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Biomedical subjects

George Demiris

Publications and source records attributed to George Demiris.

At least 19 recordsLinked to original sources
PubMed2006

Defining obtrusiveness in home telehealth technologies: a conceptual framework.

The literature of home telehealth technology recommends that systems be designed to minimize their obtrusiveness to end users. However, this term is neither explicitly defined nor consistently used. This paper presents a definition of the concept of obtrusiveness. Within this definition, twenty-two categories of what may be perceived as obtrusive in home telehealth technology are proposed based on a review of the literature. These categories are grouped into eight dimensions. This effort represents an initial step toward developing measures of obtrusiveness associated with home telehealth technology. A validated and reliable instrument would allow for evaluation of individual applications as well as theory-building across applications.

Attitude to Health↗
PubMed2006

The diffusion of virtual communities in health care: concepts and challenges.

OBJECTIVE: This paper providers an overview and discussion of virtual communities in health care. Furthermore, we aim to discuss in this context ethical, legal and technical considerations and the current status of research in this domain. METHODS: We searched medical and social science literature including survey studies, randomized and non-randomized controlled interventions and reviews. RESULTS: The literature indicates that a virtual community in health care as a group of people using telecommunication with the purposes of delivering health care and education, and/or providing support, covers a wide range of clinical specialties, technologies and stakeholders. Examples include peer-to-peer networks, virtual health care delivery and research teams. Ethical challenges including the concepts of identity and deception, privacy and confidentiality and technical issues, such as sociability and usability are discussed. CONCLUSION: Virtual communities may empower patients and enhance coordination of care services; however, there is not sufficient systematic evidence of the effectiveness of virtual communities on clinical outcomes or patient empowerment. Researchers need to address issues, such as sample sizes and experimental design to further the research field in this domain. PRACTICE IMPLICATIONS: When practitioners utilize virtual community tools to communicate with patients or colleagues they have to maximize sociability and usability of this mode of communication, while addressing concerns for privacy and the fear of de-humanizing practice, and the lack of clarity or relevance of current legislative frameworks.

Attitude of Health Personnel↗
PubMed2006

Telehospice support for elder caregivers of hospice patients: two case studies.

This project reports on the experience of two hospice caregivers using videophone technology to enhance communication with their care providers. The data show the overall satisfaction and technical feasibility with videophone technology in home hospice. The case studies have great implication for future research because they reveal many unexpected issues relevant for future large-scale interventions.

Aged↗
PubMed2006

Social work informatics: a new specialty.

The use of technology in social work practice has risen dramatically over the past 10 years. Clinical interventions such as psychotherapy using telephones, interactive video, and the Internet are gaining in popularity. For a discipline traditionally tied to face-to-face interaction, many concerns about moving to technology-based practices have been raised. The National Association of SocialWorkers recently embraced a new initiative to address the challenges associated with technology in practice.The authors propose social work informatics as a new specialty for the profession to assist in meeting those challenges.

Humans↗
PubMed2006

Principles of survey development for telemedicine applications.

Surveys can be used in the evaluation of telemedicine applications but they must be properly designed, consistent and accurate. The purpose of the survey and the resources available will determine the extent of testing that a survey instrument should undergo prior to its use. The validity of an instrument is the correspondence between what is being measured and what was intended to be measured. The reliability of an instrument describes the 'consistency' or 'repeatability' of the measurements made with it. Survey instruments should be designed and tested following basic principles of survey development. The actual survey administration also requires consideration, for example data collection and processing, as well as the interpretation of the findings. Surveys are of two different types. Either they are self-administered, or they are administered by interview. In the latter case, they may be administered by telephone or in a face-to-face meeting. It is important to design a survey instrument based on a detailed definition of what it intends to measure and to test it before administering it to the larger sample.

Health Care Surveys↗
PubMed2006

Facilitating interdisciplinary design specification of "smart" homes for aging in place.

"Smart homes" are defined as residences equipped with sensors and other advanced technology applications that enhance residents' independence and can be used for aging in place. The objective of this study is to determine design specifications for smart residences as defined by professional groups involved both in care delivery to senior citizens and development of devices and technologies to support aging. We assessed the importance of specific devices and sensors and their advantages and disadvantages as perceived by the interdisciplinary expert team. This work lays the ground for the implementation of smart home residencies and confirms that only an interdisciplinary design approach can address all the technical, clinical and human factors related challenges associated with home-based technologies that support aging. Our findings indicate that the use of adaptive technology that can be installed in the home environment has the potential to not only support but also empower individual senior users.

Activities of Daily Living↗
PubMed2005

An evaluation framework for a rural home-based telerehabilitation network.

This study was a needs assessment to inform the design and evaluation of a home-based telerehabilitation network for rural elderly patients. We conducted a literature review of telerehabilitation studies and a needs-assessment by interviewing 43 professionals, including homecare nursing staff, members of volunteer organizations and service agencies, social workers, discharge planners, researchers, and rehabilitation therapists. The survey addressed perceived needs, advantages, and disadvantages with the use of telemedicine technologies for rehabilitation services. All respondents agreed that there are unmet needs among elderly people who are discharged from hospital settings, and identified several problems including: medication noncompliance, isolation, limited access to specialists and community-based services. Our findings defined a framework for the development of a client-oriented rural telehealth network that will be used to guide patients discharged to homecare following stroke, through a complex array of health, mental health, and social services, spanning all levels of care.

Aged↗
PubMed2005

The usability of videophones for seniors and hospice providers: a brief report of two studies.

This article uses a human factors evaluation framework to assess the usability of commercially available videophone technology. One study focuses on minimally functionally impaired seniors living in an assisted living facility. The second study focuses on usability for hospice staff. Seniors found the technology easy to use and were willing to accept the equipment in their homes, especially if requested by a healthcare provider. Administrators and hospice care providers also reported that the videophones were easy to use and would be of benefit to the patients they care for. The results indicate that videophones are a promising intervention with identifiable limitations.

Aged↗
PubMed2005

A comparison of communication models of traditional and video-mediated health care delivery.

BACKGROUND: While there may be benefits that accrue to the use of telemedicine technology in patient care, such as decreased costs and improved access, it has yet to be determined how telemedicine impacts patients' ability to express themselves and accordingly, how it impacts health care providers' communication of instructions or expressions of empathy. AIM: The aim of this study was to examine the effect of telemedicine technology on communication by comparing the style and content of communication between actual (i.e., face to face) and virtual (i.e., non-face to face, telemedical) dermatology visits. The hypothesis was that there is no difference in the content and style of communication between actual and virtual visits in dermatology. METHODS: Face-to-face and video-mediated dermatology sessions were observed and also audiotaped, timed and transcribed. A content analysis was performed. RESULTS: Average duration of a face-to-face session was 11 min (S.D. 0.08) and of a telemedical session 9 min (S.D. 0.002). Small talk occurred in 20% of all face-to-face and 29.6% of all telemedical visits. Clinical assessment occurred in all sessions. Patient education occurred in 90% of face-to-face and 78% of telemedical visits. Other themes were also identified (e.g., discussion of treatment, promotion of compliance, psychosocial issues). In 14.8% of telemedical sessions technical issues were raised. Findings indicate that communication patterns in the two modes of care delivery are comparable.

Communication↗
PubMed2005

An analysis of the specialized literature in the field of telemedicine.

We studied all articles in journals specializing in telemedicine and indexed in MEDLINE. Non-peer-reviewed journals or those that were in print for less than five years were excluded. The two journals which met the inclusion criteria were the Journal of Telemedicine and Telecare (JTT) and the Telemedicine Journal and E-Health (TJE). For each article we examined the Medical Subject Heading (MeSH) terms, the country of the first author and the study type. In October 2004, there were 1321 articles listed: 993 in the JTT (75%) and 328 in the TJE (25%). The majority of papers were classified as general journal articles; the number classified as clinical trials was very low (4%). Based on the MeSH term, teleradiology was one of the most widely studied application areas (14%). The Internet was used in 137 publications (10%) as a MeSH term. Of all papers, 24% were from the USA, followed by 21% from the UK and 12% from Australia. However, 47 countries contributed the other one-third of papers (9% country unknown). The present study shows that publications in telemedicine cover a wide range, both geographically and in terms of clinical disciplines. This suggests that the field of telemedicine is maturing.

Bibliometrics↗
PubMed2005

Users' needs and expectations of electronic medical record systems in family medicine residence settings.

While physician informational needs have been examined in the literature, rarely do the findings have the specificity required to drive development of Electronic Medical Records (EMRs) features. Using Delphi methodology, a comprehensive list of desirable, ranked EMR features was developed for physician residency practices. The identified EMR features and implications for system development are explored in this paper.

Computer Systems↗
PubMed2005

Exploring electronic conversion of behavioral instruments for telehealth.

As research interests in telehealth applications increase, traditional behavioral instruments need to be adapted for use for new mediums in telehealth evaluation. Display and method of presentation changes can affect the reliability and occasionally the validity of the revised instruments. This paper explores critical concerns to be addressed with electronic conversion of psychometric instruments and provides an example of testing methodology and psychometric properties for an instrument measuring quality of life (CQLI) converted in electronic format for use within a telehealth intervention.

Humans↗
PubMed2005

Patient and family involvement in hospice interdisciplinary teams.

Hospice programs rely on interdisciplinary team (IDT) collaboration in the delivery of quality care at the end of life. The hospice philosophy advocates patient autonomy in decision making, and treatment of the patient and family as a unit of care. Including patients and families in IDT meetings regarding their care is a logical corollary of this philosophy. Hospice professionals in one Midwestern US state were interviewed by phone to determine the extent of patient and family involvement in their IDT meetings. A few programs had direct experience with patients and families attending IDT meetings, but attendance was not routine. Better communication was recognized as a potential benefit. The patient's frailty and the burdens of caregiving for the family were noted challenges to participation. Video-mediated communication is offered as a potential solution.

Attitude of Health Personnel↗
PubMed2005

Home-based assistive technologies for elderly: attitudes and perceptions.

This study aim is to explore the perceptions of seniors in regard to "smart home" technology aiming to improve their quality of life and/or monitor their health status. A total of 15 older adults participated in three focus groups. Participants had a positive attitude towards these technologies and identified application areas such as emergency help, detection of falls, monitoring of physiological parameters. Concerns were expressed about privacy and the need for tailored training.

Activities of Daily Living↗