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Objective: The study was designed to determine the acceptability, feasibility and validity of measuring quality of life in a representative sample of dementia patients with a generic instrument, the Duke Health Profile. Method: The French version of the Duke Health Profile was administered to 148 subjects with a mental disorder according to the DSM-III-R diagnostic criteria. The feasibility and acceptability of employing the instrument were determined by the refusal rate, the type of administration, and the percentage and distribution of missing data. Reliability was determined with Cronbach’s α coefficient. Instrument reproducibility was assessed with the intraclass correlation coefficient for test-retest values. Internal construct validity was determined by factor analysis. Discriminant capacity was determined by comparing the average scores on each measure among patients with and without an additional chronic pathology. The measurements obtained were compared by source of information (patient, family proxy and care provider proxy). Results: The feasibility and acceptability of the instrument was good. Only 2% of the patients refused to complete the questionnaire. Help from the interviewer was necessary in 79% of the cases. The average completion time was 10.6 min. Missing data exist in only 3.5% of the cases on average, except among patients with severe dementia (Mini Mental State Examination <10). For reliability, internal consistency was acceptable (Cronbach’s coefficient α = 0.5–0.7) when the self-esteem (0.23) and social health (0.26) concepts were eliminated. Reproducibility as measured by test-retest scores was moderate to good (intraclass correlation coefficient r = 0.53–0.80), except for anxiety (0.48) and perceived health (0.45). Severity of dementia mainly affected the feasibility, acceptability and reproducibility of the instrument. The family proxy seemed to agree more with the patient than did the care provider proxy. Conclusion: Quality of life can be measured in patients with dementia, but special tools need to be developed for severe dementia.

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The objectives of the present study were to explore the feasibility of conducting a telepsychological assessment with demented elderly patients, and to define the advantages and limitations of remote consultations.Remote consultations were compared with face-to-face consultations in the same patients. Each consultation consistedof aninitial interviewandtwo short psychometric tests (Mini-Mental State Examinationand the Clock Face Test). Observation schedules of patient behaviour were completed by the interviewing psychologist and also by the observer psychologist in the two consultationsituations. The remote interviews were carried out using two rooms in the hospital linked by a coaxial cable. Each roomwas equipped witha mobilecamera, amicrophone, atelevisionscreenandavideorecorder. Twenty-five hospitalized elderly people participated inthe study. Tenof the patients were diagnosedas demented (DSMIVcriteria) and 15 had no known cognitive deficits.Thevideo-linkedconsultationtooklonger thantheface-tofaceconsultationfor dementedpatients(26minvs 20min). However, for non-dementedpatients, theremoteinterviewwas shorter(18minvs22 min). Thetest scoresobtainedbythe dementedpatientsweresimilarinthetwotypesofconsultation. However, for non-dementedpatients, thescores obtainedwere significantlylowerintheremotesituation(P<0.003).Theratings of patientbehaviour bythetwopsychologistsindicatedthat dementedpatientsweremoreateasewiththevideo-linkthanthe non-dementedpatients. Teleconsultationisthereforepossible withdementedpatients, withlittledistortionofthetestresults.The provisionof medical services via a telemedical link has nowreached the stage where qualified medical staff at shore-based establishments can treat patients on remote vessels using videoconferencing facilities onboard ship. The main objective of seeing the patient is to provide better curative health care by effective visual examinationof the patient, followed by instructionof medical attendants onboard to performsurgical or medical procedures whichwere previously carriedoutbyradiomedical voiceinstruction. However, if this advanced health-care systemis to be successful, medical attendants on board ship and shore-based medical practitioners (at telemedicine centres) need to have much better theoretical and practical knowledge of curative care.One waytoprovide medical training for medical personnel involvedintelemedical careisbytheimplementationof more intensive medical training at nautical colleges and institutions. These courses should include training in basic investigations suchas an electrocardiogram(ECG) and blood andurine analysis as well as some of the invasive therapeutic measures (such as tracheotomy and minor surgery) expected to be made possible by the implementation of advanced telemedicine.Current medical training procedures in various countries have been reviewed. There are certain areas that need upgrading, especially the training that needs to be given in readiness toaccept healthcare bytelemedicine. The skills and competency requiredof medical personne...