You Are Not Alone! Care Professionals’ Acceptance of Telemedicine in Nursing Homes Comparing Pre- and Post-Implementation Evaluations

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript investigates the acceptance of telemedicine among care professionals in nursing homes, comparing evaluations before and after the implementation of telemedical consultations. The study aims to understand how telemedicine can reduce unnecessary hospitalizations of geriatric patients and support care personnel in making medical decisions in uncertain situations. The research is part of the Optimal@NRW project, which implemented telemedical consultations in 24 nursing homes in Germany.

This research is significant as it addresses a critical issue in today’s aging society—the shortage of care personnel and the high number of unnecessary hospitalizations of elderly patients. By exploring the acceptance of telemedicine, the study provides valuable insights into how technological solutions can be effectively integrated into nursing homes to improve patient care and reduce the burden on care professionals. The practical implications of this study are substantial, offering guidelines for the successful implementation and communication of telemedical applications in care settings.

While the study has significant practical implications, enhancing its academic rigor would further elevate its contribution to the field. Here are my suggestions:

Formulate Hypotheses: Presenting hypotheses instead of research questions can enhance the directionality of the study, increase the potential for scientific verification, and contribute more significantly to theoretical advancement. Additionally, it aids in structuring the research design systematically and clarifies the interpretation of results. For these reasons, formulating hypotheses is a highly beneficial approach to improving the quality and reliability of the research.

Use Structural Equation Modeling (SEM): Employing Structural Equation Modeling (SEM) instead of regression analysis can provide a more comprehensive understanding of the complex relationships between variables, allowing for the analysis of direct and indirect effects simultaneously. SEM also offers the advantage of assessing the overall model fit, ensuring a more robust and reliable analysis. For these reasons, using SEM alongside formulated hypotheses is a highly beneficial approach to improving the quality and reliability of the research.

Comments on the Quality of English Language

The manuscript is generally well-written and comprehensible, but there are several areas where the language can be improved for better clarity and readability. Some sentences are overly complex and could benefit from simplification to enhance understanding. Additionally, there are minor grammatical errors and awkward phrasings that need to be corrected to ensure smooth reading. Consistency in terminology, tense usage, and style throughout the manuscript also requires attention. Therefore, moderate editing of the English language is recommended to polish the text, improve its flow, and ensure that the content is communicated effectively to the readers.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The manuscript explores the acceptance of telemedicine among care professionals in nursing homes. It provides a comparison of acceptance evaluations conducted before and after the implementation of telemedical consultations. The study is significant, considering the growing importance of telemedicine in managing the healthcare needs of an aging population. However, several aspects of the manuscript require significant improvement to enhance its clarity, contribution to the field, and overall readability.

 

The manuscript currently lacks detailed descriptions of the technical aspects of the telemedicine systems implemented. It is crucial to provide comprehensive information on the technical setup, including hardware, software, communication protocols, and any integration with existing healthcare systems. This detail is essential for replicability and for understanding the potential challenges faced during implementation.

 

The introduction and related works sections need to thoroughly compare the current study with existing literature to highlight its unique contributions. For instance, the manuscripts "Multi-sensor guided hand gesture recognition for a teleoperated robot using a recurrent neural network" and "Whole-Body Teleoperation Control of Dual-Arm Robot Using Sensor Fusion" provide valuable insights into the use of advanced control methods and sensor fusion, which are relevant to telemedical applications.

 

While the manuscript discusses the reduction of perceived barriers, it should also address the efficiency and safety of telemedical consultations. Advanced control methods and continuous monitoring are vital to ensure the safe and effective operation of telemedical services.

 

The manuscript needs a clearer articulation of its contributions to the field. Specifically, it should highlight how the findings advance our understanding of telemedicine acceptance in nursing homes and its implications for future research and practice.

 

The methodological section requires more detail on the design, implementation, and analysis of the study. This includes a clearer description of the sampling methods, the design of the questionnaires, and the statistical analyses used to compare pre- and post-implementation evaluations.

 

Several sentences in the manuscript have grammatical errors or inconsistent use of tense. These issues need to be addressed to improve the readability and professionalism of the manuscript.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The authors have adequately addressed the review comments, significantly enhancing the manuscript's academic rigor and clarity. The changes made to the formulation of hypotheses, justification of regression analysis, language improvements, and detailed discussion of limitations contribute to the manuscript's overall quality. Please verify the following points:

 1. The use of regression analysis is sufficiently justified given the limitation of sample size. However, the authors do not clearly state the reasons for choosing regression analysis in the paper. To compensate for this, it is recommended to add a logical and specific explanation of the reasons for choosing regression analysis.

2. Although the limitations section of the study already mentions SEM, it would be beneficial to elaborate on this point more clearly and specifically.

3. Ensure that the discussion section explicitly links the findings to the hypotheses presented.

4. Consider including more detailed suggestions for future research directions based on the study's limitations and findings.

Comments on the Quality of English Language

The manuscript is well-written and generally clear. However, there are a few minor grammatical errors and some awkward phrasings that need to be addressed. Additionally, some sentences are overly complex and could benefit from simplification to enhance understanding. Consistency in terminology and tense usage could be also improved.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The current version can be accepted. 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf