Corrections to: Evaluation of Psychometric Properties of Thai Version Telehealth Usability Questionnaire (T-TUQ), International Journal of Telerehabilitation

Corrections to:  Parima Hirunwiwatkul, MD, Punnaka Pongpanich, MD, Wasee Tulvatana, MD, Supharat Jariyakosol, MD, Warongporn Phuenpathom, MD, MS, Supaporn Krittanupong, RN, Ruttanabhorn Chonramak, BS, Tidarat Pichedvanichok, BSN, RN, Roongroj Bhidayasiri, MD, FRCP, Chaichana Nimnuan, MD, PhD. Evaluation of Psychometric Properties of Thai Version Telehealth Usability Questionnaire (T-TUQ), International Journal of Telerehabilitation,  Vol. 15, No. 2 Fall 2023 • (10.5195/ijt.2023.6577)

The Confounding Influence of Older Age in Statistical Models of Telehealth Utilization

Older age is a potentially confounding variable in models of telehealth utilization. We compared unified and stratified logistic regression models using data from the 2021 National Health Interview Survey. A total of 27,626 patients were identified, of whom 38.9% had utilized telehealth. Unified and stratified modeling showed a number of important differences in their quantitative estimates, especially for gender, Hispanic ethnicity, heart disease, COPD, food allergies, high cholesterol, weak or failing kidneys, liver conditions, difficulty with self-care, the use of mobility equipment, health problems that limit the ability to work, problems paying bills, and filling a recent prescription. Telehealth utilization odds ratios differ meaningfully between younger and older patients in stratified modeling. Traditional statistical adjustments in logistic regression may not sufficiently account for the confounding influence of older age in models of telehealth utilization. Stratified modeling by age may be more effective in obtaining clinical inferences

Pulmonary Telerehabilitation for People With Chronic Obstructive Pulmonary Disease in Brazil: A Mixed-Methods Feasibility Study

This study assessed the feasibility of pulmonary telerehabilitation’s (PTR) acceptability, implementation, practicality, and adaptation for people with Chronic Obstructive Pulmonary Disease (COPD) in Brazil. It also explored associations with clinical and socioeconomic features of Brazilians with COPD. This mixed-method study included thirty-one participants with COPD (age 62±10 years; FEV1= 72±14% predicted). Most participants (74.2%) reported good PTR session acceptability on the System Usability Scale and scores of ​4.6±0.3 and 4.5±0.6 on a 1-5 Likert-type scale of implementation and practicality, respectively. Participants suggested adaptations for better comfort on the exercise bike and varying exercise modalities. PTR acceptability was associated with participants’ younger age (rS=-0.57, p<0.01) and higher education (rS=0.51, p<0.01). PTR is feasible for people with COPD in Brazil regarding acceptability, implementation, practicality, and adaptation. Younger age and higher educational level are associated with greater PTR acceptability

Hybrid Cardiac Telerehabilitation After Acute Coronary Syndrome: Self-selection Predictors and Outcomes

Aims: To evaluate the effectiveness of a hybrid cardiac telerehabilitation (HCTR) program after acute coronary syndrome (ACS) on patient quality of life (QoL) and physical activity indices throughout phases 2-3 and establish predictors for hybrid program self-selection. Methodology: This single-centre longitudinal retrospective study included patients who attended a cardiac rehabilitation program (CRP) between 2018-2021. Patients self-selected between two groups: Group 1 – conventional CRP (CCRP); Group 2 – HCTR. Baseline characteristics were registered. EuroQol-5D (EQ-5D) and International Physical Activity Questionnaire (IPAQ) were applied at three times: T0 – phase 2 onset; T1 – phase 3 onset; T2 – 3 months after T1. Results: 59 patients participated (Group 1 – 27; Group 2 – 32). We found significant between-group differences regarding occupation (p=0.003). Diabetic patients were less likely to self-select into HCTR (OR=0.21; p<0.05). EQ-5D visual analogue scale and IPAQ result significantly improved between T0-T2 only for HCTR (p=0.001; p=0.021). Conclusions: HCTR was superior to CCRP on physical activity indices and QoL of ACS patients

The iMHere 2.0 System for Family Caregivers of Older Adults: A Focus Group

Background: Family caregivers with continuous caregiving responsibilities are at increased risk for adverse physical and mental health outcomes. In response to the challenges of caregiving, a mobile health system (iMHere 2.0) was developed to support caregivers. The study's objective was to gather feedback from family caregivers of older adults on the current features of iMHere 2.0 and to formulate design criteria for future iterations of the system. Methods: An exploratory qualitative study with thematic analyses of focus group feedback. Findings: A total of 10 caregivers of older adults participated in a focus group. Five themes emerged: (1) Monitoring health data, (2) Setting up customized reminders, (3) Supporting care coordination, (4) Balancing security and multiple user access, and (5) Disseminating iMHere 2.0 into the community, along with some potential barriers to implementation. Conclusions: Design criteria were developed to provide a framework for iterative design and development of the iMHere system to support caregivers of older adults

Letter to the Editor – Update from Ukraine: Development of the Cloud-based Platform for Patient-centered Telerehabilitation of Oncology Patients with Mathematical-related Modeling

This Letter to the Editor provides an update on the research from the Glushkov Institute of Cybernetics of the National Academy of Sciences of Ukraine. The Institute’s research team in collaboration with Ternopil National Medical University began a new project called “Development of the cloud-based platform for patient-centered telerehabilitation of oncology patients with mathematical-related modeling.” The project is dedicated to the development of a hybrid cloud-based platform, and the creation on its basis of information technology for the telemedicine rehabilitation of cancer patients, and adapted for patients with combat stress disorder. The distinctive features of the proposed technology are a combination of artificial intelligence methods with accurate mathematical methods for optimization: developing mathematical models of problems of discrete, and non-smooth optimization, subgradient space transformation algorithms (to minimize non-smooth functions with tens of thousands of variables), and a method of global equilibrium search, etc

The Effects of Virtual Caregiver Coaching in Antigua & Barbuda on the Implementation of EMT Language Support Strategies in Naturalistic Environments

This single-case multiple baseline design investigation set out to determine the effectiveness of using a telepractice service delivery model to coach caregivers in Antigua & Barbuda in the use of Enhanced Milieu Teaching (EMT) language support strategies with a child with language impairment. A slightly modified version of the Teach-Model-Coach-Review (TMCR) method was used during virtual instruction to train a caregiver on the language support strategies of environmental arrangement, matched turns, expansions, and time delay with milieu prompting. The caregiver attended sessions three times a week for up to 45 minutes for four weeks. The results of this study indicated a positive relationship between the intervention and caregiver use of strategies. The caregiver demonstrated increased responsiveness to the child’s communication attempts and exhibited the use of language support strategies across activities. This study suggests that telepractice can be an effective service delivery model for providing coaching to caregivers

Development of a Physical Therapy Telehealth Examination Battery for People with Parkinson Disease

Scope: The rapid transition to telehealth following the COVID-19 pandemic raised challenges for remote delivery of physical therapy. One challenge was identifying outcome measures for people with Parkinson Disease (PwP) that could safely be conducted via telehealth. This paper evaluates the feasibility of a telehealth physical therapy examination battery for PwP in early to middle stage of disease progression. Methodology: We reviewed recommended outcome measures from the American Physical Therapy Association’s Academy of Neurologic Physical Therapy (ANPT) Parkinson Evidence Database to Guide Effectiveness (EDGE) document and evaluated their appropriateness for remote administration. A clinical decision tree was created to streamline the examination process, incorporating elements of the ANPT movement analysis of tasks as a movement screen. The examination battery was then conducted on three PwP and evaluated for safety and feasibility. Conclusion: This physical therapy telehealth examination battery provides physical therapists with a method to conduct safe and efficient remote assessments for PwP

Guiding Documents for Engaging with Remote Chronic Disease Management Programs as a Healthcare Provider: A Scoping Review

Introduction: Chronic disease management programs (CDMP) that include education and exercise enhance outcomes and reduce healthcare costs. Remote CDMP have the potential to provide convenient, cost-effective, and accessible options for individuals, but it is unclear how to best implement programs that include education and exercise. This review identified and synthesized resources for implementing remote CDMP programs that incorporate education and exercise. Methods: Peer-reviewed and grey literature were systematically searched from January 1998 to May 2022. Covidence software was used for screening and extraction. The data were synthesized and presented in a narrative and tabular format. Results: Six peer-reviewed manuscripts and six grey literature documents published between 2006-2022 were included. All resources described individual programs targeting various chronic conditions. Provider training, consent, participant screening, and safety considerations were identified. Conclusions: Guidelines for remote CFMP programs are lacking. Additional work is needed to design remote CDMP guidelines incorporating education and exercise.

Evaluation of Psychometric Properties of Thai Version Telehealth Usability Questionnaire (T-TUQ)

This cross-sectional validation study aimed to translate, cross-culturally adapt, and investigate the psychometric properties of a Thai version of the Telehealth Usability Questionnaire (T-TUQ). Two hundred and ten Thai participants, mean age of 61.2±15.2 years, were recruited from three specialty clinics: 50 (23.8%) hematology, 70 (33.3%) movement disorders, and 90 (42.9%) general neurology. The T-TUQ was translated from the original English version to produce a Thai language version. Back translation and pilot cognitive interviews were completed. All five subscales (usefulness, ease of use, effectiveness, reliability, and satisfaction) showed excellent internal consistency (alpha >0.80), displayed by Cronbach's alpha coefficient of 0.83, 0.94, 0.86, 0.83, and 0.92, respectively. For construct validity, exploratory factor analysis revealed two dimensions from eigenvalues and scree plot, defined as utility and accessibility subscales. In conclusion, the T-TUQ could be a reliable and valid instrument to evaluate the usability of telehealth with a Thai population