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Journal ArticleDOI

A comparison of communication modes in adult psychiatry.

C J Ball, Paul McLaren1, A. B. Summerfield1, Maurice Lipsedge1, J P Watson1 
01 Mar 1995-Journal of Telemedicine and Telecare (J Telemed Telecare)-Vol. 1, Iss: 1, pp 22-26
TL;DR: There were few significant differences between communication modes when using single measures; only multiple levels of analysis can adequately assess the differences between such modes of communication.
Abstract: The process and outcome of clinical tasks in an acute psychiatric unit were compared using four different communication modes: face to face, telephone, hands-free telephone, and a low-cost videoconferencing system. Six doctors and six patients took part in the study. Four assessment measures were used. The videoconferencing system was positively received by both patients and doctors. Both doctors and patients preferred communication modes with visual cues. However, there were few significant differences between communication modes when using single measures; only multiple levels of analysis can adequately assess the differences between such modes of communication.
Citations
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Journal ArticleDOI
03 Jun 2000-BMJ
TL;DR: The studies suggest that teleconsultation is acceptable to patients in a variety of circumstances, but issues relating to patient satisfaction require further exploration from the perspective of both clients and providers.
Abstract: Objective: To review research into patient satisfaction with teleconsultation, specifically clinical consultations between healthcare providers and patients involving real time interactive video. Design: Systematic review of telemedicine satisfaction studies. Electronic databases searched include Medline, Embase, Science Citation Index, Social Sciences Citation Index, Arts and Humanities Citation Index, and the TIE (Telemedicine Information Exchange) database. Subjects: Studies conducted worldwide and published between 1966 and 1998. Main outcome measures: Quality of evidence about patient satisfaction. Results: 32 studies were identified. Study methods used were simple survey instruments (26 studies), exact methods not specified (5), and qualitative methods (1). Study designs were randomised controlled trial (1 trial); random patient selection (2); case-control (1); and selection criteria not specified or participants represented consecutive referrals, convenience samples, or volunteers (28). Sample sizes were20 (10 trials),100 (14), >100 (7), and not specified (1). All studies reported good levels of patient satisfaction. Qualitative analysis revealed methodological problems with all the published work. Even so, important issues were highlighted that merit further investigation. There is a paucity of data examining patients9 perceptions or the effects of this mode of healthcare delivery on the interaction between providers and clients. Conclusions: Methodological deficiencies (low sample sizes, context, and study designs) of the published research limit the generalisability of the findings. The studies suggest that teleconsultation is acceptable to patients in a variety of circumstances, but issues relating to patient satisfaction require further exploration from the perspective of both clients and providers.

735 citations

Journal ArticleDOI
TL;DR: Progression of telemedicine services from "trial" status to routine health service must be supported by improved research into patients' satisfaction with telemedics, and factors that influence patient acceptance of teleomedicine are indicated.
Abstract: The objective of this study is to provide a systematic review of studies on patient satisfaction with telemedicine. The review included empirical studies that investigated patient satisfaction with that telemedicine service. The search strategy involved matching at least one of 11 'telemedicine' terms with one of 5 'satisfaction' terms. The following databases were searched: Telemedicine Information Exchange (TIE) database, MEDLINE, Science Citation Index (SCI), Social Science Citation Index (SSCI), Psycinfo, and Citation Index of Nursing and Allied Health (CINAHL). A highly structured instrument was used for data extraction. The review included 93 studies. Telepsychiatry represents the largest portion of these studies (25%), followed by multispecialty care (14%), nursing (11%), and dermatology (8%). Real-time videoconferencing was used in 88% of these studies. Only 19 (20%) included an independent control group, including 9 (10%) randomized control trial (RCT) studies. One third of studies were based on samples of less than 20 patients, and only 21% had samples of over 100 patients. Aspects of patient satisfaction most commonly assessed were: professional-patient interaction, the patient's feeling about the consultation, and technical aspects of the consultation. Only 33% of the studies included a measure of preference between telemedicine and face-to-face consultation. Almost half the studies measured only 1 or 2 dimensions of satisfaction. Reported levels of satisfaction with telemedicine are consistently greater than 80%, and frequently reported at 100%. Progression of telemedicine services from "trial" status to routine health service must be supported by improved research into patients' satisfaction with telemedicine. Further investigation of factors that influence patient acceptance of telemedicine is indicated.

220 citations

Journal ArticleDOI
TL;DR: Telepsychiatry is feasible, increases access to care, enables specialty consultation, yields positive outcomes, allows reliable evaluation, has few negative aspects in terms of communication, generally satisfies patients and providers, facilitates education, and empowers parties using it.
Abstract: Objective: Telepsychiatry in the form of videoconferencing brings enormous opportunities for clinical care, education, research, and administration. Focusing on videoconferencing, we reviewed the telepsychiatry literature and compared telepsychiatry with services delivered in person or through other technologies. Methods: We conducted a comprehensive review of telepsychiatry literature from January 1, 1965, to July 31, 2003, using the terms telepsychiatry, telemedicine, videoconferencing, effectiveness, efficacy, access, outcomes, satisfaction, quality of care, education, empowerment, and costs. We selected studies for review if they discussed videoconferencing for clinical and educational applications. Results: Telepsychiatry is successfully used for various clinical services and educational initiatives. Telepsychiatry is feasible, increases access to care, enables specialty consultation, yields positive outcomes, allows reliable evaluation, has few negative aspects in terms of communication, generally satisfies patients and providers, facilitates education, and empowers parties using it. Data are limited with regard to clinical outcomes and cost-effectiveness. Conclusions: Telepsychiatry is effective. More short- and long-term quantitative and qualitative research is warranted on clinical outcomes, predictors of satisfaction, costs, and educational outcomes.

216 citations


Cites background from "A comparison of communication modes..."

  • ...rate positively the experience with the specialist (47)....

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Journal ArticleDOI
TL;DR: Verbal content analysis is important for the development of interventions aimed at facilitating doctor-patient telecommunication, with all but two of the 23 categories analysed (non-verbal behaviour and lack of touch) reporting more positive than negative results.
Abstract: The literature about the effect of telemedicine on doctor-patient communication was reviewed. A total of 38 studies were identified: six were surveys of provider and community attitudes; 21 were post-encounter surveys of participants in a medical consultation; and 11 were qualitative analyses of behaviour in a medical encounter. Twenty-one of the 38 investigations originated in the USA, six in the UK, four in Australia, three in Norway, two in Canada, one in Finland and one in Sweden. All were relatively recent. The findings from each study were coded according to 23 categories developed from the literature and a positive or negative rating was assigned to each of the 213 communication results. Approximately 80% of abstracted findings favoured telemedicine, with all but two of the 23 categories analysed (non-verbal behaviour and lack of touch) reporting more positive than negative results. Verbal content analysis is important for the development of interventions aimed at facilitating doctor-patient telecommunication. However, further research is necessary if the nature and content of the communication process are to be fully understood.

160 citations

Journal ArticleDOI
TL;DR: A combined positivist and interpretivist evaluation strategy would enable researchers to make better-informed connections between telemedicine, medical encounter behaviour and health outcomes.
Abstract: The influence of telemedicine on the nature and content of doctor-patient communication stems from both its technical and its interpersonal aspects. While the technical aspects are concerned with the communication technologies used and the clinical processes enabled by those technologies, the interpersonal aspects are concerned with relationships between system personnel, providers and patients, and the way in which those relationships are organized. On the one hand, this paper posits that the influence of the technical environment stems from depersonalization of the doctor-patient relationship, participatory enhancements and impediments, and sensory and non-verbal limitations. On the other hand, it posits that the influence of the interpersonal environment stems from third-party participation, social and professional distancing, and underdeveloped norms and standards. A combined positivist and interpretivist evaluation strategy would enable researchers to make better-informed connections between telemedicine, medical encounter behaviour and health outcomes.

154 citations

References
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Journal ArticleDOI
TL;DR: The authors summarizes some measures of nonverbal behavior that have been found to be significant indicators of a communicator's attitude toward, status relative to, and responsiveness to his addressee.
Abstract: This paper summarizes some of the measures of nonverbal behavior that have been found to be significant indicators of a communicator’s attitude toward, status relative to, and responsiveness to his addressee. The nonverbal cues considered include posture, position, movement, facial, and implicit verbal cues. In addition to providing criteria for the scoring of these cues, experimental findings that relate to the various cues are summarized.

520 citations

Journal ArticleDOI
TL;DR: The high correlations achieved between the test scores in the two conditions suggests that this cognitive screening test may be reliably performed in this group of patients over a Low-Cost VideoConferencing System (LCVC).
Abstract: Mini-Mental State Examination scores were compared in an adult psychiatric population when the test was performed face to face and over a Low-Cost VideoConferencing System (LCVC). The minor changes to the instrument that are required to make it compatible with the LCVC are described. The high correlations achieved between the test scores in the two conditions suggests that this cognitive screening test may be reliably performed in this group of patients over the LCVC.

80 citations

Journal ArticleDOI
TL;DR: It is suggested that television may have its greatest value in remote sites where the sense of isolation is great and the need to reduce long-distance referrals offsets the costs of the system.
Abstract: Television and telephone communications were randomly used to compare their effectiveness in allowing consultation between a hospital-based physician and remote nurse practitioners. Visits using television for consultation averaged 50 minutes as compared with 40 minutes for telephone. This difference was caused by longer work-ups before the consultation, longer delays after it was requested, and longer consultations, themselves, on television. However, television consultations resulted in significantly fewer immediate referrals of patients to hospital physicians: 6 ±1 as compared to 12±1 per cent (mean ±S.E.M)of all telephone consultations(p < 0.05). Although no overall difference in satisfaction was documented between the results of television and telephone consultations, participants preferred the former for medical decision making and cited it for allowing more social interaction than telephone. These findings suggest that television may have its greatest value in remote sites where the sense ...

68 citations

Journal ArticleDOI
TL;DR: The role of the telephone in delivering primary health care in the UK is reviewed, highlighting the wide differences between the UK and other countries, notably the USA, in knowledge of and experience with telephone care.
Abstract: This paper reviews the role of the telephone in delivering primary health care It highlights the wide differences between the UK and other countries, notably the USA, in knowledge of and experience with telephone care The volume and nature of telephone contacts in family medicine are explored before focusing on calls which may be described as consultations, both in and out of office hours Aspects of telephone consultations examined include the quality of care, the effectiveness of training programmes and the role of other health professionals Important gaps in the literature are identified, including the lack of comparisons between telephone and face-to-face care in terms of the quality of process and outcomes and the lack of data on costs and benefits

45 citations

Journal ArticleDOI
TL;DR: Efficiency and effectiveness of color television, black and white television and hands-free telephone were compared with physical presence consultation, and significant rank order correlations were found between years of experience and both diagnostic accuracy and appropriate patient management.
Abstract: While the problem of providing adequate health care to remote populations has been widely recognized, little research has been undertaken to evaluate alternative systems designed to provide such care. An essential part of such a system is the communications link between the doctor and the community he is serving. Studying this two-way subsystem in the context of primary diagnosis and patient management, efficiency and effectiveness of color television, black and white television and hands-free telephone were compared with physical presence consultation. No significant differences in performance were found among the three systems using telecommunications. Physical presence consultation was found superior only for detecting secondary medical problems. Significant rank order correlations were found, however, between the years of experience of the consulting physician and both diagnostic accuracy and appropriate patient management. Also, the attitudes of the patients, doctors and nurses alike ranked physical presence over color television over black and white television over hands-free telephone for medical consultations.

31 citations