Date of Graduation

5-2016

Document Type

Thesis

Degree Name

Bachelor of Science

Degree Level

Undergraduate

Department

Health, Human Performance and Recreation

Advisor/Mentor

Elbin, RJ

Committee Member/Reader

McDermott, Brendon

Committee Member/Second Reader

Hammig, Bart

Abstract

Background: Proper management of sport-related concussion (SRC) is critical for improved recovery outcomes in youth athletes. Several barriers exist to improving the standard of care for youth athletes with SRC. Many rural areas lack medical professionals with specialized training in SRC. Innovative methods for providing specialized healthcare to youth athletes with SRC are needed. Telehealth may be an effective means of providing specialized care for youth athletes with SRC located in underserved areas that have a shortage of healthcare providers specializing in SRC.

Purpose: The purpose of this study was to compare patient, caregiver, and provider ratings of the therapeutic alliance and clinical visit satisfaction scores between telehealth and in-office consultations for youth athletes with SRC.

Study Design: A between-subjects design was used.

Methods: Eighteen patients with SRC (13-17 years) and their accompanying caregiver along with the treating clinician participated. Patients were randomly assigned to either a traditional face-to-face visit or a mock teleconcussion visit during their initial clinical visit at an outpatient clinic specializing in SRC. The teleconcussion visit consisted of the patient and caregiver seeing the clinician via telehealth videoconferencing technology in a separate room. After the visit, all patients completed the TASC-R, and SEQ-5, and the caregiver completed the TASCP. In addition, the patient, caregiver, and clinician completed the Satisfaction with the Videoconferencing/Telehealth Clinical Setting questionnaire for the telehealth visit, while for the in-office visit they completed the Satisfaction with the Traditional/In-Office Clinical Setting questionnaire.

Results: The results on the SEQ-5 showed significant differences for difficult-easy (p = .02), weak-powerful (p = .03) and happy-sad (p = .05), with patients reporting higher positive evaluations (easy, powerful and happy) in the telehealth group. The results on the TASC-R between patients in the telehealth (M = 33.56, SD = 2.60) and face-to-face conditions (M = 32.00, SD = 3.20) revealed no significant differences between the groups (t (16) = -1.13, p=.28). In addition, parents in the telehealth group (M = 32.00, SD = 1.85) did not differ on the TASCP total score compared to the parents in the face-to-face group (M = 31.75, SD = 2.31) (t (14) = -.24, p=.82). A 2 condition X 3 group between-groups ANOVA was conducted on the first item of the Satisfaction with the Clinical Setting scale. The results of this analysis revealed a significant between-subjects effect for condition (F [1,53] = 4.78, p =.03, η2 = .09) and group (F [2,53] = 5.47, p =.007, η2 = .19).

Discussion: Satisfaction ratings from the clinician in this study were lower than the ratings from the other participants and this has been shown in the literature. The literature suggests a high level of patient satisfaction with clinical visits via videoconferencing; however, the current study shows significant differences in overall satisfaction between the telehealth and in-office conditions.

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