Authors (including presenting author) :
Cheung HL (1), Luk TW (1), Lo R.S.K (2), Chiang KH (1)
Affiliation :
(1)Physiotherapy department, Shatin Hospital, (2)Palliative care team, Shatin Hospital
Introduction :
Outbreak of COVID-19 in Hong Kong in 2020 led to prolonged suspension of non-emergency service in Hospital Authority. Corporate direction of implementation of Tele-care program could solve the problem of “accessibility of service” in certain extent. This new model of service gave challenges to staff on feasibility of this program to support our patients through new media.
Objectives :
To develop the construct of Physiotherapy Tele-care program in palliative day care center (PDCC) in Shatin Hospital and evaluate how this program support our patients
To investigate the impacts of suspension of service to patients in PDCC during 1st and 2nd wave of COVID-19 pandemic
Methodology :
Construct of Tele-care program was based on the patients’ need and role of physiotherapy in PDCC. This included symptoms management, exercise training and advice & education. Feasibility of Tele-assessment was reviewed including pain, oedema, mobility, caregiver skills and home environment assessment by means of phone call, video-call, photo and video-recording.
By means of reviewing medical history from CMS and phone contact with patients/caregivers, information of hospital admission, changes of symptoms, fall history and changes of mobility were collected to review the impacts of suspension of service.
Result & Outcome :
PDCC was suspended from 13th February to 29th May 2020 during 1st and 2nd wave of COVID-19 pandemic. Physiotherapy Tele-care program was implemented from 26th March to 29th May 2020.
105 patients were recruited. 20 patients (19%) had history of hospital admission during review period (13th February to 29th May 2020). 36.2% of patients had new (or increase) symptoms or problems. The commonest symptoms or problems included fall (n=10), pain (n=9), deconditioning (n=8) and dyspnoea (n=7).
12 patients (11%) showed declined in mobility after suspension of service. 5 out of these 12 patients (42%) and 3 patients (25%) showed same and improvement in mobility level respectively after they received Tele-care program. 4 patients (33%) died within 4 months (average: 57 days).
Percentage of patients received different physiotherapy Tele-care interventions were 86.7% (exercise prescription), 28.6% (symptoms management) and 38.1% (advice & education). Exercise prescription media included video clips (58.1%), electronic pamphlets (33.3%), and HA Go (21.9%). Commonest symptoms management included dyspnoea (n=13), pain (n=7) and bronchial hygiene management (n=4). Advice and education included fall prevention (n=26), transfer training (n=8) and pressure injury prevention (n=3). Feedback was collected from 45 patients/caregivers. Over 85% of them satisfied with the “usefulness of Tele-care service”.
In conclusion, physiotherapy Tele-care program in PDCC acted as an essential bridge to safeguard the accessibility of patients’ service in terms of exercise prescription, symptoms management, advice & education.
