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  • 1. Biagio, Leigh
    et al.
    Swanepoel, De Wet
    Laurent, Claude
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
    Lundberg, Thorbjörn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Video-otoscopy recordings for diagnosis of childhood ear disease using telehealth at primary health care level2014In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Journal of telemedicine and telecare, ISSN 1758-1109, Vol. 20, no 6, p. 300-306Article in journal (Refereed)
    Abstract [en]

    We studied the diagnoses made by an otologist and general practitioner (GP) from video-otoscopy recordings on children made by a telehealth facilitator. The gold standard was otomicroscopy by an experienced otologist. A total of 140 children (mean age 6.4 years; 44% female) were recruited from a primary health care clinic. Otomicroscopic examination was performed by an otologist. Video-otoscopy recordings were assigned random numbers and stored on a server. Four and eight weeks later, an otologist and a GP independently graded and made a diagnosis from each video recording. The otologist rated the quality of the video-otoscopy recordings as acceptable or better in 87% of cases. A diagnosis could not be made from the video-otoscopy recordings in 18% of ears in which successful onsite otomicroscopy was conducted. There was substantial agreement between diagnoses made from video-otoscopy recordings and those from onsite otomicroscopy (first review: otologist κ = 0.70 and GP κ = 0.68; second review: otologist κ = 0.74 and GP κ = 0.75). There was also substantial inter-rater agreement (κ = 0.74 and 0.74 at the two reviews) and intra-rater agreement (κ = 0.77 and 0.74 for otologist and GP, respectively). A telehealth facilitator, with limited training, can acquire video-otoscopy recordings in children for asynchronous diagnosis. Remote diagnosis was similar to face-to-face diagnosis in inter- and intra-rater variability.

  • 2.
    Boman, Kurt
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Brenander, Andre
    Gustavsson, Mats
    Furberg, Curt D
    A pilot test of a new tool for remote blood pressure monitoring2014In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 20, no 5, p. 239-241Article in journal (Refereed)
    Abstract [en]

    We conducted a pilot trial of a remote blood pressure (BP) monitoring system, in which subjects measured their own BP at a primary healthcare centre. The data were wirelessly transmitted to the general practitioner. A total of 132 subjects with a new or prior diagnosis of hypertension were enrolled. Their mean age was 61 years and 77 were men (58%). They were followed for an average of 487 days (range 19-1110). The median number of BP measurements made was 6 per patient (range 2-49). The mean blood pressure decreased from 137/85 to 132/78 mmHg (P < 0.001) and the percentage of subjects with adequately controlled BP (defined as < 140/90 mmHg) increased from 47 to 66% (P < 0.01). Randomised trials are now required to confirm these findings.

  • 3.
    Boman, Kurt
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Davidson, Thomas
    Gustavsson, Mats
    Olofsson, Mona
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Renström, Gun-Britt
    Johansson, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Telemedicine improves the monitoring process in anticoagulant treatment2012In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 18, no 6, p. 312-316Article in journal (Refereed)
    Abstract [en]

    We compared the INR (International Normalized Ratio) monitoring process using a telemedicine device with the conventional approach in which blood samples were sent to the hospital for analysis. We conducted a randomized controlled trial. We enrolled 40 patients on chronic warfarin therapy from two primary healthcare centres (PHCs). Half were monitored using the telemedicine device and half were monitored conventionally. Each patient received three INR measurements. The total processing time was measured from blood sampling until warfarin dosing was performed in the anticoagulant clinic. The median total processing time was significantly shorter with telemedicine than usual care (34 vs. 260 min, P < 0.001). This was mainly because sample transport was avoided using the point-of-care device and automatic data transmission. Telemedicine reduced the total processing time for INR monitoring and has the potential to improve the management of patients undergoing anticoagulant treatment at PHCs.

  • 4. Eriksson, Lisbeth
    et al.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ekenberg, Lilly
    Patients' experiences of telerehabilitation at home after shoulder joint replacement2011In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 17, p. 25-30Article in journal (Refereed)
    Abstract [en]

    We investigated the experience of ten patients who received video-based physiotherapy at home for two months after a shoulder joint replacement. Videoconferencing took place via the patient's home broadband connection at a bandwidth of 256-768 kbit/s. Qualitative interviews were carried out, transcribed and analysed. Through qualitative content analysis six categories were identified: (1) a different reinforced communication; (2) pain-free exercising as an effective routine; (3) from a dependent patient to a strengthened person at home; (4) closeness at a distance; (5) facilitated daily living; and (6) continuous physiotherapy chain. The access to bodily knowledge, continuity, collaboration and being at home were all aspects that contributed to the patients' recovery. The patients described experiences of safety, and strengthening during their daily exercise routine at home. The frequent interplay with the patient during telerehabilitation made it possible for the physiotherapist to make an individual judgement about each patient; this could be one reason for the positive findings. Home video-based physiotherapy may be useful in other kinds of physiotherapy.

  • 5. Eriksson, Lisbeth
    et al.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gard, Gunvor
    Lysholm, Jack
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Physiotherapy at a distance: a controlled study of rehabilitation at home after a shoulder joint operation.2009In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 15, no 5, p. 215-220Article in journal (Refereed)
    Abstract [en]

    We explored the benefit of video communication in home rehabilitation after shoulder joint replacement and compared it to referral for physiotherapy in the conventional way. A total of 22 patients were included in the study. The intervention group (n = 10) had training at home under the supervision of a physiotherapist at the hospital using videoconferencing. The control group (n = 12) had physiotherapy training in a conventional way in their home town. All patients had the same postoperative, three-phase-programme for two months. The outcome measures were a Visual Analogue Scale (VAS) for pain, range of motion (ROM), shoulder function ability (Constant score and SRQ-S) and health-related quality of life (SF-36). Questions about areas of priority for improvement and general satisfaction with the shoulder were also included. The telemedicine group received a greater number of treatments compared to the control group. After the intervention, there were significant improvements in VAS-pain, Constant score and SRQ-S for both groups. The telemedicine group improved significantly more in all three measurements than the control group (P < 0.001 for all). When changes from baseline to follow-up were compared, the telemedicine group improved significantly more in terms of decrease in pain (P = 0.004) and vitality (P = 0.001) than the control group. Despite some limitations, there seem to be clear benefits from physiotherapy at a distance with a telemedicine technique that allows patients to obtain access to physiotherapy at home.

  • 6. Nilsson, Mats
    et al.
    Rasmark, Ulf
    Nordgren, Helena
    Hallberg, Per
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Umeå University, Faculty of Science and Technology, Centre for Biomedical Engineering and Physics (CMTF).
    Skönevik, Johan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Westman, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    The physician at a distance: the use of videoconferencing in the treatment of patients with hypertension2009In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 15, no 8, p. 397-403Article in journal (Refereed)
    Abstract [en]

    We evaluated the feasibility and quality of uncomplicated hypertension care based on telemedicine in a rural area of northern Sweden. The intervention subjects were 91 consecutive patients with primary hypertension. For comparison, 182 age- and sex-matched patients with hypertension were randomly selected from a similar health centre. The telemedicine equipment consisted of a video link between the physician and the patients, supported by a system for accessing medical data via the Internet. During a 21-month study period, telemedicine was used in 270 (91%) of the 297 consultations in the intervention group. All health personnel involved in the telemedicine treatment rated the method as feasible. Both systolic and diastolic blood pressure improved in the two groups during the study period. In the intervention group, a higher proportion had their blood pressure within treatment goals (systolic blood pressure <140 mmHg, diastolic blood pressure <90 mmHg) both at baseline and at follow-up than in the comparison group. An adjusted multivariate model (adjustment for sex, age, time between visits, change in number of drugs between first and last visit, blood pressure at first visit) showed that the intervention group had a higher probability (OR 2.7, 95% CI 1.4-5.2) of reaching the target blood pressure levels than the reference group. Treatment of hypertension by means of telemedicine was quite feasible and at least as effective as face-to-face consultations with a physician.

  • 7.
    Sävenstedt, Stefan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing.
    Family members’ narrated experiences of communicating via video-phone with patients with dementia staying at a nursing home2003In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 9, no 4, p. 216-220Article in journal (Refereed)
    Abstract [en]

    We studied the experience of family members who communicated via video-phones with elderly demented patients who were either staying at a home for temporary respite care or living in a nursing home. The study was based on qualitative data from seven interviews. The interviewees each had three or more months' experience with a video-phone. The open interviews were transcribed. Content analysis showed that video-phone conversations made the relatives of patients at nursing homes more involved in the caring process and that conversation via the video-phone was a different way of communicating. Video-phone conversations with demented patients were in some cases more focused and of better quality than face-to-face conversations. In most cases the video-phone conversations required the assistance of staff at the home in order to be meaningful. Video-phones have the potential to become useful tools for family members caring for elderly relatives.

  • 8.
    Sävenstedt, Stefan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bucht, Gösta
    Norberg, Lennart
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurse-doctor interaction in teleconsultations between a hospital and a geriatric nursing home2002In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 8, no 1, p. 11-18Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to elucidate both the interactionbetween a doctor and five registered nurses and the problemsor tasks dealt with in teleconsultations between a universityclinic for geriatric medicine and a nursing home for the elderlyin northern Sweden. The interaction and problems or tasks werestudied through analyses of video-recorded teleconsultationsand through open interviews with the participating staff. Theresults indicated that teleconsultations between a geriatricianand the nurses at a nursing home for the elderly can be a usefultool for providing medical services. Teleconsultations alterboth the 'power-control' and 'practice spheres' for the doctorand the nurses, and must be based on mutual trust. The use ofteleconsultations gives the nurse a larger role as the presenterof medical problems, and gives the doctor the role of remoteconsultant.

1 - 8 of 8
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  • en-US
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  • nn-NO
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