title: Growing up with confidence: using telehealth to support continence self-care deficits amongst young people with complex needs.
abstract: BACKGROUND
  Many young people with chronic ill health use technology for self-care activities, but little is known about the use of telehealth amongst those with spina bifida. The limited availability of specialist continence nurses in primary care settings, for this client group in the UK, exacerbates their reliance on parents or carers.
  
  
  OBJECTIVE
  1. Exploring the way in which home-based and technology-enabled clinical interventions affect young people's engagement in continence self-care. 2. Articulating the way in which telehealth impacts on nursing practice and the conduct of remote clinical encounters.
  
  
  METHODS
  A virtual nurse-led clinic was established to support a small cohort of service users and their parents from home. Data from participants were collected and analysed alongside a narrative record of a reflective diary, used by the continence specialist nurse.
  
  
  RESULTS
  Participants reported increased level of self-confidence, which was attributed to interacting remotely with the specialist nurse. The virtual clinic assisted users to attain some self-care goals as well as assert their role as partners in care planning. The specialist nurse gained new valuable skills in mastering telehealth technology and managing remote clinical provision.
  
  
  CONCLUSIONS
  Using Skype™ to support young people with complex needs is an effective intervention to support continence care at home. Dedicated technical support during the initial set-up phase and on-going clinical mentorship are needed to ensure that telehealth is successfully embedded within health care practice.
authors.affiliation: The University of Edinburgh, Nursing Studies, Teviot Place Edinburgh EH8 9AG, UK. sharon.levy@ed.ac.uk.
authors.forename: Sharon
authors.initials: S
authors.lastname: Levy
authors.affiliation: The Scottish Spina Bifida Association, Cumbernauld, Dullatur, North Lanarkshire G68 0LS, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Henderson
authors.affiliation: The Scottish Spina Bifida Association, Cumbernauld, Dullatur, North Lanarkshire G68 0LS, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: McAlpine
mesh_terms: D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D020407:Internet; D059017:Primary Care Nursing / Q000379:methods; D011320:Primary Health Care / Q000379:methods; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D016135:Spinal Dysraphism / Q000523:psychology / Q000628:therapy*; D017216:Telemedicine / Q000458:organization & administration*; D006113:United Kingdom; D014584:User-Computer Interface