenous HWs with various aspects of the teleoncology service.
    Lessons learnt: Our evaluation suggests that teleoncology is an acceptable model of care for Indigenous patients, with high levels of satisfaction expressed from patients, families and HWs. Health professionals involved with providing this service need to be adaptive to the needs of individual patients and local communities in order to provide culturally appropriate care. Formal skills training for staff, effective communication between specialist and local HWs, and informed consent procedures are essential to maintain safety of practices. Strategies for change are: • Mandatory informed consent procedure for all patients offered with VC. • Formalised competency training for staff in skills essential to maintain safe practices in teleoncology. • Clear clinical documentation to facilitate improved communication in patient management between medical staff at main centre and distant sites. • Further efforts in promotion, education and support for staff to participate in telemedicine.
    MeSH term(s) Adult ; Aged ; Female ; Health Personnel/psychology ; Humans ; Male ; Medical Oncology ; Middle Aged ; Neoplasms/ethnology ; Neoplasms/therapy ; Oceanic Ancestry Group ; Patient Satisfaction ; Qualitative Research ; Queensland ; Telemedicine
    Language English
    Publishing date 2012-10
    Publishing country Australia
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2069573-1
    ISSN 1440-1584 ; 1038-5282
    ISSN (online) 1440-1584
    ISSN 1038-5282
    DOI 10.1111/j.1440-1584.2012.01302.x
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  9. Article ; Online: Telemedicine in specialised palliative care: Healthcare professionals' and their perspectives on video consultations-A qualitative study.

    Funderskov, Karen Frydenrejn / Boe Danbjørg, Dorthe / Jess, Mia / Munk, Lene / Olsen Zwisler, Ann-Dorthe / Dieperink, Karin B

    Journal of clinical nursing

    2019  Volume 28, Issue 21-22, Page(s) 3966–3976

    Abstract: ... a nurse-participated in the study. The healthcare professionals' knowledge was based on n = 82 video ... multidisciplinary participation and co-operation among healthcare professionals. The continuous use of video ... practice: The use of video consultations can provide direct specialised palliative care over distance ...

    Abstract Aims and objectives: To explore the advantages and disadvantages of using video consultations, as experienced by specialised palliative care healthcare professionals, who are involved in palliative care at home.
    Background: One challenge in the work of specialised palliative care teams is the substantial resources used in terms of time and transport to and from the patient's home. Video consultations may be a solution for real-time specialised palliative home care.
    Designs: Hermeneutic, postphenomenology.
    Methods: An explorative qualitative study utilising data from field notes of an autobiographical diary, participant observations and semi-structured interviews with healthcare professionals. The COREQ guideline was used for reporting the study. See Appendix S1. The data collection took place in patients' homes and at the Department of Oncology, Odense University Hospital, Denmark.
    Results: Eight participants (n = 8); five community nurses; and three specialised palliative care team members-a head physician, a physiotherapist and a nurse-participated in the study. The healthcare professionals' knowledge was based on n = 82 video consultations with 11 patients. The range of video consultations was 3-18 per patient. The use of tablets in video consultations facilitated direct palliative care and led the community nurses and the specialised palliative care team nurse to co-operate. Potential barriers against using video consultations are the discussions about personal, and private issues regarding the illness, while family members are present.
    Conclusions: Video consultations in specialised palliative home care are feasible, and the technology can facilitate multidisciplinary participation and co-operation among healthcare professionals. The continuous use of video consultations over time may increase the quality of specialised palliative home care.
    Relevance to clinical practice: The use of video consultations can provide direct specialised palliative care over distance involving healthcare professionals, patients and their relatives.
    MeSH term(s) Adult ; Attitude of Health Personnel ; Denmark ; Female ; Hospice and Palliative Care Nursing/methods ; Humans ; Middle Aged ; Palliative Care/methods ; Qualitative Research ; Remote Consultation/methods ; Remote Consultation/statistics & numerical data
    Language English
    Publishing date 2019-08-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 1159483-4
    ISSN 1365-2702 ; 0962-1067 ; 1752-9816
    ISSN (online) 1365-2702
    ISSN 0962-1067 ; 1752-9816
    DOI 10.1111/jocn.15004
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  10. Article ; Online: What Are Orthopaedic Healthcare Professionals' Attitudes Toward Addressing Patient Psychosocial Factors? A Mixed-Methods Investigation.

    Reichman, Mira / Bakhshaie, Jafar / Grunberg, Victoria A / Doorley, James D / Vranceanu, Ana-Maria

    Clinical orthopaedics and related research

    2021  Volume 480, Issue 2, Page(s) 248–262

    Abstract: ... healthcare professionals?: Methods: In this multisite, mixed-methods study (that is, a study collecting ... secure live video with 79 orthopaedic healthcare professionals at three geographically diverse Level ... they related? (2) How do orthopaedic healthcare professionals' beliefs, reasonings, and experiences help ...

    Abstract Background: Integrating psychosocial resources into orthopaedic clinics can reduce psychological distress and opioid use after injury, enhance functional outcomes, and increase patient satisfaction with care. Establishing referral pathways for connecting orthopaedic patients with psychosocial resources requires the active collaboration and buy-in of orthopaedic healthcare professionals. Designing and disseminating psychosocial training materials for orthopaedic healthcare professionals requires a nuanced understanding of orthopaedic healthcare professionals' current attitudes toward addressing psychosocial factors, including any stigma and misconceptions about mental health that exist.
    Questions/purposes: (1) What are orthopaedic healthcare professionals' attitudes toward addressing patient psychosocial factors, and how are they related? (2) How do orthopaedic healthcare professionals' beliefs, reasonings, and experiences help to explain these attitudes? (3) How do attitudes differ between physicians and nonphysician healthcare professionals?
    Methods: In this multisite, mixed-methods study (that is, a study collecting both quantitative and qualitative data), our team of psychology researchers conducted qualitative focus groups over secure live video with 79 orthopaedic healthcare professionals at three geographically diverse Level I trauma centers. We approached all orthopaedic healthcare professionals within the three trauma centers to participate in the study to collect as many diverse perspectives as possible. Eighty-four percent (79 of 94) of the professionals we approached participated in qualitative data collection (the group of professionals comprised 20 attending surgeons; 28 residents; 10 nurse practitioners, registered nurses, and physician assistants; 13 medical assistants; five physical therapists and social workers; and three research fellows). We also asked participants to complete self-report items that assessed their attitudes toward addressing patients' psychosocial factors (research question 1). The different attitudes identified through the quantitative measurement served as a priori defined themes within which our two independent coders organized the qualitative data and identified beliefs and experiences that explained attitudes (research question 2). We used both quantitative and qualitative data to assess differences between surgeons and residents and nonphysician healthcare professionals (research question 3).
    Results: We quantitatively identified six underlying attitudes toward addressing psychosocial factors: professional confidence, perceived resource availability, fear of offending patients, fear of negative patient reactions, blame toward patients, and professional role resistance. We observed a strong quantitative correlation between the attitudes of professional confidence and perceived resource availability, and qualitative data revealed how healthcare professionals' willingness to discuss psychosocial issues with patients is shaped by their perception of psychosocial resources available for orthopaedic patients, as well as their perception of their own skills and tools to navigate these conversations. Quantitative data suggested that surgeons and residents endorse higher blame toward patients for psychosocial factors (medium effect size; p = 0.04), which is a stigmatizing attitude that serves as a barrier to integrating psychosocial resources into orthopaedic settings.
    Conclusion: The varying levels of confidence orthopaedic healthcare professionals reported with respect to the topic of discussing psychosocial factors and the misconceptions they endorse regarding psychosocial factors (such as blame toward patients) highlight the need for more specific education for orthopaedic healthcare professionals to help equip them with skills to raise and discuss psychosocial factors with patients in an empathic and destigmatizing manner.
    Clinical relevance: The strong relationship observed between the attitudes of professional confidence and perceived resource availability suggests that expanding the provision of psychosocial resources in orthopaedic settings and establishing specific, efficient referral processes to connect patients with psychosocial resources will in turn increase orthopaedic healthcare professionals' confidence discussing psychosocial issues with patients.
    MeSH term(s) Attitude of Health Personnel ; Cross-Sectional Studies ; Female ; Health Personnel ; Humans ; Internship and Residency ; Male ; Mental Health ; Orthopedic Surgeons ; Pain Management/psychology ; Physician-Patient Relations ; Professional Role ; Referral and Consultation
    Language English
    Publishing date 2021-11-15
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 80301-7
    ISSN 1528-1132 ; 0009-921X
    ISSN (online) 1528-1132
    ISSN 0009-921X
    DOI 10.1097/CORR.0000000000002043
    Database MEDical Literature Analysis and Retrieval System OnLINE

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