![]() ![]() Participants were invited to communicate with their surgeon via Skype, in addition to their scheduled follow-up appointments, on five separate occasions: 1, 3, 4, 6 and 9 weeks. 10 The Skype service was offered to 78 patients following total joint arthroplasty. 9Ī 2014 study reported the use of Skype for orthopaedic clinical follow-up. A study of increased social contact among older adults with access to Skype suggests an alternative explanation: Skype itself may be a valuable tool for wider social integration, thus improving mental health. The authors speculated that the more focused nature of the Skype-delivered sessions may have been responsible for these sustained benefits. However, at 36-week follow-up, the participants in the Skype arm of the trial experienced significantly better outcomes than those in the in-person condition. 8 Both the in-person and Skype-delivered problem-solving therapy were effective at reducing depression scores and disability outcomes. In one study of the management of depression in older housebound adults, participants were randomised to receive either in-person problem-solving therapy, Skype-delivered problem-solving therapy or a weekly telephone call with no therapeutic content. Some studies have studied the use of Skype in the management of other chronic diseases. 7 However, losses to follow-up were high: of 47 (of 92) participants randomised to Skype, follow-up data were available in only 32. 6 Adherence to treatment and glycaemic control were also similar in the Skype and face-to-face groups. 5 The authors found that 10 sessions delivered via Skype were as effective as 10 face-to-face sessions at maintaining the working alliance. Below, we review the higher quality primary studies from Arnfield and colleague's review that are relevant to our own study along with some additional studies published recently.Ī study of family-based behavioural support for adolescents with poorly controlled type 1 diabetes mellitus focused on the ‘working alliance’-that is, the strength of the working relationship between patients, caregivers and healthcare professionals. 4 Most of these studies were brief descriptions of small, pilot-stage projects (some with as few as five patients). 2–4 In particular, a recent review identified 27 published studies of the use of Skype in clinical care, all but one of which reported positive benefits. The evidence base on remote consultations by video technology such as Skype is currently sparse but has begun to accumulate. But fears have been expressed that they may be clinically risky and/or less acceptable to patients or staff, and they bring significant technical, logistical and regulatory challenges. Remote consultations offer potential advantages to patients (who are spared the cost and inconvenience of travel) and the healthcare system (eg, they may be more cost-effective). ![]() The UK's National Information Board has argued that to respond effectively to these demographic and epidemiological trends, we need a different kind of health service in which the traditional outpatient consultation, for example, will become increasingly obsolete. ![]() The health service faces rising rates of chronic illness and dependency, but also a proportion of citizens who are confident to self-manage illness, and improved long-term outlook for serious conditions such as cancer. Technology-supported consulting is viewed by many as at least a partial solution to the complex challenges of delivering healthcare to an ageing and increasingly diverse population. Howard said she wanted to share her experience with her 2.One of the greatest opportunities of the 21st century is the potential to safely harness the power of the technology revolution…to meet the challenges of improving health and providing better, safer, sustainable care for all.-UK National Information Board, November 2014, page 6 1 “Instead, I’m an emotionally-charged ball of wonder and awe, practicality and possibility, with an indefatigable capacity to find humor and joy in the absurdity of whatever life serves up.” “I’m not the optimist I once envisioned myself to be,” she wrote. Instead of fighting back every negative emotion that comes her way, Howard said she now tries to embrace all her feelings. Those challenges ARE the journey, the purpose, not an annoyance we can gaslight with militant optimism and denial.” And that realization marked a turning point in her mental health journey: “It’s taken quite a bit, but what I’ve learned since is that my form of ‘optimism’ means having the grace to navigate both internal and external obstacles. ![]()
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