Oncol Nurs Forum. 2026 Jan 5;53(1):1-11. doi: 10.1188/26.ONF.e26535240.

ABSTRACT

OBJECTIVES: To assess the efficacy of telenursing counseling in improving the sexual function of women undergoing treatment for breast cancer.

SAMPLE & SETTING: 59 women undergoing outpatient treatment for breast cancer.

METHODS & VARIABLES: Three telehealth counseling sessions were conducted in the intervention group during an eight-week period. The primary outcome was assessed with the Female Sexual Function Index, Brazilian version, at baseline and at 8 weeks and 12 weeks postintervention.

RESULTS: The intervention and control groups had significant differences in education, race, occupation, menstrual status, and previous treatment performed. Sexual function after telenursing counseling in the intervention and control groups showed no statistically significant differences at 8 weeks or 12 weeks.

IMPLICATIONS FOR NURSING: Telephone counseling did not differ from usual care in improving sexual function in women undergoing treatment for breast cancer. Nurses should consider integrating multiple intervention components.

PMID:41553237 | DOI:10.1188/26.ONF.e26535240

Cureus. 2025 Dec 18;17(12):e99527. doi: 10.7759/cureus.99527. eCollection 2025 Dec.

ABSTRACT

Background Telemedicine is increasingly used in musculoskeletal care, but the accuracy of remote physical examination for rotator cuff syndrome, compared with magnetic resonance imaging (MRI), remains unclear. This study evaluated the diagnostic performance of telemedicine-based shoulder maneuvers against MRI, with secondary analyses including in-person examination. Methods A cross-sectional diagnostic accuracy study was conducted. Patients underwent standardized teleconsultations with Jobe, infraspinatus, and Bear Hug tests, each analyzed for pain and weakness. All patients also underwent the same in-person maneuvers. MRI of the affected shoulder, reviewed by blinded musculoskeletal radiologists, served as the reference standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and balanced accuracy were calculated. Secondary analyses included comparisons between telemedicine and in-person performance, and agreement between modalities. Results Thirty-two patients (mean age, 59.6 years) were included. Against MRI, telemedicine tests were highly sensitive: Jobe pain sensitivity was 96.2%, infraspinatus weakness sensitivity was 76.9%, and Bear Hug weakness sensitivity was 57.1%. In-person tests showed similar sensitivity for most maneuvers, with a tendency to classify fewer tendons as weak in MRI-negative shoulders. Paired analyses demonstrated minor differences for pain outcomes, but significant differences for weakness, with telemedicine being more sensitive and in-person examinations being more conservative in classifying weakness. Agreement between modalities was excellent for pain (κ up to 1.00) and moderate for weakness (κ, 0.11-0.47). Conclusion Telemedicine-based shoulder examination demonstrated high sensitivity compared with MRI, similar to in-person examination. Because all patients had MRI-confirmed pathology, and few true negative tendons were available, the ability of either modality to rule out rotator cuff tears based solely on clinical testing was limited. These findings support the use of telemedicine as a sensitive triage tool, while MRI remains necessary for definitive diagnosis and treatment planning.

PMID:41552046 | PMC:PMC12811830 | DOI:10.7759/cureus.99527

Arch Dermatol Res. 2025;317:933. doi: 10.1007/s00403-025-04402-9. Epub 2025 Nov 1.

ABSTRACT

PURPOSE: This study aimed to identify barriers and facilitators influencing transgender individuals' participation in teledermatology-based acne research and their perceptions of artificial intelligence use in acne research.

METHODS: This was a qualitative study conducted between 2021 and 2023. Transgender and gender diverse individuals who received gender-affirming hormone therapy and had acne were recruited from a public safety-net hospital and from academic endocrinology and dermatology clinics. Semi-structured interviews exploring factors influencing teledermatology-based acne research participation were analyzed using thematic analysis.

RESULTS: Among 32 participants, 17 (53%) identified as transgender men, 11 (34%) as transgender women, and 4 (13%) as non-binary or other gender identities. Mild or lower acne severity was reported by 21 (66%) participants, while 11 (34%) reported moderate-to-severe acne. Access to equipment and comfort in photographing sensitive areas determined capability of participation in hypothetical teledermatology research. Accessibility, flexibility, and reduced transportation cost of remote research, and in-clinic recruitment from established clinicians presented opportunities for participation. Motivating factors included trust in research team members, privacy concerns, and improving acne treatment for transgender individuals. Perspectives on artificial intelligence were mixed and included concerns regarding security and potential for bias.

CONCLUSION: Teledermatology offers opportunity to improve recruitment and retention of transgender individuals in acne research. Incorporating perspectives of transgender individuals can inform the design of future teledermatology research on acne in the context of gender-affirming hormone therapy.

PMID:41551404 | PMC:PMC12806185 | DOI:10.1007/s00403-025-04402-9

Aphasiology. 2025 Dec 28. doi: 10.1080/02687038.2025.2609801. Online ahead of print.

ABSTRACT

BACKGROUND: Prior studies have highlighted the importance of the right hemisphere in recovery from aphasia due to left hemisphere stroke. In particular, the right hemisphere homologous language network appears to support subacute (and sometimes chronic) recovery for many patients. We developed a telemedicine-delivered therapy that engages diverse right hemisphere-dominant skills to target nouns and verbs within utterances, Producing Increasingly Complex Themes Using Right-hemisphere Engagement - Implemented with Telemedicine "PICTURE-IT".

AIMS: This randomized crossover pilot study was designed to examine the feasibility of the PICTURE-IT therapy and determine whether some participants improve more with PICTURE-IT compared to an established telemedicine approach that targets lexical skills.

METHODS & PROCEDURES: Seventeen adult English-speaking participants with subacute (1-4 months) or chronic (over 6 months) aphasia who continued to experience naming deficits as measured on the Boston Naming Test or Hopkins Assessment of Naming Actions were included. Participants received fifteen 45-minute sessions of each therapy approach, followed by a washout period. Three participants withdrew due to worsening medical circumstances unrelated to therapy. Participants' naming and discourse were assessed at baseline and one week after each therapy block. As the pilot had a modest number of participants, each participant's trajectory was examined separately in order to consider how individual differences may play a role in therapy benefit. After the trial, participants were asked to complete a brief survey rating the PICTURE-IT approach and the established approach in their enjoyableness and utility.

OUTCOMES & RESULTS: Both treatments were effectively administered remotely throughout the trial. Fisher's Exact tests contrasting the improvements provided by each therapy approach were not significant for any individual, nor were there significant differences in the proportion of people who experienced more benefit from one approach or the other relative to their time since stroke (sub-acute versus chronic).

CONCLUSIONS: Although average improvements in communication skills were similar across treatments, order, and subacute vs chronic, individuals often responded better to one therapeutic approach or the other. Future studies will build upon these preliminary observations of effectiveness and identify reasons participants respond better to one treatment or the other.

PMID:41551290 | PMC:PMC12807486 | DOI:10.1080/02687038.2025.2609801

Palliat Care Soc Pract. 2026 Jan 13;20:26323524251408888. doi: 10.1177/26323524251408888. eCollection 2026.

ABSTRACT

BACKGROUND: The growing number of patients diagnosed with advanced cancer increases the pressure on health systems, especially in lower-middle-income countries. Telemedicine palliative care consultation is innovative in providing quality cancer care while reducing costs. However, there is a lack of randomized controlled studies that evaluate the effects of digital consultations in the palliative treatment of cancer patients. This study aims to investigate the efficacy of telemedicine consultation in outpatient palliative care settings.

METHODS/DESIGN: During an 18-month recruitment period, participants recently diagnosed with advanced cancer who are not already receiving palliative care are invited to participate in a randomized controlled trial. Eligible participants are randomized to the intervention group (telemedicine) or the control group (face-to-face) consultations. Patients have monthly scheduled consultations (three such consultations), and unscheduled consultations as needed, provided through telemedicine or face-to-face visits. The primary outcomes are patients' quality of life assessed monthly using the EORTC-QLQ-C30 Questionnaire, changes in self-reported symptom control measured at every visit through the mean changes in distress score on the IPOS Questionnaire, and patients' satisfaction assessed monthly using the FAMCARE P16 Questionnaire. Secondary outcomes are eHealth Literacy, the domain of intervention, number of patients satisfied with physician communication, patients' experiences with the care, number of emergency room visits, number of unscheduled visits, adherence to intervention, changes in medication adherence, number of completed telemedicine scheduled visits, and physician's ability to evaluate a patient through telemedicine.

DISCUSSION: This is one of the first randomized controlled trials investigating virtual palliative care. Our data will determine whether telemedicine is appropriate for outpatient palliative care.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06538350.

PMID:41550463 | PMC:PMC12804634 | DOI:10.1177/26323524251408888

Diabetes Metab. 2026 Jan 15:101728. doi: 10.1016/j.diabet.2026.101728. Online ahead of print.

ABSTRACT

AIM: . - To assess the outcomes of teleophthalmology-based diabetic retinopathy (DR) screening in individuals over 70 years within the OPHDIAT network and to compare them with those of patients aged 18-70 years.

METHODS: . - A cohort of 16,459 diabetic patients, without known DR or with mild non-proliferative DR (NPDR), screened in 2024 in 32 OPHDIAT centers, was included and divided into two groups: < 70 years (n=13,639) and ≥ 70 years (n=2,820). Two non-mydriatic retinal photographs per eye were analyzed by certified ophthalmologists.

RESULTS: - Among patients aged ≥70 years, 21.3% (95% CI: 19.8-22.8) had any DR, and 6.1% (95% CI: 5.2-6.9) were referred to an ophthalmologist for moderate NPDR or a more severe form of the disease, including suspected macular edema. These proportions did not significantly differ from those found in patients < 70 years: 21.9% (95% CI: 21.2-22.6) and 6.1% (95% CI:5.6-6.5), respectively. Severe NPDR or proliferative DR were rare in both groups (1.0%, 95% CI: 0.6-1.4% vs. 1.7%, 95% CI: 1.5-1.9%, P < 0.001). The proportion of ungradable images was higher in the group ≥70 year (14.4%, 95% CI:13.1-15.7% vs. 6.1%, 95% CI: 5.7-6.5%, P < 0.001), particularly in phakic eyes, although 80% of patients had interpretable images for both eyes. Pupil dilation significantly improved image quality in this group. Screening also allowed detecting other ocular disorders, including age-related macular degeneration and glaucoma, which were more common in the group ≥ 70 years (2.1%, 95% CI: 1.5-2.6% vs. 0.6%, 95% CI: 0.4-0.7% P < 0.001).

CONCLUSION: . - Teleophthalmology-based DR screening appeared feasible and clinically relevant in patients aged ≥70 years, allowing identifying patients requiring ophthalmologic evaluation, while also detecting other age-related ocular diseases. Pupil dilation is recommended to optimize image quality in this population.

PMID:41547437 | DOI:10.1016/j.diabet.2026.101728

Neurol Sci. 2026 Jan 17;47(1):174. doi: 10.1007/s10072-025-08594-w.

ABSTRACT

INTRODUCTION: Nocturnal hypokinesia (NH) (i.e., reduced bed mobility) is common in people with Parkinson's Disease (PwPD), significantly affecting sleep quality. Physiotherapy showed encouraging results to treat this symptom but was poorly investigated. Moreover, telerehabilitation could be useful to increase treatment capillarity and to overcome logistic limitations. In this pilot study we investigated preliminary feasibility, safety and effectiveness of a telerehabilitation program in mild-to-moderate PwPD with NH.

MATERIALS AND METHODS: Sixteen PwPD with disease stage < 4, presence of NH and no cognitive impairment, were enrolled and 12 completed the study. Participants underwent a 6-week telerehabilitation program though a digital remote video call platform. The rehabilitation program included progressive exercises performed during both remote supervised sessions with a physiotherapist and self-conducted sessions through video-tutorials. PwPD were evaluated before (T0) and after the program (T1) using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) parts I-IV, Parkinson's disease questionnaire 39 (PDQ-39), Parkinson's Disease sleep Scale (PDSS2), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Nocturnal Hypokinesia Questionnaire (NHQ).

RESULTS: Dropout rate was 25%. We found a significant improvement in PSQI score (p = 0.039, median difference: 2) and in item 2.9 of the MDS-UPDRS part II assessing NH (p = 0.026; median difference: 1). A tendency toward significance was found in NHQ score (p = 0.069). No significant adverse events were reported during treatment.

CONCLUSION: Our pilot study showed that telerehabilitation could be a feasible, safe and effective option to improve NH and sleep quality in mild-to-moderate PwPD.

PMID:41546734 | DOI:10.1007/s10072-025-08594-w

Psychooncology. 2026 Jan;35(1):e70377. doi: 10.1002/pon.70377.

ABSTRACT

BACKGROUND: With the continuous advancement of cancer treatment technology, the proportion of cancer survivors is gradually increasing, but they also face many psychological challenges. These challenges can seriously affect their quality of life. Telemedicine, as an innovative medical service model, can be combined with psychosocial intervention to provide cancer survivors with convenient, economical and accessible services to assist them in more effectively managing the difficulties posed by cancer and enhancing their overall well-being.

OBJECTIVE: This meta-analysis sought to assess the impact of telemedicine-based psychosocial interventions on fear of cancer recurrence, mindfulness, and posttraumatic growth in cancer survivors and to explore the influence of intervention duration, the age of participants, and specific online intervention methods on posttraumatic growth.

DESIGN: A systematic review and meta-analysis of randomized controlled trials was performed, in accordance with the PRISMA 2020 statement.

METHODS: The meta-analysis included 11 randomized controlled trials involving 1951 cancer survivors. Data were extracted and analyzed via Review Manager 5.4, with supplementary robust variance estimation (RVE) and RVE-based meta-regression (R 4.5.1, robumeta) for robustness. Subgroup analyses were performed on the basis of the intervention duration, the age of the participants, the gender of the participants, the specific online intervention methods, and the follow-up time.

RESULTS: Psychosocial interventions based on telemedicine significantly reduced cancer survivors' levels of fear of cancer recurrence (SMD = -0.37, 95% CI: -0.52 to -0.21, p < 0.0001) and increased their levels of mindfulness (SMD = -0.87, 95% CI: -1.69 to -0.04, p = 0.04) and posttraumatic growth (MD = 5.96, 95% CI: 3.57-8.36, p < 0.00001). RVE confirmed the robustness of core findings. Subgroup analyses revealed that less than 8 weeks of interventions, interventions targeting participants aged 60 and under, interventions for female participants only, telephone-based online interventions, and with a follow-up of ≤ 6 months interventions were more likely to be effective in promoting PTG.

CONCLUSION: Psychosocial interventions based on telemedicine can effectively alleviate the fear of cancer recurrence, improve mindfulness, and promote posttraumatic growth in cancer survivors. The duration of the intervention, the age of the participants, the gender of the participants, the specific online intervention methods, and the follow-up time affect the effectiveness of the intervention. RVE further validates conclusion robustness. Additional studies are required to evaluate the enduring effects of these interventions, to understand the degree of patient involvement in digital interventions, and to examine how cultural context, socioeconomic position, and other variables might affect the intervention outcomes.

TRAIL REGISTRATION: CRD42024611421.

PMID:41546656 | DOI:10.1002/pon.70377

Scand J Med Sci Sports. 2026 Jan;36(1):e70209. doi: 10.1111/sms.70209.

ABSTRACT

Exercise training is recommended in coronary heart disease (CHD) and type 2 diabetes (T2DM) patients alike; however, uncertainty remains on the influence of exercise intensity and duration in older patients with both entities. To address this, we performed a secondary analysis including 201 patients (67.9 ± 8.2 years; 84.1% men) from the LeIKD trial (NCT038359), which introduced 6 months of home-based telemedicine-supported exercise intervention in patients with CHD and T2DM. We assessed the relationships between exercise duration and intensity with change in peak oxygen uptake (V̇O₂peak) (simple and multiple regression analyses, α = 0.05). V̇O₂peak increased by 0.42 mL/kg/min per hour of endurance exercise/week (95% CI: 0.17-0.66, p = 0.001). Exercise intensity was not significantly associated with the change in V̇O₂peak (p = 0.10). In a subgroup of patients with high adherence (≥ 66.7% of prescribed total duration and meeting prescribed exercise duration in ≥ 50% of weeks of intervention), a 10% increase in exercise intensity (mean % heart rate reserve (HRR)) was associated with an increase in V̇O₂peak of 0.26 mL/kg/min (95% CI: 0.00-0.52; p = 0.05). Longer training duration within the initial 2 weeks of intervention was significantly associated with high adherence over 6 months (increased likelihood per 10 min/week: OR of 1.09 [95% CI: 1.05-1.14], p < 0.001). Therefore, exercise duration but not intensity influences changes in V̇O₂peak during exercise intervention in a high-risk population of older patients with CHD and T2DM. In patients with high adherence to exercise duration, higher exercise intensity led to an additional increase in V̇O₂peak. Training duration within the first 2 weeks was an important predictor of long-term adherence. Trial Registration: https://www.clinicaltrials.gov: Identifier: NCT038359.

PMID:41546594 | DOI:10.1111/sms.70209

Injury. 2026 Jan 10:113020. doi: 10.1016/j.injury.2026.113020. Online ahead of print.

ABSTRACT

BACKGROUND: Gamified virtual patients (VPs) can enhance motivation and learning in military trauma management. However, there is a need to better understand design preferences and expectations regarding VP features and game elements. This study explores how such elements are experienced and interpreted by military trauma care professionals.

METHODS: This qualitative study applied systematic text condensation to analyze the shared experiences of 17 participants, consisting of military medics and instructors, who interacted with a gamified VP system.

RESULTS: Five main themes were identified: Feeling Challenged; Supporting Reflection and Learning; Realism Matters; Developing Confidence; and Balancing Learning and Playing. Participants expressed mixed views on game rewards, competition, and time-pressure, with instructors warning that such features could detract from learning objectives. Instructors emphasized the value of feedback that explains consequences, while both instructors and medics highlighted the importance of immediate corrective feedback.

DISCUSSION: Gamified VPs can support military trauma training by enhancing engagement, building confidence, and supporting reflection and learning. However, the inclusion of game elements requires careful consideration. Elements that contribute to realism and immersion, such as narrative, multimedia, and tactical challenges, were viewed as valuable for maintaining authenticity and contextual relevance. Hints and progressive difficulty levels were also perceived as beneficial for supporting gradual skill development. Features such as scoring, competition, rewards and time-pressure elicited mixed responses. While some participants found these elements engaging, others perceived them as distracting or misaligned with the goal of acquiring life-saving skills. Instructors were critical of mechanisms that induced artificial stress or rewarded speed over reasoning, warning that such features could shift focus from learning to performance. Therefore, rather than adopting gamification features uncritically, designers and educators should carefully evaluate which elements enhance learning in high-stakes environments and which risk undermining it.

PMID:41545241 | DOI:10.1016/j.injury.2026.113020