Objective: The study sought to explore the experiences of participants affected by stroke with home video visit (HVV) for follow-up visits in order to understand the determinants, barriers, and benefits associated with HVVs. Methods: Semi-structured interviews were conducted with (n = 23) participants to gather insight and descriptive information about patients’ experiences with HVV. Specifically, we sought to collect descriptions about the (1) costs and time associated with in-person visits, (2) facilitators and barriers to in-person and virtual visits, and (3) their values attached to traditional and virtual forms of patient care. Results: HVVs were perceived to be a mode of healthcare that is time-saving and convenient for both participants and physicians. However, our study also found some participants felt uncomfortable using technology to conduct medical visits while others still supported a positive view of traditional forms of in-person visits because they valued the in-person interactions and safe environment of the hospital. Conclusion: While HVVs were considered to be useful in addressing geographical barriers to health care, technological and digital health literacy may serve to impede seniors from using the service, with some of them opting to go to the hospital despite geographical barriers. Resultantly, HVVs may serve both to alleviate and exacerbate certain determinants to health care.
Objective The objective of this study is to understand the perceptions of new mothers using virtual care via video conferencing to gain insight into the benefits and barriers of virtual care for obstetric patients. Methods Semi-structured interviews were conducted with 15 patients attending the Kingston Health Sciences Centre. The interviews were 20–25 min in length and recorded through an audio recorder. Thematic analysis was conducted in order to derive the major themes explored in this study. Results New mothers must often adopt new routines to balance their needs and their child’s needs. These routines could impact compliance and motivation to attend follow-up care. In our study, participants expressed high satisfaction with virtual care, emphasizing benefits related to comfort, convenience, communication, socioeconomic factors, and the ease of technology use. Participants also perceived that they could receive emotional support and build trust with their health care providers despite the remote nature of their care. Due to its ease of use and increased accessibility, we argue that virtual care shows promise to facilitate long-term compliance to care in obstetric patients. Conclusions Virtual care is a useful modality that could improve compliance to obstetric care. Further research and clinical endeavours should examine how social factors and determinants intersect to determine how they underpin patient perceptions of virtual and in-person care.
In this commentary, we consider the motivations and implications of Vancouver Coastal Health's place-based population health strategy called the Downtown Eastside Second Generation Health Strategy (2GHS) in light of a broader historical view of shifting values in population and public health and structural health reforms in Canada over the past three decades. We argue that the tone and content of the 2GHS signals a shift towards a neoliberal clientelist model of health that treats people as patients and the DTES as a site of clinical encounter rather than as a community in its own right. In its clinical emphasis, the 2GHS fails to recognize the political dimension of health and well-being in the DTES, a community that faces compounding health risks associated with colonialism, gentrification, human displacement, the criminalization of poverty, sex work, and the street economy. Furthermore, we suggest that in its emphasis on allocating funding based on a rationalist model of health system access, the 2GHS undermines well-established insights and best practices from community-driven health initiatives. Our aim is to provide a provocation that will encourage public health policy-makers to embrace community-based leadership as well as the broader structural health determinants that are at the root of the current circumstances of people in the DTES and other marginalized communities in Canada.KEY WORDS: Health care reform; social determinants of health; mental health La traduction du résumé se trouve à la fin de l'article.
Virtual care (VC), a novel method of healthcare delivery, allows patients to stay home or at their preferred location and use personal internet-enabled devices to video-conference with their healthcare provider. VC is becoming ubiquitous across the US and Canada, particularly in response to COVID-19. In this paper, we discuss the benefits and limitations of VC and explore how it may align with or detract from the four principles of bioethics through case studies. Overall, we argue that it allows for greater accessibility, availability, and affordability of healthcare. However, certain clinical scenarios may not be suitable for VC, particularly when a thorough physical examination is required. While it may not always be clear when to use digital health technologies, it is prudent to have an honest and open conversation with the patient when offering this option.
Objective: This study aimed to understand the perceptions of new mothers using virtual care in the form of video conferencing to gain insight into the social and environmental determinants that could potentially impact compliance for post-natal follow-up visits.Methods: Semi-structured interviews were conducted with 15 patients of Kingston Health Sciences Centre. The interviews were 20-25 minutes in length and recorded through an audio recorder. Thematic analysis was conducted in order to derive the major themes explored in this study.Results: In general, new mothers reported high satisfaction with virtual care, emphasizing benefits related to comfort, convenience, communication, socioeconomic factors, and the ease of technology use.Conclusions: Not only can virtual care address many of the barriers that new mothers face in accessing in-person healthcare services, but virtual care can also elucidate various social and environmental determinants responsible for facilitating access to postnatal follow-up care. Further research and clinical endeavours should focus on these various determinants (and the ways they intersect) and how they underpin patient perceptions of virtual and in-person care. Such a lens not only addresses the struggle of long-term patient compliance to maternal health care, but will additionally shed light on how to make obstetric care more equitable.
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