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   2019| July-September  | Volume 24 | Issue 3  
    Online since June 26, 2019

 
 
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ORIGINAL ARTICLES / ARTICLES ORIGINAUX
Telepsychiatry and patient–provider concordance
Nicholas James Schubert, Paul J Backman, Rajiv Bhatla, Kimberly M Corace
July-September 2019, 24(3):75-82
DOI:10.4103/CJRM.CJRM_9_18  PMID:31249155
Context: Telepsychiatry has become a common modality for the provision of psychiatric consultations to patients in rural regions. Aims: The aims of this study were to assess and compare patient and provider satisfaction and perceptions of access to care with telepsychiatry. Methods: Telepsychiatric consultations were given by providers based on an urban tertiary academic health centre to patients located in rural primary care clinics. Results: Patients (n = 110) and providers (n = 10) were both highly satisfied with telepsychiatry and both believed that telepsychiatry provided patients with better access to care. Paired patient and provider survey results demonstrated a high level of concordance between patients and provider responses. Conclusions: Concordance between patient and provider satisfaction may contribute to adherence and positive treatment outcomes. These results provide support for the use of telepsychiatry consultations to improve patient access to psychiatric care in rural regions.
  5,504 1,037 7
Standardised early warning scores in rural interfacility transfers: A pilot study into their potential as a decision-making aid
Andrew Stanley, Holly Buhler, Brent Hobbs, Jude Kornelsen, Scott Lamont, Rebecca Kaus, Kari Grant, Stefan Grzybowski
July-September 2019, 24(3):83-91
DOI:10.4103/CJRM.CJRM_17_18  PMID:31249156
Introduction: While 12.4% of British Columbians live rurally, only 2.0% of specialists practise rurally, making interfacility transport of high-acuity patients vital. Decision-making aids have been identified as a way to improve the interfacility transfer process. We conducted a pilot study to explore the potential of the Standardised Early Warning Score (SEWS) as a decision-making aid for staff at sending facilities. Methods: SEWSs were calculated from a database of 418 transfers from sending facilities in rural, small and medium population centres to larger receiving facilities. The SEWSs were compared against one another over time using McNemar's and the Wilcoxon signed-ranks tests. The SEWSs were then tested for their association with six outcomes using Pearson's or Fisher's Chi-squared test and the Mann–Whitney U-test. Results: While at the sending facility, both the number of SEWSs that was four or greater and the average SEWS decreased over time (P < 0.001 for both). A first SEWS of four or greater was predictive of more intervention categories during transport (P = 0.047), an adverse event during transport (P = 0.004), an adverse event within 30 min of arrival at the receiving facility (P = 0.004) and death before discharge from the receiving facility (P = 0.043) but not deterioration during transport, or the length of stay at the receiving facility. Conclusion: Overall, the performance of the SEWS in the context of rural interfacility transport suggests that the tool will have utility in supporting decision-making.
  3,716 411 4
PROCEDURE
The occasional allergy skin test
Peter Hutten-Czapski
July-September 2019, 24(3):92-94
DOI:10.4103/CJRM.CJRM_10_19  PMID:31249157
  2,918 437 -
EDITORIALS / ÉDITORIAUX
We don't want to think about it
Peter Hutten-Czapski
July-September 2019, 24(3):71-71
DOI:10.4103/CJRM.CJRM_32_19  PMID:31249151
  2,261 308 -
Nous ne voulons pas y penser
Peter Hutten-Czapski
July-September 2019, 24(3):72-72
DOI:10.4103/1203-7796.261318  PMID:31249152
  2,157 274 -
President's Message. A rural lens
Margaret Tromp
July-September 2019, 24(3):73-73
DOI:10.4103/CJRM.CJRM_33_19  PMID:31249153
  2,169 234 -
PODIUM
Beyond an admission - Support for an ageing population
Christopher Patey
July-September 2019, 24(3):95-96
DOI:10.4103/CJRM.CJRM_23_18  PMID:31249158
  2,105 270 -
EDITORIALS / ÉDITORIAUX
Message du Président. Une lentille rurale
Margaret Tromp
July-September 2019, 24(3):74-74
DOI:10.4103/1203-7796.261320  PMID:31249154
  2,088 218 -