The following projects are an indication of research being conducted in this theme.

An Intelligent Approach to Bed Occupancy Modelling to Enhance Patient Care

Aberystwyth University Contributors; Department Affiliation

Kieran Stone, Neil Mac Parthalain, Reyer Zwiggelaar

External Collaborators; Affiliation Hywel Dda UHB

Dr Phil Jones, Sarah Jones

Patient hospital Length of Stay (LoS) can be defined as the number of days that an in-patient will remain in hospital for a single admission event. LoS is a useful determinant of required hospital resource allocation, staffing and patient needs. It can also help to provide an understanding of the efficiency of care units, the flow of patients and the hospital environment. This is a significant factor in the evaluation of the operational performance of various health care systems and processes.

There is considerable variability amongst patient lengths of stay for different patient diagnoses. The LoS for the same diagnosis may vary from 2 to 50+ days between patients. This variation can due to a number of factors. In order to be able to provide a more accurate estimate of bed usage, data associated with any given patient gathered within 24 hours of admission will assist in building robust prediction models.

Currently, there is no consensus amongst researchers regarding LoS prediction methods, as each modelling approach is only appropriate to the environment in which it was employed. Therefore, this project will investigate the factors that directly influence LoS of patients, the modelling that can be performed to better inform clinical decision making and how the generated prediction models can be translated to other health boards in Wales.

Relevant Publications:

Stone, K, Zwiggelaar, R, Jones, P, Mac Parthaláin, N & Yoon, D (ed.) 2022, ‘A systematic review of the prediction of hospital length of stay: Towards a unified framework’, PLOS Digital Health, vol. 1, no. 4. 10.1371/journal.pdig.0000017

A feasibility study on enhancing rural health services using autonomous air vehicles

Researchers:  Dr Rachel Rahman

External collaborators: Dr Rukshan Navaratne, University South Wales (now Cardiff University), Mokarram Hussain, Swansea University, Dr Xiuyi Fan, Swansea University

This project was funded by the Welsh Government Welsh Crucible programme and explored stakeholder acceptability of the use of autonomous aircraft in rural health service delivery. The project engaged the general public, rural health professionals and policy and industry experts in a series of focus groups designed to explore their views and opinions about whether and how drones could be used in rural health care services.

Negotiating conversation and interaction through videoconferencing in speech language therapy: A conversation analytic study

Researcher: David Dalley (MPhil student-completed);
Supervisors: Dr Rachel Rahman & Dr Antonia Ivaldi; Aberystwyth University
External Collaborators: Ms Sali Curtis; Speech Language Therapist Abertawe Bro Morgannwg UHB contracted to Hywel Dda UHB

Over the past 40 years, telehealth technologies have been introduced into a variety of domains of health-care. Previous studies have demonstrated how the quality of the interaction between health-care providers and patients can influence patient understanding of medical information, perceptions of their diagnosis and quality of life. This is particularly relevant in speech language therapy, where conversation may already be challenging and differing methods of communication maybe required. The introduction of telehealth into these interactions adds an additional dynamic to be negotiated within the conversation. This study explores the how communication and interactions between speech and language therapists and patients are negotiated when sessions are delivered via telehealth. The research uses naturalistic audio-visual recordings of speech and language telehealth consultations to analyse the talk and non-verbal gestures between the therapist and consenting patients using conversation analysis. This will enable better understanding of best practice to facilitate effective communication in telehealth consultations.

Relevant Publications:

Dalley, D., Rahman, R., & Ivaldi, A. (2021). Healthcare professionals’ and patients’ management of the interactional practices in telemedicine videoconferencing: A conversation analytic and discursive systematic review. In Qualitative Health Research, 31(4), 804-814.

Telehealth to facilitate group psychosocial support for immunosuppressed patients in a rural setting

Lead researcher: Dr Rachel Rahman, Aberystwyth University
Contributors: Ms Martine Robson, Aberystwyth University
External Collaborators: Ms Gudrun Jones, Art therapist; Hywel Dda UHB

Social support is a critical component of treatment for immunosuppressed patients undergoing chemotherapy. However, travel to a communal venue to access group support can add both increased fatigue and risk of infection for immune vulnerable patients. This is particularly relevant to rural communities where the increased travel times required to access services compound the fatigue and the rural geography increases the risk of social isolation when these services are not available. The following research programme established a novel service to provide rural patients with the opportunity to engage with group art therapy delivered from the comfort of their own home via telehealth videoconferencing technology. The research aims to explore how patients and the therapist experience engaging in group therapy in this way and how group art therapy and conversation is negotiated when delivered via telehealth

Relevant Publications:

Jones, G. Rahman, R. & Robson, M. (2019). Group art therapy using telemedicine technology forimmunosurpressed patients undergoing chemotherapy. In R. Jacobson & M. Wood (Eds). Art therapy in hospice/palliative care and bereavement around the world.  Routledge USA .Publishers.

Jones, G. Rahman, R. & Robson, M. (2018). Group art therapy and communication through technology. In C. Malchiodi (Ed). Art Therapy and Digital Technology.  Jessica Kingsley Publishers.

Patient and professional acceptability of telehealth to monitor COPD and Diabetes

Lead researcher: Dr Rachel Rahman, Aberystwyth University
Contributors: Dr Joseph Keenan, Aberystwyth University
External Collaborators: Professor Keir Lewis, Dr Sam Rice, Ms Claire Hurlin, Ms Sarah Hicks; Hywel Dda UHB

This study formed part of a larger project managed by Hywel Dda University Health Board as part of the European Commission sponsored project ‘United for Health.’ This utilised a randomised controlled trial of the telemonitoring technologies in Chronic Obstructive Pulmonary Disease and Diabetes and explored a range of clinical and well-being outcomes. However, for telehealth to achieve its potential in encouraging autonomous behaviour and self-management amongst patients, both patients and health professionals must be accepting of technology in their service provision. This research was commissioned by Hywel Dda UHB as an independent evaluation of how patients health care providers involved with the trial experienced the telemonitoring technologies and as a result how acceptable they felt these were to incorporate into service delivery.

Relevant publications:

Rahman, R., & Keenan, J. 2016. Patient and professional acceptability of telehealth to monitor COPD and diabetes. European Health Psychology Society and BPS Division of Health Psychology Annual Conference 2016, Aberdeen, United Kingdom of Great Britain and Northern Ireland, 23/09/2016 – 27/09/2016. pp. 622

Rahman, R., & Keenan, J. (2015). Patient and professional acceptability of telehealth to monitor COPD and diabetes. Commissioned report for Hywel Dda UHB.

Utilising telehealth to provide psychosocial support in palliative care

Researcher: Dr Joseph Keenan (PhD research)
Supervisors: Dr Rachel Rahman, Aberystwyth University and Dr Joanne Hudson, Swansea University
External Collaborators: Ms Gudrun Jones, Art Therapist, & Dr Gokul, Palliative Care Physician. Hywel Dda UHB

The use of telehealth has emerged as a potential way to overcome organisational and geographical barriers to service delivery in rural areas. For palliative care patients and their carers accessing psychosocial support can form a critical component of their care. However, the increased travel times for either the patient or healthcare professional can mean that access to this support can be limited or non-existent. Whilst telehealth may offer a viable solution, the sensitive nature of end of life and palliative care can mean that health care professionals are reluctant to offer what can be considered a sub-standard form of support. This programme of postgraduate research explored health care professionals’ barriers and facilitators to using telehealth technologies in palliative care and compared these with the lived experiences of a group of patients who accessed psychosocial support via telehealth videoconferencing over a period of three months.

Relevant publications:

Keenan, J., Rahman, R., & Hudson, J. (2021). Exploring the acceptance of telehealth within palliative care: A Self-Determination Theory Perspective. Health and Technology, 11, 575-584

Rahman, R., Keenan, J., & Hudson, J. (2020). Exploring rural palliative care patients’ experiences of accessing psychosocial support through telehealth: A longitudinal approach. In Qualitative research in Healthcare and Medicine, 4, 31-42.

Keenan, J., Rahman, R., Hudson, J. (2016). Experiences of palliative care patients accessing psychosocial support through telehealth. European Health Psychology Society and BPS Division of Health Psychology Annual Conference 2016, Aberdeen, United Kingdom of Great Britain and Northern Ireland, 23/09/2016 – 27/09/2016. pp. 485.

Keenan, J.R., Rahman, R., Hudson, J. 2014. Exploring psychological underpinnings of medical professionals’ perceptions of telehealth implementation in palliative care. European Health Psychology Society conference, Innsbruck, United Kingdom of Great Britain and Northern Ireland, 18/09/2016.