Kantarcigil Cagla, Malandraki Georgia A
Department of Speech, Language, & Hearing Sciences, Purdue University, Lyles-Porter Hall, 715 Clinic Drive, West Lafayette, IN, 47907, USA.
Dysphagia. 2017 Aug;32(4):548-558. doi: 10.1007/s00455-017-9798-y. Epub 2017 Apr 19.
The need for developing effective telehealth tools for dysphagia management is high not only for people who live in rural areas, but also for individuals with mobility/access limitations. We aimed to develop an electronic case History Tool/form (thereafter, e-HiT) for dysphagia, and compare its effectiveness with its paper-based version (PBV) on completion time, completeness, independence, and patient perceptions/satisfaction. Secondarily, we examined associations between the aforementioned variables and predictor variables, such as age, cognition, and computer/internet use. Forty adults who expressed concerns with eating/swallowing participated. To compare both versions, a randomized, controlled two-period crossover design was used. In Visit 1, Group A completed the e-HiT and Group B completed the PBV. In Visit 2, Group A completed the PBV and Group B completed the e-HiT. A satisfaction survey was completed post visits. There were no statistically significant differences for completion time (p = 0.743), completeness (p = 0.486), and independence (p = 0.738). Patient perception/satisfaction was significantly higher with the e-HiT (p = 0.004). In addition, a significant association was found between completion time and age (p = 0.0063). Our results indicate that completing the e-HiT is as time efficient as completing the PBV and that both forms elicit the same amount of information with no or minimal support. Also, completion of the e-HiT yielded significantly higher satisfaction responses. This is the first study documenting the effectiveness of the e-HiT for outpatients with dysphagia, providing evidence that the first step of a swallowing assessment-case history completion-can be effectively completed via telehealth by individuals with reliable internet connection and basic computer literacy skills.
开发有效的远程医疗工具用于吞咽困难管理的需求不仅对于生活在农村地区的人很高，对于行动不便/获取资源受限的个体也是如此。我们旨在开发一种用于吞咽困难的电子病史工具/表单（以下简称e-HiT），并在完成时间、完整性、独立性以及患者认知/满意度方面将其与纸质版本（PBV）的有效性进行比较。其次，我们研究了上述变量与预测变量之间的关联，如年龄、认知以及计算机/互联网使用情况。40名对进食/吞咽表示担忧的成年人参与了研究。为了比较两个版本，采用了随机、对照的两阶段交叉设计。在第1次就诊时，A组完成e-HiT，B组完成PBV。在第2次就诊时，A组完成PBV，B组完成e-HiT。就诊后完成了满意度调查。在完成时间（p = 0.743）、完整性（p = 0.486）和独立性（p = 0.738）方面没有统计学上的显著差异。患者对e-HiT的认知/满意度显著更高（p = 0.004）。此外，发现完成时间与年龄之间存在显著关联（p = 0.0063）。我们的结果表明，完成e-HiT与完成PBV在时间效率上相同，并且两种表单在无支持或极少支持的情况下能获取相同数量的信息。此外，完成e-HiT产生了显著更高的满意度反馈。这是第一项记录e-HiT对吞咽困难门诊患者有效性的研究，提供了证据表明吞咽评估的第一步——病史填写——可以由具有可靠互联网连接和基本计算机素养技能的个体通过远程医疗有效完成。
