Browsing by Author "Mars, Maurice"

Now showing 1 - 8 of 8
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    Developing telepsychiatry services in KwaZulu-Natal - an action research study
    (OMICS Publishing Group, 2012) Chipps, Jennifer; Ramlall, Suvira; Madigoe, Thebe; King, Howard; Mars, Maurice
    OBJECTIVE: In 2009, the Departments of Psychiatry and Telehealth of the University of KwaZulu-Natal (UKZN) initiated a three year project to develop telepsychiatry services in KwaZulu-Natal. This paper describes the challenges and opportunities of this project. METHOD:This was a collaborative, in situ health service project and an action research framework was adopted. Over the three years, following a needs assessment and an e-health Readiness Assessment, two action research cycles were completed. Cycle 1: The preparation, implementation and evaluation of educational material, technical requirements and clinical guidelines and clinical support materials. Cycle 2: Preparation and evaluation of educational and clinical outreach sessions. RESULTS: Videoconference education sessions were beneficial to health staff without post-qualification psychiatry training. A flexible format for education improved knowledge outcomes. Clinical sessions are feasible, but require administration and technical support for facilitation. With facilitator training, 128Kbps is a suitable bandwidth for education but 384Kbps is preferred for clinical consultation. CONCLUSION: Telepsychiatry offers tremendous potential to facilitate the three strategies suggested by the World Psychiatric Association to address the treatment gap, save time and costs and improve access to the small pool of specialist psychiatrists in resource constrained environments.
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    Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence
    (OMICS Publishing Group, 2012) Chipps, Jennifer; Mars, Maurice
    OBJECTIVE: A review of systematic reviews of the effectiveness and feasibility of videoconference-based telepsychiatry services for resource constrained environments was conducted. Specifically with the aim of producing an evidence-based review of the effectiveness and feasibility of videoconference-based telepsychiatry services in resource constrained countries like South Africa. METHODS: Eight key questions on telepsychiatry effectiveness and feasibility were identified and inclusion and exclusion criteria were developed. Review of citations from 2000-2011 from CINAHL, Medline, Pubmed, PsycInfo, EBSCOhost, SABINET, Cochrane Database of Systematic Reviews (CCTR), Cochrane Controlled Trial Registry (CCTR), Database of Abstracts of Reviews of Effectiveness (DARE), unpublished abstracts through NEXUS and internet search engines (Google/Google scholar) was conducted. RESULTS: Ten systematic reviews were included for review. Despite the methodological limitations and heterogeneity of the systematic reviews, there appears to be good evidence of effectiveness (reliability and improved outcomes) and feasibility (use, satisfaction, acceptability and cost) for videoconference-based telepsychiatry internationally. The application of this evidence in lower middle income countries is dependent on the integration of telepsychiatry into local health system contexts. CONCLUSION: Based on the evidence, resource constrained countries such as South Africa should be encouraged to develop telepsychiatry programs along with rigorous evaluation methods.
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    A Model for Telepsychiatry for South Africa
    (2012) Chipps, Jennifer; Ramlall, Suvira; Mars, Maurice
    The access of rural Mental Health Care Users in South Africa to specialist psychiatrists and quality mental health care is currently sub-optimal. Health professionals and planners working in psychiatry lack a well-defined and feasible outreach model to facilitate the delivery of services to remote and rural areas. In response to this challenge, a three-year action research telepsychiatry study was undertaken by the Departments of Psychiatry and TeleHealth at the University of KwaZulu-Natal, to develop a telepsychiatry outreach model based on local research and international evidence. The Model draws on needs and infrastructure assessments of the designated psychiatric hospitals in the province, a review of the published international evidence on telepsychiatry and videoconference-based education, and an evaluation of local clinical and educational telepsychiatry implementations in KwaZulu-Natal. The Model proposed is “virtual”, i.e. not bound to provincial or district referral patterns, aims not to add to the burden on the current workforce and is intended to be integrated into psychiatry outreach services and policy. The Model should be subjected to in situ testing for validation and implementation. It is hoped that an implementation of this Model will improve the access of Mental Health Care Users to specialist psychiatry care.
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    Practice guidelines for videoconference-based telepsychiatry in South Africa
    (OMICS Publishing Group, 2012) Chipps, Jennifer; Ramlall, Suvira; Mars, Maurice
    Telepsychiatry, the practice of psychiatry over distance using information and communication technologies is, after teleradiology, the most practiced form of telemedicine in the world. As with any new technology, clinical service, or intervention in medicine, it is prudent to have guidelines for the safe and efficacious use of the technology in clinical practice. Guidelines facilitate best practice and provide both clinicians and patients with a set of standards and procedures that serve to protect their interests. Protection is particularly important when dealing with vulnerable groups.
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    Readiness of health-care institutions in KwaZulu-Natal to implement telespsychiatry
    (2012) Chipps, Jennifer; Mars, Maurice
    We assessed the preparedness of health districts and designated hospitals in the KwaZulu-Natal (KZN) province for proposed telepsychiatry services. An e-health readiness questionnaire for developing countries was administered to managers of health districts and managers of designated psychiatric hospitals by telephone interview. Ten of the 11 district managers and managers/medical officers of 45 of 58 designated hospitals were interviewed. Notwithstanding some concerns regarding the tool, low levels of e-health readiness were found. District managers recorded e-health readiness scores of 137–217 out of 300. This was similar to the hospital managers, who recorded readiness scores of 121–260 out of 300. For telepsychiatry to succeed in KZN, an awareness programme will be required to facilitate the necessary change management.
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    A systematic review of the effectiveness of videoconference-based tele-education for medical and nursing education.
    (Wiley, 2012) Chipps, Jennifer; Brysiewicz, Petra; Mars, Maurice
    BACKGROUND: Rural nurses and doctors typically have little opportunity to further their education and training. Studies have shown high participant satisfaction with the use of educational technology, such as videoconferencing, for education. A review of effectiveness of videoconference-based tele-education for medical and nursing education was conducted. AIMS The aims of this study were to: (1) systematically review the literature and critique the research methods on studies addressing the review question: “How effective is videoconference-based education for the education of doctors and nurses?” (2) summarize the existing evidence on the effectiveness of videoconference education for medical and nursing staff; and (3) apply the findings to South Africa and other countries across the globe. Methods: Research citations from 1990 to 2011 from cumulative index of nursing and allied health literature, Medline, Pubmed, PsycInfo, EBSCOhost, SABINET, Cochrane Database of Systematic Reviews, the Cochrane Controlled Trial Registry, Database of Abstracts of Reviews of Effectiveness, unpublished abstracts through NEXUS and Internet search engines (Google/Google scholar) were searched. Review methods included searching, sifting, abstraction, and quality assessment of relevant studies by two reviewers. Studies were evaluated for sample, design, intervention, threats to validity, and outcomes. No meta-analysis was conducted as the studies provided heterogeneous outcome data. RESULTS: Five studies were reviewed. Videoconference and face-to-face education is at least equivalent and one study reported an increase in knowledge and knowledge integration. Recommendations: Despite the methodological limitations and heterogeneity of the reviewed studies, there appears to be sufficient evidence of effectiveness to provide a rigorous Grade B evidence-based recommendation of moderate support. Conclusions: The use of videoconferencing for nursing and medical education should be encouraged along with guidelines for the use of videoconferencing. The paucity of studies and the lack of empirical precision in evaluating effectiveness of these interventions necessitate future rigorously designed experimental studies.
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    Technology enhanced learning for remote nurses in KwaZulu-Natal.
    (International information management corporation, 2010) Chipps, Jennifer; Mars, Maurice
    The paper describes a project at the School of Nursing at the University of KwaZulu-Natal in Durban South Africa to increase access to university based education through the use of videoconference specialist education for nurses in rural areas of KwaZulu-Natal. Objectives: To evaluate the perceptions of lecturers and participants on the use of video-conferencing for nurse education. METHODOLOGY: Two surveys were conducted: a perceptions survey with lecturers of the School of Nursing and an initial and second survey with participants of a pilot advanced midwifery education programme conducted by video-conferencing. RESULTS: Both participants and lecturers had very little prior experience of video-conferencing, but felt that it would increase access for rural nurses to high quality specialist education. Concerns were mainly about technical issues in running and conducting the sessions and the application of progressive education strategies using this technology CONCLUSION: Videoconferenced academic specialist nursing programs would provide technology enhanced learning for remote nurses in KwaZulu-Natal, but for optimal use, the presenters need to be trained in the use of VC.
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    Videoconference-based education for psychiatry registrars at the University of KwaZulu-Natal, South Africa
    (OMICS group, 2012) Chipps, Jennifer; Ramlall, Suvira; Mars, Maurice
    Objective: Psychiatry registrars form the backbone of specialized psychiatric service provision in South Africa. Medical schools are centralized while clinical services need to be widespread and accessible. Video-conferencing has the potential to link registrars at satellite hospitals with academic centers. The study thus evaluated of the use of videoconferencing in a Psychiatry Education Program delivered via videoconferencing. Method: To evaluate the implementation of the videoconference-based psychiatry registrar program, a pre- and post evaluative design was used. This involved all registrars in the 2008 and 2009 academic education program at the University of KwaZulu-Natal, South Africa. Access to education, satisfaction, suitability and costs of the psychiatry registrar education were studied. Results: In the evaluation of the Registrar Program, general satisfaction with the videoconferencing program was reported, though concerns were expressed about the level of interaction using this mode, the quality of the transmitted pictures of the anatomy specimens and the quality of the sound. Access to education was improved with potential cost savings identified. Conclusion: Well supported and planned videoconference-based teaching is a feasible, cost-effective and acceptable method of supporting registrars at sites distant from academic centers.