BACKGROUND: Telemedicine can facilitate delivery of thrombolysis in acute stroke. The aim of this qualitative study was to explore patients' and carers' views of their experiences of using a stroke telemedicine system in order to contribute to the development of reliable and acceptable telemedicine systems and training for health-care staff. METHOD: We recruited patients who had, and carers who were present at, recent telemedicine consultations for acute stroke in three hospitals in NW England. Semi-structured interviews were conducted using an interview guide based on normalization process theory (NPT). Thematic analysis was undertaken. RESULTS: We conducted 24 interviews with 29 participants (16 patients; 13 carers). Eleven interviews pertained to 'live' telemedicine assessments (at the time of admission); nine had mock-up telemedicine assessments (within 48 h of admission); four had both assessments. Using the NPT domains as a framework for analysis, factors relating to coherence (sense making) included people's knowledge and understanding of telemedicine. Cognitive participation (relational work) included interaction between staff and with patients and carers. Issues relating to collective action (operational work) included information exchange and support, and technical matters. Findings relating to reflexive monitoring (appraisal) included positive and negative impressions of the telemedicine process, and emotional reactions. CONCLUSION: Although telemedicine was well accepted by many participants, its use added an additional layer of complexity to the acute stroke consultation. The 'remote' nature of the consultation posed challenges for some patients. These issues may be ameliorated by clear information for patients and carers, staff interpersonal skills, and teamworking.
BACKGROUND: Telemedicine can facilitate delivery of thrombolysis in acute stroke. The aim of this qualitative study was to explore patients' and carers' views of their experiences of using a stroke telemedicine system in order to contribute to the development of reliable and acceptable telemedicine systems and training for health-care staff. METHOD: We recruited patients who had, and carers who were present at, recent telemedicine consultations for acute stroke in three hospitals in NW England. Semi-structured interviews were conducted using an interview guide based on normalization process theory (NPT). Thematic analysis was undertaken. RESULTS: We conducted 24 interviews with 29 participants (16 patients; 13 carers). Eleven interviews pertained to 'live' telemedicine assessments (at the time of admission); nine had mock-up telemedicine assessments (within 48 h of admission); four had both assessments. Using the NPT domains as a framework for analysis, factors relating to coherence (sense making) included people's knowledge and understanding of telemedicine. Cognitive participation (relational work) included interaction between staff and with patients and carers. Issues relating to collective action (operational work) included information exchange and support, and technical matters. Findings relating to reflexive monitoring (appraisal) included positive and negative impressions of the telemedicine process, and emotional reactions. CONCLUSION: Although telemedicine was well accepted by many participants, its use added an additional layer of complexity to the acute stroke consultation. The 'remote' nature of the consultation posed challenges for some patients. These issues may be ameliorated by clear information for patients and carers, staff interpersonal skills, and teamworking.
Authors: Bart M Demaerschalk; Madeline L Miley; Terri-Ellen J Kiernan; Bentley J Bobrow; Doren A Corday; Kay E Wellik; Maria I Aguilar; Timothy J Ingall; David W Dodick; Karina Brazdys; Tiffany C Koch; Michael P Ward; Phillip C Richemont Journal: Mayo Clin Proc Date: 2009 Impact factor: 7.616
Authors: Katie Gallacher; Deborah Morrison; Bhautesh Jani; Sara Macdonald; Carl R May; Victor M Montori; Patricia J Erwin; G David Batty; David T Eton; Peter Langhorne; Frances S Mair Journal: PLoS Med Date: 2013-06-25 Impact factor: 11.069
Authors: Beverley French; Elaine Day; Caroline Watkins; Alison McLoughlin; Jane Fitzgerald; Michael Leathley; Paul Davies; Hedley Emsley; Gary Ford; Damian Jenkinson; Carl May; Mark O'Donnell; Christopher Price; Christopher Sutton; Catherine Lightbody Journal: BMC Med Inform Decis Mak Date: 2013-11-14 Impact factor: 2.796
Authors: Carl R May; Amanda Cummings; Melissa Girling; Mike Bracher; Frances S Mair; Christine M May; Elizabeth Murray; Michelle Myall; Tim Rapley; Tracy Finch Journal: Implement Sci Date: 2018-06-07 Impact factor: 7.327
Authors: Michael Lyerly; Griffin Selch; Holly Martin; Michelle LaPradd; Susan Ofner; Glenn Graham; Jane Anderson; Sharyl Martini; Linda S Williams Journal: Stroke Date: 2020-11-23 Impact factor: 7.914
Authors: Michelle Farr; Jonathan Banks; Hannah B Edwards; Kate Northstone; Elly Bernard; Chris Salisbury; Jeremy Horwood Journal: BMJ Open Date: 2018-03-19 Impact factor: 2.692
Authors: Kathleen L Bagot; Dominique A Cadilhac; Christopher F Bladin; Caroline L Watkins; Michelle Vu; Geoffrey A Donnan; Helen M Dewey; Hedley C A Emsley; D Paul Davies; Elaine Day; Gary A Ford; Christopher I Price; Carl R May; Alison S R McLoughlin; Josephine M E Gibson; Catherine E Lightbody Journal: BMC Health Serv Res Date: 2017-11-21 Impact factor: 2.655