Authors (including presenting author) :
Wu WY(1), Liu YT(1), Cheung TM(1), Ngai TH(1), Kam CY(1), Ly YFC(1)
Affiliation :
(1) Department of Physiotherapy, Tin Shui Wai Hospital
Introduction :
In the path of returning a patient from in-patient setting to home care, carer education is an essential stepping stone. It allows carers to visualize the current mobility of the patient, as well as to learn hands-on caring skills. While they are practicing the techniques, physiotherapists can correct and enhance their skills, especially manual handling skills.
However, covid-19 limits carers from face-to-face education in in-patient settings due to infection control policies. Tele-carer education is done with real time demonstration by physiotherapists via ZOOM. Carers cannot actually practice on patient and physiotherapists cannot assess their manual handling skills.
It is skeptical if carers could really grasp the caring skills. It is also concerned that patient might suffer from fall or immobility at home due to the incompetence of carers. Therefore, a ZOOM follow-up was arranged 2 weeks post-discharge to review the skills of carers and the mobility of the patient.
Objectives :
1. To share the experience on tele-carer education and ZOOM follow-up.
2. To assess the satisfaction of patient and carer, and confidence and competency of the carers after the tele-carer education.
3. To review outcome and change in patient’s physical performance after discharge with tele-carer education.
Methodology :
Patients who admitted to TSWH and required carer education before discharge in TSWH were included for analysis during the period of 1 Mar 2021 – 31 Aug, 2021 (26 weeks). This study aims to recruit at least 20 patients. Tele-carer education would be arranged during the hospitalization. A ZOOM follow up would be done around 14 days post-discharge. Outcome measures including: [1] carer satisfaction level (0-6, 6 means the most satisfactory); [2] patient satisfaction level (0-6, 6 means the most satisfactory); [3] carer confidence level (0-6, 6 means the most confident); [4] MFAC (cat 1-7); and [5] fall rate would be assessed by the day of discharge and 14 days post-discharge via ZOOM follow-up.
Result & Outcome :
39 patients were included in the study during the period of 1 Mar 2021 – 31 Aug 2021. 21 patients and their respective carers participated in the ZOOM follow-up. The dropout rate was 46.15% due to loss of contact(11.1%) , hospital re-admission(77.7%), or discharge to institution(11.1%). Among the patients who were re-admitted to hospital, 35.7% was due to fall.
After tele-carer education, the mean carer satisfactory level was 5.57 (±0.68) out of 6 while the mean patient satisfactory level was 5.75 (±0.62) out of 6. Upon ZOOM follow-up, the mean carer satisfactory level was 5.62 (±0.5) out of 6while the mean patient satisfactory level was 5.50 (±0.9) out of 6. The mean carer confidence level increased from 4.48 (±1.29) to 4.76 (±1.30). The median MFAC maintained at category 4 upon 14 days post-discharge. Only 1 patient (4.76%) with fall incident was noted during the follow-up.
Conclusion:
Both carer and patient are satisfied with the tele-carer education and ZOOM follow-up. The tele-carer education can simulate real time situation and could be a feasible mean of post-discharge follow-up. A slight increase in mean carer confidence level was also seen. The study outcome was limited by high drop-out rate. It was highly noted that difficulties were encountered due to poor compatibility of hardware and software from carers. Technological support was always required from therapists. In the future, ZOOM follow-up can be extended to other patients with or without tele-carer education.
