Telemedicine in Surgical Care in Low‐ and Middle‐Income Countries: A Scoping Review

Owolabi, Eyitayo Omolara; Quene, Tamlyn Mac; Louw, Johnelize; Davies, Justine; Chu, Kathryn

doi:10.1007/s00268-022-06549-2

Cited by 27 publications

(23 citation statements)

References 247 publications

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“…Adherence to close follow-up of BMS patients is important but challenging beyond 2 years, where the rate is reported to be 40–62% [ 31 – 33 ]. We observed in the current study, as in most other BMS studies, that the rate of postoperative patient-reported dietitian interaction and routine blood testing was quite low.…”

Section: Discussionmentioning

confidence: 99%

Long-term Reported Outcomes Following Primary Laparoscopic Sleeve Gastrectomy

et al. 2022

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Background Long-term laparoscopic sleeve gastrectomy (LSG) outcomes in patients with obesity are scarce. We aimed to examine the outcomes and subjective experience of patients who underwent primary LSG with long-term follow-up. Methods The study is a retrospective observational analysis of patients who underwent primary LSG in a single center with 5–15 years of follow-up. Patients’ hospital chart data supplemented by a detailed follow-up online questionnaire and telephone interview were evaluated. Results The study sample included 578 patients (67.0% female) with 8.8 ± 2.5 years of mean follow-up, with a response rate to the survey of 82.8%. Mean baseline age and body mass index (BMI) were 41.9 ± 10.6 years and 42.5 ± 5.5 kg/m 2 , respectively. BMI at nadir was 27.5 ± 4.9 kg/m 2 , corresponding to a mean excess weight loss (EWL) of 86.9 ± 22.8%. Proportion of patients with weight regain, defined as nadir ≥ 50.0% EWL, but at follow-up < 50.0% EWL, was 34.6% ( n = 200) and the mean weight regain from nadir was 13.3 ± 11.1 kg. BMI and EWL at follow-up were 32.6 ± 6.4 kg/m 2 and 58.9 ± 30.1%, respectively. The main reasons for weight regain given by patients included “not following guidelines,” “lack of exercise,” “subjective impression of being able to ingest larger quantities of food in a meal,” and “not meeting with the dietitian.” Resolution of obesity-related conditions at follow-up was reported for hypertension (51.7%), dyslipidemia (58.1%) and type 2 diabetes (72.2%). The majority of patients (62.3%) reported satisfaction with LSG. Conclusions In the long term, primary LSG was associated with satisfactory weight and health outcomes. However, weight regain was notable. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

Long-term Reported Outcomes Following Primary Laparoscopic Sleeve Gastrectomy

et al. 2022

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“…This possible explanation is supported by the World Bank report, “The Health Workforce in Ethiopia”, which shows Ethiopia is one of the countries with a very low health workforce, five times below the minimum threshold of 4.45 per 1000 population set by the World Health Organization to achieve the SDG Health. 37 …”

Section: Discussionmentioning

confidence: 99%

Preoperative Patient Education Practices and Predictors Among Nurses Working in East Amhara Comprehensive Specialized Hospitals, Ethiopia, 2022

Tadesse¹,

Kumar²,

Girma³

et al. 2023

JMDH

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Background The time before surgery is a traumatic period for patients. Despite this fact, no research has been conducted on nurses’ preoperative patient education in Ethiopia. This study aimed to assess preoperative patient education practices and associated factors among nurses working in East Amhara comprehensive specialized hospitals, Ethiopia, 2022. Methods A hospital-based cross-sectional study was conducted with 416 nurses. Pretested, structured questionnaires were used to collect the data. Bivariable analysis was performed for each independent variable with a P-value < 0.25 on the data imported to multivariate logistic regression analysis. AOR with a 95% CI and a P-value < 0.05 at a 5% level of significance were considered. Results Only 38.5% of nurses were found to have good practices for preoperative patient education, with a response rate of 98%. Nurses with 6 years of work experience (AOR = 3.15, 95% CI: 1.692–5.874), adequate time (AOR = 2.33, 95% CI: 1.119–4.889), training (AOR = 4.27, 95% CI: 1.548–11.796), age 25–29 (AOR = 0.15, 95% CI: 0.070–0.331), age 30–34 (AOR = 0.25, 95% CI: 0.137–0.479), and knowledge (AOR = 3.73, 95% CI: 2.222–6.273) were significantly associated. Conclusion Preoperative patient education practices among nurses were poor. Work experience, knowledge, training, and adequate time were found to be significant. Organize preoperative patient education programs for nurses that share experiences and provide ongoing training.

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“…While the use of telemedicine for surgical care has been emerging in LMICs and has been shown to streamline the follow-up care of CHD patients, this data is not captured withing the IQIC database. 20 21 Another limitation was the small sample size for quantitative analysis and that there was variation in the timing of the impact of the pandemic on various programmes, which only compared data between March and November in 2019 vs 2020. Further studies should be conducted regarding the effects of COVID-19 on paediatric cardiac critical access centres at later time periods.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the role of telemedicine was not adequately explored among the participating sites. While the use of telemedicine for surgical care has been emerging in LMICs and has been shown to streamline the follow-up care of CHD patients, this data is not captured withing the IQIC database 20 21. Another limitation was the small sample size for quantitative analysis and that there was variation in the timing of the impact of the pandemic on various programmes, which only compared data between March and November in 2019 vs 2020.…”

Section: Discussionmentioning

confidence: 99%

Effects of COVID-19 on paediatric cardiac centres in low-income and middle-income countries: a mixed-methods study

Dopke

Connor

Zheleva³

et al. 2022

BMJ Open

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ObjectivesThe aim of this study was to understand the effects of the COVID-19 pandemic on paediatric cardiac services in critical access centres in low-income and middle-income countries.DesignA mixed-methods approach was used.SettingCritical access sites that participate in the International Quality Improvement Collaborative (IQIC) for congenital heart disease (CHD) were identified.ParticipantsEight IQIC sites in low-income and middle-income countries agreed to participate.Outcome measuresDifferences in volume and casemix before and during the pandemic were identified, and semistructured interviews were conducted with programme representatives and analysed by two individuals using NVivo software. The qualitative component of this study contributed to a better understanding of the centres’ experiences and to identify themes that were common across centres.ResultsIn aggregate, among the seven critical access sites that reported data in both 2019 and 2020, there was a 20% reduction in case volume, though the reduction varied among programmes. Qualitative analysis identified a universal impact for all programmes related to Access to Care/Clinical Services, Financial Stability and Professional/Personal Issues for healthcare providers.ConclusionsOur study identified and quantified a significant impact of the COVID-19 pandemic on critical access to CHD surgery in low-income and middle-income countries, as well as a significant adverse impact on both the skilled workforce needed to treat CHD and on the institutions in which care is delivered. These findings suggest that the COVID-19 pandemic has been a major threat to access to care for children with CHD in resource-constrained environments and that this effect may be long-lasting beyond the global emergency. Efforts are needed to preserve vulnerable CHD programmes even during unprecedented pandemic situations.

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Telemedicine in Surgical Care in Low‐ and Middle‐Income Countries: A Scoping Review

Cited by 27 publications

References 247 publications

Long-term Reported Outcomes Following Primary Laparoscopic Sleeve Gastrectomy

Long-term Reported Outcomes Following Primary Laparoscopic Sleeve Gastrectomy

Preoperative Patient Education Practices and Predictors Among Nurses Working in East Amhara Comprehensive Specialized Hospitals, Ethiopia, 2022

Effects of COVID-19 on paediatric cardiac centres in low-income and middle-income countries: a mixed-methods study

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