Most Proposed Topic :
HA Young Investigators Session (projects to be presented by and HA staff who had joined HA for less than 15 years)
Proposed Topic (Second preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patient and improve patient communication)
Authors: (including presenting author): :
Sit LK (1), Mok WS (1), Chan KK (1), Hui N (1), Chan SFR (2), Wong SYV (2)
Affiliation: :
(1) Occupational Therapy (OT) Department, United Christian Hospital (UCH), (2) Health Resource Centre (HRC), United Christian Hospital
Introduction: :
Cognitive Training has been well known for its effectiveness in dementia management non-pharmacologically. In current OT practice, certain cognitive training groups including computerized training and/or group therapy would be arranged to indicated cases after initial cognitive assessment. However, difficulties in attending training regularly were experienced by our patients due to different reasons, including patient’s mobility constraints, fair social support with no carer for escorting etc. These greatly hindered their precious opportunities in receiving timely and quality rehabilitation. Aiming to provide better care to the needy and following “SMART Hospital” strategic development, and with the funding support from Alice Ho Miu Ling Nethersole Charity Foundation, OT department UCH designed a brand-new apps “距智醒” “TeleSmart”. Different cognitive training elements including attention, calculation, memory etc. were incorporated into different daily life themes like meals preparation and grocery shopping etc. Non-immersive VR approach was adopted in designing the program in enhancing the quality of training simulations. Web conference software Zoom was utilized in providing telehealth training allowing patient to receive cognitive training equivalent to current face-to-face practice. Collaboration was established between OT and HRC for tablet loan service in facilitating the smooth running of program. Cargivers can borrow the tablet with pre-installed “TeleSmart” app and data SIM card in HRC to ensure patient can access the training at home environment. Volunteers or collaborated NGO support could also provide technical support to patients and caregivers if indicated.
Objectives: :
To study the effect and feasibility in conducting cognitive training “TeleSmart” to patients with cognitive impairment via telehealth means.
Methodology: :
Cases were recruited after completion of initial cognitive assessment from 9/2022. Suitable candidates had to fulfil the following criteria including Functional Assessment Staging Test (FAST), difficulties encountered to attend centre-based training and suitable home environment for conducting Tele-VR training. Patients would be provided with 6 tele-VR sessions at home. Pre-post assessment Montreal Cognitive Assessment Hong Kong Version (HK-MoCA) was done face-to-face. Post-training satisfaction survey would be completed by caregivers after training completed.
Result & Outcome: :
15 cases were recruited currently and 10 cases completed full course of training. The average age of participants was 83 and 80% were male. After completion of 6 sessions of tele-VR rehab, their average HK-MoCA scores increased by 1.1 points clinically, a 3.7% increase (from 16.9/30 to 18/30). For the satisfaction survey results, the average score for the 6 questions in evaluating tele-health training was 3.7 out of 5 (Scale 1-5, 1: Strongly Disagree; 5: Strongly Agree). Regarding the future development direction of telehealth, 70% of participants/ caregivers indicated that they were willing to received charged telehealth service in the future. These illustrate the satisfactory results for the program and clients’/ families’ willingness in receiving cognitive rehab remotely at home via advanced technology. Though there were no significant difference (W=12, p> 0.05) between the pre-post results using Wilcoxon signed-rank test owing to relatively small sample size (N< 20), the project was still ongoing and it is hoped that further promising results will be yielded and this project will serve a great stepping stone in directing future cognitive rehabilitation via tele-health means for target patients in needs.
