Homework answers / question archive / Analysing the impacts of telemedicine on behavioural changes among dementia patients during covid-19 in the KSA nursing homes Discussion The aim of this research was to analyse the impact of telemedicine on the behavioural changes among the patient of dementia during the pandemic of COVID-19

Analysing the impacts of telemedicine on behavioural changes among dementia patients during covid-19 in the KSA nursing homes Discussion The aim of this research was to analyse the impact of telemedicine on the behavioural changes among the patient of dementia during the pandemic of COVID-19

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Analysing the impacts of telemedicine on behavioural changes among dementia patients during covid-19 in the KSA nursing homes Discussion The aim of this research was to analyse the impact of telemedicine on the behavioural changes among the patient of dementia during the pandemic of COVID-19. The aim of the research was to analyse the phenomenon in the nursing home of KSA. Thus, the current section has discussed and critiqued the result by evaluating the significance of the research with the research question. Additionally, this section has analysed potential weakness of the current research along with the association to the prior studies. Commented [s1]: Remove this entirely – you don’t need to explain what the Discussion section is to the reader How research answer the question Commented [s2]: You don’t need these section headings The research question that was developed for the study was to assess the behavioural impact of utilising telemedicine approaches on the patient of dementia during COVID-19. The result of the study demonstrated that the prevalence rate of dementia is comparatively higher in KSA particularly in the aged population and older adult. Thus, thise result of the study Commented [s3]: Remove demonstrated that the the core reason behind increased prevalence of COVID-19 among dementia Also, I don’t think the prevalence rate of dementia is a key results of this study? This didn’t seem like a surveillance study to me patients is due to issues in particularly complexities in remembering to wearing face masks, and that the. Additionally, the finding of this research also demonstrated that the collected data reflects that older populationaged populations increasingly witnessexperience a greater? the behavioural impact from receivingof telemedicine during the COVID-19 pandemic. Watch grammar!!! Also, I don’t think any of this is particularly consistent with what you proposed to do in your Methods section or the results reported in your Results section. You should schedule a time to meet with me ASAP… - Commented [s4]: You’ve used this phrase twice in the beginning of a sentence – it’s a little too repetitious. Read your writing out loud to yourself to identify areas that are awkwardly written or too repetitious. Also, the first three sentences here don’t flow well together in terms of sentence structure (too similar in length) and in terms of logical flow (unclear how sentence two is a reason behind sentence three, i.e. the use of “thus”) Commented [s5]: This is a better candidate for your first sentence for the Discussion section Formatted: List Paragraph, Bulleted + Level: 1 + Aligned at: 0.25" + Indent at: 0.5" Possible weakness in research The potential limitation is that this study does not examine weakness in the current research is that the study could have explored the COVID-19 behavioural impact of the telemedicine intervention on as per different age groups. Is this really a relevant limitation? Does it impact your results or the interpretation of our results? Or the generalizability of your results? You need to explain why this is a limitation that impacts your study, how it impacts your study and the interpretation of the results, and what should be done about it. Additionally, the research could Commented [s6]: You don’t need thiese section headings have involved the individual of middle age as well in order to develop a comparative analysis. Same comment as before. Association of result to prior literature The finding of the current researchThis study demonstrated that that the rate of dementia is growing among the older population at an exponential rate. < not a good topic sentence for this paragraph However, the utilisation of telemedicine greatly lower depressive behaviour and anxiety among the patient of dementia patients during COVID-19. Thise finding of the current research contradicts with the finding of Kim et al. (2017), which depicted found that the telemedicine Commented [s7]: Your Methods section and your Results section do not suggest that this is a surveillance study! Your initial study proposal proposes to look at the impact of telemedicine on behavioural outcomes in dementia patients during the pandemic, using an intervention and control group. results in cognitive decline among dementia patients. You need to discuss possible reasons for such a contradiction. On the other hand, the research of Cuffaro et al. (2017) demonstrated that due to COVID-19 pandemic, most of the clinics has suspended their activities. It’s not clear how this relates to the previous sentence? Consequently, this situation greatly urges to utilisation of telemedicine for remote care and monitoring. Broader implication for field The current study has increasingly assisted in evaluating the problems being faced by dementia patient during COVID-19. Additionally, it also evaluates the impact of telemedicine on dementia patient during COVID-19. Thus, the study finding will assist the nursing homes in Commented [s8]: This sounds increasingly more and more like a descriptive study instead of a randomized controlled trial. Why? evaluating more about the phenomenon and how to handle such patient during the pandemic situation. Lots of grammar issues throughout – please get a grammar checker or schedule a time with the NYU Writing Center. Prospect for future progress The finding of the current research was effective, however, it will be significant to evaluate how telemedicine in particular assists in reducing the developmental risk of developing negative mental health outcomes. Commented [s9]: This doesn’t make sense Commented [s10]: This is confusing because we don’t know what mental health outcomes you have been looking at, and it hasn’t been discussed or mentioned in this section or any of the previous sections. Conclusion The aim of the study was to evaluate the behavioural change impact of telemedicine on the behavioural changes outcomes among the patient of dementia patients during the pandemic of COVID-19 pandemic. For this purpose, the telemedicine was evaluated to analyse the way it can affect the patient of dementia during the COVID-19. The finding of the study demonstrated that the collected data increasingly demonstrated that the dementia is increasingly visible particularly in the older age. These older age population are likely to witness the behavioural effect of telemedicine during the COVID-19. The finding further concludes that the increased prevalence of dementia during COVID-19 was due to the fact that patient face difficulties in remembering mask. However, the overall discussion and the finding depicted that approach of telemedicine increasingly assist in reducing depressive behaviour and anxiety among patient. The current research also offer positive path that comprising control group in nursing home of KSA will assist the patient of dementia in recovering from the anxiety and depression. References Cuffaro, L., Di Lorenzo, F., Bonavita, S., Tedeschi, G., Leocani, L. and Lavorgna, L., 2020. Dementia care and COVID-19 pandemic: a necessary digital revolution. Neurological Sciences, 41(8), pp.1977-1979. Kim, H., Jhoo, J.H. and Jang, J.W., 2017. The effect of telemedicine on cognitive decline in patients with dementia. Journal of telemedicine and telecare, 23(1), pp.149-154. Grade: 5/10 1. Interprets results to answer research question – -1 it is completely unclear what the results are and how they are being interpreted to answer the initial research question that was proposed 2. Considers possible weaknesses -1 not enough discussion about limitations, why they are of concern, how they impact the study and the interpretation of the results, and what can be done about them 3. Relationship of results to prior literature - -0.5 needs more clarity 4. Broader implications of answering research question -0.5 unclear Commented [s11]: Very confusing, not clear what this means Commented [s12]: Again, this isn’t a surveillance study looking at the prevalence of dementia?? Commented [s13]: Unclear what behavioral outcomes you’re looking at? Commented [s14]: This makes it seem like people have dementia because they forgot to wear their mask, which definitely doesn’t make sense 5. 6. 7. 8. Prospects for future progress -0.5 unclear Appropriate text (nothing belonging in other sections) Writing structure (organization) -1 topic sentences need to be improved Mechanics (spelling/grammar) -1.5 needs extensive grammar checking ANALYZING THE IMPACTS OF TELEMEDICINE ON BEHAVIOURAL CHANGES AMONG DEMENTIA PATIENTS DURING COVID-19 PANDEMIC IN THE KINGDOM OF SAUDI ARABIA (KSA) NURSING HOMES [Name of Writer] [Name of Institute] Abstract “Telemedicine: A Ray of hope for dementia patients in the depressing times of COVID-19 pandemic” Introduction: It is now an established fact that the prevalence of dementia increases significantly with the increase in age. Almost 90 percent of patients diagnosed with dementia suffer from various behavioral symptoms of dementia and this becomes vital in the wake of current pandemic. The recently imposed measures of social distancing and self-isolation in the COVID-19 pandemic increase the risk of behavioral and psychological disturbances among the elderly dementia 2 patients in Saudi Arabia. In the face of this problem, telemedicine comes to be a tool to mitigate the negative impacts of the pandemic. Methods: In this study we discussed the impacts of telemedicine in alleviating the stigma of social isolation in dementia patients as well as the reduction of the risk of Covid-19 infection in such patients. We effectively selected a sample size of 100 patients aged above 60 years and after getting informed consent, allocated them randomly into the control or intervention group. Telemedicine care was provided to the intervention group by the doctors, while the participants of both of the groups continued to receive general health care from their attendants. Data collection was done with the help of a questionnaire. Results: The assembled data depicted that the COVID-19 pandemic has had a disproportionately negative impact on people affected by dementia, However, telemedicine can reduce the risk for development of negative outcomes in mental health precipitated by the reduction of social contact and less access to health services, improving the overall management of dementia symptoms. Conclusion: Telemedicine is an effective tool in management of dementia patients therefore, it is humbly suggested that proper guidelines for the usage of this approach should be designed and practiced specially in the unfortunate circumstances if COVID-19 pandemic. Keywords: dementia, social isolation, social distancing, COVID-19, telemedicine, elderly, challenges of the pandemic, psychological symptoms in dementia. 3 4 1.0. Introduction 1.1. Background In the Kingdom of Saudi Arabia (KSA), the prevalence rate of dementia is significantly higher among the aged population from 1.1% and 2.3% of 70-80 years to 13.5% and 18.5% of 90 and older adults. The dementia patients encountered problems such as lack of cognitive thinking skills, disorientation, confusion, lack of proper communication skills, behavioural issues, memory loss etc. (Azarpazhooh et al., 2020). In this regard, Goodman-Casanova et al. (2020) stated that COVID-19 pandemic significantly affected the behaviour of dementia patients. Due to limited access and the inability to understand all the information regarding COVID-19, the pandemic has negatively impacted patients with dementia, either in nursing homes or at home. The increased prevalence of COVID-19 among dementia patients can be attributed to the difficulties in remembering to wear masks, following safeguarding procedures, and measuring self-quarantine, leading to anxiety and depression among patients. However, the telemedicine approach significantly reduced anxiety and depressive behaviour among dementia patients during COVID-19. The telemedicine approach includes those practices used to provide care to the patients at home in cases when the patients and physician are not physically present with each other. In this approach, the patients used to consult with the doctors using video conferencing and other telecommunication methods (Lai et al., 2020). It was observed that COVID-19 has negatively impacted the behaviour of dementia patients either in nursing homes or at their own houses. The reasons behind the prevalence of COVID-19 among dementia patients are the difficulties in remembering the wearing masks following safeguarding procedures, and measures of self-quarantine that developed anxiety and depression among the patients. However, it was observed that the use of the telemedicine approach significantly reduced anxiety and depression among dementia patients during the COVID-19 (Dorman et al., 2020). Despite the sensitivity of the issue, the behavioural impacts of COVID-19 on dementia patients are not studied in KSA nursing homes. This study will correspondingly help in finding out the problems of dementia patients due to COVID-19. Thus, nursing homes will know how to take care of such patients and how to assist the dementia patients so that the behavioural problems can 5 be reduced and there will be increased health-related outcomes for the patients that will impact on improving the quality of life of the patients. 1.2. Aim of the study Based on the above information, the present study is aimed to analyse the telemedicine impacts on behavioural changes among dementia patients during COVID19 in KSA nursing homes. 1.3. Research Question The research question of the present research study was “What are the behavioural impacts of using telemedicine approaches on dementia patients during COVID-19 pandemics in KSA nursing homes”? 1.4. PICOT Question The PICO template was used to explain the question of this research study: P (Population): Dementia patients in COVID-19 situations I (Intervention): Telemedicine practices for the intervention group C (Comparison): Control group who did not receive or use the practices of telemedicine technology. O (Outcomes): Improvement in the behavioural outcomes of dementia patients in COVID-19 situations after using the telemedicine approaches in the intervention group. 6 Methodology The primary purpose of this research is to investigate the impact of telemedicine on dementia patients in Saudi Arabia in the recent Covid-19 pandemic. Since, the pandemic has imposed restrictions on social interaction throughout the communities, therefore, one of the greatest victims have been patients of long-term care, especially in the nursing homes. In this context, the current study examined how dementia patients are being treated in the nursing homes in Saudi Arabia and the impact of telemedicine in their usual treatment. This research involved data related to the randomized clinical trial phase 3 of behavioral changes in dementia patients due to telemedicine. Data collection and analysis Since this study is pertinent to clinical trials of dementia patients in Saudi Arabia during Covid19, therefore, we conduct primary data collection. In Saudi Arabia (KSA), the prevalence rate of dementia is significantly higher among the aged population from 1.1% and 2.3% of 70-80 years to 13.5% and 18.5% of 90 and older adults. In such scenario, the research covered 1000 patients from five primary health care centers. For the analysis, patients were categorized into two groups i.e., the intervention group and the control group, in order to discern difference induced by the telemedicine approach at homes to the dementia patients. Telemedicine is the practice of medicine using technology to deliver care at a distance. A physician in one location uses a telecommunications infrastructure to deliver care to a patient at a distant site. The clinical trials were blinded and the two groups were not informed about their belonging to either arms of the trials. Telemedicine was used to treat the intervention group only, by the researcher with the help of doctor in those care centers. The process of proper usage of telemedicine approach was described and effectively demonstrated to all the participants. Data collection was done through observing the changes of behaviors and impacts of telemedicine on dementia patients. Observations were made once every week, for a period of 4 months, by the duty doctors in nursing care homes, so that affects of both approaches could be observed without fluctuations of data. The duty doctors were duly explained about the observations so that the data collected was standardized to a 7 maximum limit. Five nursing care homes in Saudi Arabia were selected as the site for experiments, in which a sample of 1000 patients was selected as participants. The statistical technique of power analysis was utilized to ascertain the sample size required to observe changes in behaviors and effectiveness of medicinal approach in the participants group. Selection was done through random sampling, which ensured that no biases enter the selection procedure, and every patient have the equal opportunity for selection. This was in line with the assertions of Ritchie et al. (2015), which propounded for mitigation of errors at every step of the trials. For the experimental treatment, standard telemedicine techniques were utilized which involved online connectivity with the patient and their counseling. Appropriate care was taken to conduct the telemedicine and observation of results by making sure that every step and procedure is recorded without delays. With respect to the experiment, significant challenge was faced in obtaining conscious consent of the patients due to the nature of dementia in memory retention. Further, nursing homes in Saudi Arabia are not sufficiently equipped compared to international levels, to ensure undisturbed conduct of experiment. 8 Results considering the topic "ANALYZING THE IMPACTS OF TELEMEDICINE ON BEHAVIOURAL CHANGES AMONG DEMENTIA PATIENTS DURING COVID-19 IN THE KSA NURSING HOMES", we have to develop survey questionnaire in which there will be two variables including " TELEMEDICINE" and " BEHAVIOURAL CHANGES AMONG DEMENTIA PATIENTS DURING COVID-19". The tests which are required to be conducted include frequency analysis,regressions and correlation analysis. 9 3.1. Frequency Analysis In response to the question that telemedicine makes the consultancy easy in this pandemic of Covid-19, 28% of the healthcare providers in KSA strongly agreed to the statement while 34% of them agree. In addition, 24% of them provided neutral response while 14% of them disagreed. In response to the second question that telemedicine helps to save time for patients and doctors, 17% of the healthcare providers strongly agreed while 39% of them agreed. On the other hand, 28% of the healthcare providers responded neutrally and 13% of them disagreed. However, 3% of them strongly disagreed to the statement. 10 In response to the question that telemedicine helps to provide instant consultancy to patients, 15% of the healthcare providers strongly agreed to the statement while 41% of them agreed. Moreover, 29% of the healthcare providers neutrally responded to the statement and 12% of them disagreed. In contrast, 3% of the healthcare providers strongly disagreed. In response to the fourth question that with the help of telemedicine, dementia patients are able to communicate in a better manner with healthcare providers, 9% of the healthcare providers strongly agreed while 41% of them agreed. Moreover, 21% of them neutrally responded to the statement while 24% of them disagreed. In contrast, 5% of the healthcare providers strongly disagreed. 11 The question that telemedicine has been effective for the dementia patients as they are able to connect with healthcare providers while being at their homes was responded strongly agree by 29% of the healthcare providers. In addition, 34% of them agreed to the statement while 14% of them provided neutral response. However, 20% of them disagreed and 3% of them strongly agreed. 12 In response to the question that telemedicine has reduced the risk of Covid-19 among dementia patients, 24% of healthcare providers strongly agreed and 31% agreed. In addition to this, 32% of the healthcare providers responded neutrally to the statement and 13% of them disagreed. 3.2. Correlation Analysis The below table shows the correlation analysis of variables. In this manner, it is evident that there is significant and positive association among telemedicine and behavioural changes among dementia patients during Covid-19. In addition to this, the correlation was determined to be strong as the correlation value was computed to be 0.934. 13 3.3. Regression Analysis The below table shows model summary of the regression analysis on the basis of which, it is evident that R-square for behavioural changes among dementia patients during Covid-19 is 0.872 which shows that variance telemedicine is explaining 87.2% of the variance in behavioural changes among dementia patients during Covid-19. However, this variance is obtained as 87% after the adjustments. The below table shows Anova of the regression model on the basis of which, it is evident that F-statistics is determined to be 665.175 while the sig value is computed to be 0.000. It posits that the overall model is significant as the sig value is computed below the threshold of 0.05. 14 Coefficients of the regression analysis have been determined in the below table. Therefore, it is evident that telemedicine has significant effect over the behavioural changes among dementia patients during Covid-19. It is due to the reason that B= 0.989, p= 0.00< 0.05. It depicts that the change in telemedicine will also cause change in the behavioural changes among dementia patients during Covid-19. 15 Questionnaire Questions S A Telemedicine Telemedicine makes the consultancy easy in this pandemic of Covid-19 Telemedicine helps to save time for patients and doctors. Telemedicine helps to provide instant consultancy to patients. Behavioural changes among Dementia Patients With the help of telemedicine, dementia patients are able to communicate in a better manner with healthcare providers. Telemedicine has been effective for the dementia patients as they are able to connect with healthcare providers while being at their homes. Telemedicine has reduced the risk of Covid-19 among dementia patients. A N D D S 16 Discussion The aim of this research was to analyse the impact of telemedicine on the behavioural changes among the patient of dementia during the pandemic of COVID-19. The aim of the research was to analyse the phenomenon in the nursing home of KSA. Thus, the current section has discussed and critiqued the result by evaluating the significance of the research with the research question. Additionally, this section has analysed potential weakness of the current research along with the association to the prior studies. How research answer the question The research question that was developed for the study was to assess the behavioural impact of utilising telemedicine approaches on the patient of dementia during COVID-19. The result of the study demonstrated that the prevalence rate of dementia is comparatively higher in KSA particularly in the aged population and older adult. Thus, the result of the study demonstrated that the core reason behind increased prevalence of COVID-19 among dementia patient particularly complexities in remembering wearing face mask. Additionally, the finding of this research also demonstrated that the collected data reflects that older population increasingly witness the behavioural impact of telemedicine during the COVID-19. Possible weakness in research The potential weakness in the current research is that the study could have explored the COVID-19 behavioural impact as per different age groups. Additionally, the research could have involved the individual of middle age as well in order to develop a comparative analysis. Association of result to prior literature The finding of the current research demonstrated that that the rate of dementia is growing among older population at exponential rate. However, the utilisation of telemedicine greatly lower depressive behaviour and anxiety among the patient of dementia during COVID19. The finding of the current research contradicts with the finding of Kim et al. (2017) which depicted that the telemedicine result in cognitive decline among dementia patient. On the other 17 hand, the research of Cuffaro et al. (2017) demonstrated that due to COVID-19 pandemic most of the clinic has suspended their activities. Consequently, this situation greatly urges to utilisation of telemedicine for remote care and monitoring. Broader implication for field The current study has increasingly assisted in evaluating the problems being faced by dementia patient during COVID-19. Additionally, it also evaluates the impact of telemedicine on dementia patient during COVID-19. Thus, the study finding will assist the nursing homes in evaluating more about the phenomenon and how to handle such patient during the pandemic situation. Prospect for future progress The finding of the current research was effective, however, it will be significant to evaluate how telemedicine in particular assist in reducing the developmental risk of negative mental health outcome. Conclusion The aim of the study was to evaluate the behavioural change impact of telemedicine on the behavioural changes among the patient of dementia during the pandemic of COVID-19. For this purpose, the telemedicine was evaluated to analyse the way it can affect the patient of dementia during the COVID-19. The finding of the study demonstrated that the collected data increasingly demonstrated that the dementia is increasingly visible particularly in the older age. These older age population are likely to witness the behavioural effect of telemedicine during the COVID-19. The finding further concludes that the increased prevalence of dementia during COVID-19 was due to the fact that patient face difficulties in remembering mask. However, the overall discussion and the finding depicted that approach of telemedicine increasingly assist in reducing depressive behaviour and anxiety among patient. The current 18 research also offer positive path that comprising control group in nursing home of KSA will assist the patient of dementia in recovering from the anxiety and depression. References Azarpazhooh, M.R., Amiri, A., Morovatdar, N., Steinwender, S., Ardani, A.R., Yassi, N., Biller, J., Stranges, S., Belasi, M.T., Neya, S.K. and Khorram, B., 2020. Correlations between COVID-19 and burden of dementia: An ecological study and review of literature. Journal of the Neurological Sciences, 416, p.117013. Dorman, G., Dengra, A.A., Fiorini, A., Failla, B., Vallejos, F., Pontello, N., Roca, M. and Bustin, J., 2020. Experience and results with a telehealth treatment program in patients with cognitive disorders during the COVID?19 pandemic. International Journal of Geriatric Psychiatry. Goodman-Casanova, J.M., Dura-Perez, E., Guzman-Parra, J., Cuesta-Vargas, A. and Mayoral-Cleries, F., 2020. Telehealth home support during COVID-19 confinement for community-dwelling older adults with mild cognitive impairment or mild dementia: survey study. Journal of medical Internet research, 22(5), p.e19434. Lai, F.H.Y., Yan, E.W.H., Yu, K.K.Y., Tsui, W.S., Chan, D.T.H. and Yee, B.K., 2020. The Protective Impact of Telemedicine on Persons With Dementia and Their Caregivers During the COVID-19 Pandemic. The American Journal of Geriatric Psychiatry, 28(11), p.1175. 19 Bajpai, N., 2015. Marketing Research. Pearson Education India. Bloomfield, J. and Fisher, M.J., 2019. Quantitative research design. Journal of the Australasian Rehabilitation Nurses Association, 22(2), p.27. Bryman, A., 2017. Quantitative and qualitative research: further reflections on their integration. In Mixing methods: Qualitative and quantitative research (pp. 57-78). Routledge. Choy, L.T., 2014. The strengths and weaknesses of research methodology: Comparison and complimentary between qualitative and quantitative approaches. IOSR Journal of Humanities and Social Science, 19(4), pp.99-104. Duberley, J., Johnson, P. and Cassell, C., 2012. Philosophies underpinning qualitative research. Qualitative organizational research: Core methods and current challenges, 15. Soiferman, L.K., 2010. Compare and Contrast Inductive and Deductive Research Approaches. Online Submission. Ritchie, C.W., Terrera, G.M. and Quinn, T.J., 2015. Dementia trials and dementia tribulations: methodological and analytical challenges in dementia research. Alzheimer's research & therapy, 7(1), pp.1-11. Cuffaro, L., Di Lorenzo, F., Bonavita, S., Tedeschi, G., Leocani, L. and Lavorgna, L., 2020. Dementia care and COVID-19 pandemic: a necessary digital revolution. Neurological Sciences, 41(8), pp.1977-1979. 20 Kim, H., Jhoo, J.H. and Jang, J.W., 2017. The effect of telemedicine on cognitive decline in patients with dementia. Journal of telemedicine and telecare, 23(1), pp.149-154. 21 Summary of the main changes : Instructions for final paper submission: • • • • • Highlight any changes you make in your final paper from the initial drafts you turned in for HW4 through HW8 o You may want to do this by keeping on "Track Changes" as you revise o Then, before turning in your final paper, highlight where the changes are and "Accept All Changes" (to minimize clutter) Write up a one-page summary of the main things you changed and why in response to the commentary you have received from me and from your peers Turn in the one-page summary with the final paper Please use 11 pt Arial font, single spacing, and one-inch margins Please turn in your final paper as a Word doc, titled, "HW9_[your name].docx" I attached 4 pdf files with my mentor comments in intro, methods, results and discussion I need you help to edit them all following instructions and comments If you need any info send to me on what's up 966561770888 to make it fast PLEASE ANALYZING THE IMPACTS OF TELEMEDICINE ON BEHAVIOURAL CHANGES AMONG DEMENTIA PATIENTS DURING COVID-19 PANDEMIC IN THE KINGDOM OF SAUDI ARABIA (KSA) NURSING HOMES [Name of Writer] [Name of Institute] 2 1.0. Introduction 1.1. Background In the Kingdom of Saudi Arabia (KSA), the prevalence rate of dementia is significantly higher among the aged population from 1.1% and 2.3% of 70-80 years to Commented [A1]: Higher compared to what? 13.5% and 18.5% of 90 and older adults. DThe dementia patients encountered Commented [A2]: Using present tense because I’m assuming that dementia patients still encounter such problems? problems such as lack of cognitive thinking skills, disorientation, confusion, lack of proper communication skills, behavioural issues, and memory loss etc. (Azarpazhooh et al., 2020). In this regard, Goodman-Casanova et al. (2020) stated that COVID-19 pandemic significantly affected the behaviour of dementia patients. Due to limited access and the inability to understand all the information regarding COVID-19, the pandemic has negatively impacted patients with dementia, either in nursing homes or at home. The increased prevalence of COVID-19 among dementia patients can be attributed to the difficulties in remembering to wear masks, following safeguarding procedures, and measuring self-quarantine, leading to anxiety and depression among patients. However, the telemedicine approach significantly reduced anxiety Commented [A3]: You should start the paragraph with how the COVID-19 has affected dementia patients, instead of the prevalence of dementia. Commented [A4]: In what ways has it negatively impacted patients? This is too vague. Does it impact their health outcomes? Their well-being? Their survival? Commented [A5]: It seems in the Goodman-Casanova sentence that you are going to talk about how the pandemic has affected the behavior of dementia patients. But in this sentence, it seems like you are changing topics to why COVID-19 is more prevalent among dementia patients…? and depressive behaviour among dementia patients during COVID-19. The telemedicine approach includes those practices used to provide care to the patients at home in cases when the patients and physician are not physically present with each other. In this approach, the patients used to consulted with the doctors using video conferencing and other telecommunication methods (Lai et al., 2020). It was observed that COVID-19 has negatively impacted the behaviour of dementia patients either in nursing homes or at their own houses. The reasons behind the prevalence of COVID-19 among dementia patients are the difficulties in remembering the wearing masks following safeguarding procedures, and measures of self-quarantine that developed anxiety and depression among the patients. However, it was observed that the use of the telemedicine approach significantly reduced anxiety and depression among dementia patients during Commented [A6]: If I was going to reduce this sentence to some of its most basic components, I would get the following, “The increased prevalence of COVID-19 lead to anxiety and depression among patients.” Or do you really mean that “self-quarantine led to anxiety and depression among patients” in the second half of the sentence? Clarify this sentence by making it simpler. What are you really trying to say here? Commented [A7]: Citation? And why? At this point, the audience has no idea whether you are concerned about improving behavior of dementia patients, improving health outcomes of dementia patients, or decreasing the prevalence of COVID among dementia patients. You haven’t provided enough information or organized the information well enough to tell us. As a result, we don’t know whether your intervention is reasonable to target your outcomes of interest, or why such an intervention is justified. Commented [A8]: Why? About what? How specifically? the COVID-19 (Dorman et al., 2020). Despite the sensitivity of the issue, the Commented [A9]: This is repetitious. behavioural impacts of COVID-19 on dementia patients are not studied in KSA nursing Commented [A10]: This makes it more confusing – are there additional problems during dementia due to having COVID, or just problems that are exacerbated by the pandemic more generally (i.e. doesn’t require you to get COVID)? homes. This study will correspondingly help in finding out the problems of dementia patients due to COVID-19. Thus, nursing homes will know how to take care of such 3 patients and how to assist the dementia patients so that the behavioural problems can be reduced and there will be increased health-related outcomes for the patients that will impact on improving the quality of life of the patients. 1.2. Aim of the study Based on the above information, the present study is aimsed to analyse the telemedicine impacts on behavioural changes among dementia patients during COVID19 in KSA nursing homes. 1.3. Research Question The research question of the present research study was “What are the behavioural impacts of using telemedicine approaches on dementia patients during COVID-19 pandemics in KSA nursing homes”? PICOT Question Grade: 4/10 - Commented [A11]: These two sections, along with the PICO question section I deleted, are repetitious. Tell your reader the objective of this study using just one method. Commented [A12]: I wonder if your real question is whether providing telemedicine to dementia patients mitigates some of the behavioral impacts from the COVID pandemic. Content – -2 you haven’t conveyed clearly to the reader throughout what the specific problems are among dementia patients, and why the telemedicine approach is appropriate. You also need to show the reader why your hypotheses are reasonable by discussing how the relevant literature has led you to specific hypotheses. - Organization – -2 there’s no paragraph unity or coherence. You actually don’t have distinct paragraphs either, given that some of the same information is repeated in two paragraphs. - Mechanics (spelling/grammar) - acceptable - Sentence structure – -1 there are several convoluted sentences that are hard to understand - Citations -1 missing key citations Formatted: Font: (Default) Times New Roman Formatted: List Paragraph, Line spacing: single, Bulleted + Level: 1 + Aligned at: 0.5" + Indent at: 4 The PICO template was used to explain the question of this research study: P (Population): Dementia patients in COVID-19 situations I (Intervention): Telemedicine practices for the intervention group C (Comparison): Control group who did not receive or use the practices of telemedicine technology. O (Outcomes): Improvement in the behavioural outcomes of dementia patients in COVID-19 situations after using the telemedicine approaches in the intervention group. 5 References Azarpazhooh, M.R., Amiri, A., Morovatdar, N., Steinwender, S., Ardani, A.R., Yassi, N., Biller, J., Stranges, S., Belasi, M.T., Neya, S.K. and Khorram, B., 2020. Correlations between COVID-19 and burden of dementia: An ecological study and review of literature. Journal of the Neurological Sciences, 416, p.117013. Dorman, G., Dengra, A.A., Fiorini, A., Failla, B., Vallejos, F., Pontello, N., Roca, M. and Bustin, J., 2020. Experience and results with a telehealth treatment program in patients with cognitive disorders during the COVID?19 pandemic. International Journal of Geriatric Psychiatry. Goodman-Casanova, J.M., Dura-Perez, E., Guzman-Parra, J., Cuesta-Vargas, A. and Mayoral-Cleries, F., 2020. Telehealth home support during COVID-19 confinement for community-dwelling older adults with mild cognitive impairment or mild dementia: survey study. Journal of medical Internet research, 22(5), p.e19434. Lai, F.H.Y., Yan, E.W.H., Yu, K.K.Y., Tsui, W.S., Chan, D.T.H. and Yee, B.K., 2020. The Protective Impact of Telemedicine on Persons With Dementia and Their Caregivers During the COVID-19 Pandemic. The American Journal of Geriatric Psychiatry, 28(11), p.1175. RESEARCH METHODOLOGY ANALYZING THE IMPACTS OF TELEMEDICINE ON BEHAVIOURAL CHANGES AMONG DEMENTIA PATIENTS DURING COVID-19 PANDEMIC IN THE KINGDOM OF SAUDI ARABIA (KSA) NURSING HOMES Submitted by [Insert name] [Date] 2 Methodology The primary purpose of this research is to investigate the impact of telemedicine on dementia patients in Saudi Arabia in the recent Covid-19 pandemic. Since, the pandemic has imposed restrictions on social interaction throughout the communities, therefore, one of the greatest victims have been patients of long-term care, especially in the nursing homes. In this context, the current study examined how dementia patients are being treated in the nursing homes in Saudi Arabia and the impact of telemedicine in their usual treatment. This research involved data related to the randomized clinical trial phase 3 of behavioral changes in dementia patients due to telemedicine. Commented [s1]: This is information that belongs in the Introduction section, not in methods You can start off more directly by clearly identifying the design of your study in the first sentence, and linking it to the purpose of your study. For instance, “This is a longitudinal, randomized clinical trial comparing telemedicine versus no telemedicine among dementia patients in Saudi Arabia during the Covid-19 pandemic.” Data collection and analysis Since this study is pertinent to clinical trials of dementia patients in Saudi Arabia during Covid19, therefore, we conduct primary data collection. In Saudi Arabia (KSA), the prevalence rate of dementia Commented [s2]: Data collection can be discussed after the description of the interventions. Commented [s3]: What were the eligibility criteria? is significantly higher among the aged population from 1.1% and 2.3% of 70-80 years to 13.5% and 18.5% of 90 and older adults. In such scenario, the research coveredWe recruited 1000 patients from five primary health care centers in Saudi Arabia. For the analysis, patients were categorized randomized into an two groups i.e., the intervention group and a the control group. The intervention group received ____, Commented [s4]: Belongs in introduction Commented [s5]: You need more information about how the patients were recruited and whether they provided informed consent. You may want to look at other studies examining dementia to see how they cover the issue of informed consent – I’m unclear about how you would effectively elicit informed consent from a cognitively impaired population. while the control group received ____. Both groups received ____. , in order to discern difference Commented [s6]: How did you randomize? induced by the telemedicine approach at homes to the dementia patients. Telemedicine is the practice of Commented [s7]: I still don’t know what intervention was received by the control group. medicine using technology to deliver care at a distance. A physician in one location uses a Commented [s8]: This information should have already been introduced in the Introduction? telecommunications infrastructure to deliver care to a patient at a distant site. The clinical trials were blinded and the two groups were not informed about their belonging to either arms of the trials. Telemedicine was used to treat the intervention group only, by the researcher with the help of doctor in Commented [s9]: I don’t see how you were able to keep the participants blinded – they either had to engage with a computer or a person (or not receive care at all, depending what your control gropu actually is). Commented [s10]: How often? What kind of care was provided via telemedicine? 3 those care centers. The process of proper usage of telemedicine approach was described and effectively demonstrated to all the participants. Primary dData collection was done throughconducted by ____, who observed and recordeding the changes inof behaviors and impacts of telemedicine onamong the dementia patients. [ What kinds of observations were made? On what dimensions of behavior?] Observations were made once every week, for a period of 4 months, by the on-duty doctors in nursing care homes. [ something about calibration ] was conducted, so that affects of both approaches could be observed without fluctuations of to increase intra- and interexaminer reliability in the collected data. The duty doctors were duly explained about the observations so that the data collected was standardized to a maximum limit. Five nursing care homes in Saudi Arabia were selected as the site for experiments, in which a sample of 1000 patients was selected as Commented [s11]: So a different doctor might be observing the same patient in any given week? You will need to talk about things like reliability and calibration in more depth. Commented [s12]: This isn’t enough description about how the data collection was standardized. participants. The statistical technique of powerThis study is powered for the primary outcomes of analysis was utilized to ascertain the sample size required to observe changes in _______ [ what are your primary outcomes? ]behaviors and effectiveness of medicinal approach in the participants group. Selection was done through random sampling, which ensured that no biases enter the selection procedure, and every patient have the equal opportunity for selection. This was in line with the assertions Commented [s13]: Random assignment is different from random sampling, which refers to how a sample is drawn from one or more populations. Which are you actually referring to? of Ritchie et al. (2015), which propounded for mitigation of errors at every step of the trials. For the connectivity with the patient and their counseling. Appropriate care was taken to conduct the telemedicine Commented [s14]: You need to describe what standard telemedicine approaches are, either in the Methods or in the Introduction. and observation of results by making sure that every step and procedure is recorded without delays. With Commented [s15]: This information seems repetitive experimental treatment, standard telemedicine techniques were utilized which involved online respect to the experiment, significant challenge was faced in obtaining conscious consent of the patients due to the nature of dementia in memory retention. Further, nursing homes in Saudi Arabia are not sufficiently equipped compared to international levels, to ensure undisturbed conduct of experiment. Grade: 6.5/10 Commented [s16]: Belonging in Discussion/Limitations 4 - Content: -2 missing information on eligibility criteria, what the specific interventions are (esp in control group, though telemedicine intervention could use more description), what the primary outcomes of interest are, how randomization was conducted, and how blinding was implemented (or why it was feasible) - Organization: -1 there were several instances where information that should belong in the Introduction, Discussion, or Limitations was slotted into the middle of paragraphs - Mechanics (spelling/grammar): fine - Sentence structure: -0.5 several instances of awkward sentence structure – I recommend scheduling an appointment with the Writing Center or asking one of your classmates to proofread - Citations where necessary - fine Formatted: List Paragraph, Bulleted + Level: 1 + Aligned at: 0.5" + Indent at: 0.75" Formatted: Font: (Default) +Headings CS (Times New Roman), 11 pt, Complex Script Font: +Headings CS (Times New Roman), 10 pt References Bajpai, N., 2015. Marketing Research. Pearson Education India. 5 Bloomfield, J. and Fisher, M.J., 2019. Quantitative research design. Journal of the Australasian Rehabilitation Nurses Association, 22(2), p.27. Bryman, A., 2017. Quantitative and qualitative research: further reflections on their integration. In Mixing methods: Qualitative and quantitative research (pp. 57-78). Routledge. Choy, L.T., 2014. The strengths and weaknesses of research methodology: Comparison and complimentary between qualitative and quantitative approaches. IOSR Journal of Humanities and Social Science, 19(4), pp.99-104. Duberley, J., Johnson, P. and Cassell, C., 2012. Philosophies underpinning qualitative research. Qualitative organizational research: Core methods and current challenges, 15. Soiferman, L.K., 2010. Compare and Contrast Inductive and Deductive Research Approaches. Online Submission. Ritchie, C.W., Terrera, G.M. and Quinn, T.J., 2015. Dementia trials and dementia tribulations: methodological and analytical challenges in dementia research. Alzheimer's research & therapy, 7(1), pp.1-11. ANALYZING THE IMPACTS OF TELEMEDICINE ON BEHAVIOURAL CHANGES AMONG DEMENTIA PATIENTS DURING COVID-19 PANDEMIC IN THE KINGDOM OF SAUDI ARABIA (KSA) NURSING HOMES [Name of Writer] [Name of Institute] Abstract “Telemedicine: A Ray of hope for dementia patients in the depressing times of COVID-19 pandemic” Introduction: It is now an established fact that the prevalence of dementia increases significantly with the increase in age. Almost 90 percent of patients diagnosed with dementia suffer from various behavioral symptoms of dementia and this becomes vital in the wake of current pandemic. The recently imposed measures of social distancing and self-isolation in the COVID-19 pandemic increase the risk of behavioral and psychological disturbances among the elderly dementia 2 patients in Saudi Arabia. In the face of this problem, telemedicine comes to be a tool to mitigate the negative impacts of the pandemic. Methods: In this study we discussed the impacts of telemedicine in alleviating the stigma of social isolation in dementia patients as well as the reduction of the risk of Covid-19 infection in such patients. We effectively selected a sample size of 100 patients aged above 60 years and after getting informed consent, allocated them randomly into the control or intervention group. Telemedicine care was provided to the intervention group by the doctors, while the participants of both of the groups continued to receive general health care from their attendants. Data collection was done with the help of a questionnaire. Results: The assembled data depicted that the COVID-19 pandemic has had a disproportionately negative impact on people affected by dementia, However, telemedicine can reduce the risk for development of negative outcomes in mental health precipitated by the reduction of social contact and less access to health services, improving the overall management of dementia symptoms. Conclusion: Telemedicine is an effective tool in management of dementia patients therefore, it is humbly suggested that proper guidelines for the usage of this approach should be designed and practiced specially in the unfortunate circumstances if COVID-19 pandemic. Keywords: dementia, social isolation, social distancing, COVID-19, telemedicine, elderly, challenges of the pandemic, psychological symptoms in dementia. 3 4 1.0. Introduction 1.1. Background In the Kingdom of Saudi Arabia (KSA), the prevalence rate of dementia is significantly higher among the aged population from 1.1% and 2.3% of 70-80 years to 13.5% and 18.5% of 90 and older adults. The dementia patients encountered problems such as lack of cognitive thinking skills, disorientation, confusion, lack of proper communication skills, behavioural issues, memory loss etc. (Azarpazhooh et al., 2020). In this regard, Goodman-Casanova et al. (2020) stated that COVID-19 pandemic significantly affected the behaviour of dementia patients. Due to limited access and the inability to understand all the information regarding COVID-19, the pandemic has negatively impacted patients with dementia, either in nursing homes or at home. The increased prevalence of COVID-19 among dementia patients can be attributed to the difficulties in remembering to wear masks, following safeguarding procedures, and measuring self-quarantine, leading to anxiety and depression among patients. However, the telemedicine approach significantly reduced anxiety and depressive behaviour among dementia patients during COVID-19. The telemedicine approach includes those practices used to provide care to the patients at home in cases when the patients and physician are not physically present with each other. In this approach, the patients used to consult with the doctors using video conferencing and other telecommunication methods (Lai et al., 2020). It was observed that COVID-19 has negatively impacted the behaviour of dementia patients either in nursing homes or at their own houses. The reasons behind the prevalence of COVID-19 among dementia patients are the difficulties in remembering the wearing masks following safeguarding procedures, and measures of self-quarantine that developed anxiety and depression among the patients. However, it was observed that the use of the telemedicine approach significantly reduced anxiety and depression among dementia patients during the COVID-19 (Dorman et al., 2020). Despite the sensitivity of the issue, the behavioural impacts of COVID-19 on dementia patients are not studied in KSA nursing homes. This study will correspondingly help in finding out the problems of dementia patients due to COVID-19. Thus, nursing homes will know how to take care of such patients and how to assist the dementia patients so that the behavioural problems can 5 be reduced and there will be increased health-related outcomes for the patients that will impact on improving the quality of life of the patients. 1.2. Aim of the study Based on the above information, the present study is aimed to analyse the telemedicine impacts on behavioural changes among dementia patients during COVID19 in KSA nursing homes. 1.3. Research Question The research question of the present research study was “What are the behavioural impacts of using telemedicine approaches on dementia patients during COVID-19 pandemics in KSA nursing homes”? 1.4. PICOT Question The PICO template was used to explain the question of this research study: P (Population): Dementia patients in COVID-19 situations I (Intervention): Telemedicine practices for the intervention group C (Comparison): Control group who did not receive or use the practices of telemedicine technology. O (Outcomes): Improvement in the behavioural outcomes of dementia patients in COVID-19 situations after using the telemedicine approaches in the intervention group. 6 Methodology The primary purpose of this research is to investigate the impact of telemedicine on dementia patients in Saudi Arabia in the recent Covid-19 pandemic. Since, the pandemic has imposed restrictions on social interaction throughout the communities, therefore, one of the greatest victims have been patients of long-term care, especially in the nursing homes. In this context, the current study examined how dementia patients are being treated in the nursing homes in Saudi Arabia and the impact of telemedicine in their usual treatment. This research involved data related to the randomized clinical trial phase 3 of behavioral changes in dementia patients due to telemedicine. Data collection and analysis Since this study is pertinent to clinical trials of dementia patients in Saudi Arabia during Covid19, therefore, we conduct primary data collection. In Saudi Arabia (KSA), the prevalence rate of dementia is significantly higher among the aged population from 1.1% and 2.3% of 70-80 years to 13.5% and 18.5% of 90 and older adults. In such scenario, the research covered 1000 patients from five primary health care centers. For the analysis, patients were categorized into two groups i.e., the intervention group and the control group, in order to discern difference induced by the telemedicine approach at homes to the dementia patients. Telemedicine is the practice of medicine using technology to deliver care at a distance. A physician in one location uses a telecommunications infrastructure to deliver care to a patient at a distant site. The clinical trials were blinded and the two groups were not informed about their belonging to either arms of the trials. Telemedicine was used to treat the intervention group only, by the researcher with the help of doctor in those care centers. The process of proper usage of telemedicine approach was described and effectively demonstrated to all the participants. Data collection was done through observing the changes of behaviors and impacts of telemedicine on dementia patients. Observations were made once every week, for a period of 4 months, by the duty doctors in nursing care homes, so that affects of both approaches could be observed without fluctuations of data. The duty doctors were duly explained about the observations so that the data collected was standardized to a 7 maximum limit. Five nursing care homes in Saudi Arabia were selected as the site for experiments, in which a sample of 1000 patients was selected as participants. The statistical technique of power analysis was utilized to ascertain the sample size required to observe changes in behaviors and effectiveness of medicinal approach in the participants group. Selection was done through random sampling, which ensured that no biases enter the selection procedure, and every patient have the equal opportunity for selection. This was in line with the assertions of Ritchie et al. (2015), which propounded for mitigation of errors at every step of the trials. For the experimental treatment, standard telemedicine techniques were utilized which involved online connectivity with the patient and their counseling. Appropriate care was taken to conduct the telemedicine and observation of results by making sure that every step and procedure is recorded without delays. With respect to the experiment, significant challenge was faced in obtaining conscious consent of the patients due to the nature of dementia in memory retention. Further, nursing homes in Saudi Arabia are not sufficiently equipped compared to international levels, to ensure undisturbed conduct of experiment. 8 Results considering the topic "ANALYZING THE IMPACTS OF TELEMEDICINE ON BEHAVIOURAL CHANGES AMONG DEMENTIA PATIENTS DURING COVID-19 IN THE KSA NURSING HOMES", we have to develop survey questionnaire in which there will be two variables including " TELEMEDICINE" and " BEHAVIOURAL CHANGES AMONG DEMENTIA PATIENTS DURING COVID-19". The tests which are required to be conducted include frequency analysis,regressions and correlation analysis. 9 3.1. Frequency Analysis In response to the question that telemedicine makes the consultancy easy in this pandemic of Covid-19, 28% of the healthcare providers in KSA strongly agreed to the statement while 34% of them agree. In addition, 24% of them provided neutral response while 14% of them disagreed. In response to the second question that telemedicine helps to save time for patients and doctors, 17% of the healthcare providers strongly agreed while 39% of them agreed. On the other hand, 28% of the healthcare providers responded neutrally and 13% of them disagreed. However, 3% of them strongly disagreed to the statement. 10 In response to the question that telemedicine helps to provide instant consultancy to patients, 15% of the healthcare providers strongly agreed to the statement while 41% of them agreed. Moreover, 29% of the healthcare providers neutrally responded to the statement and 12% of them disagreed. In contrast, 3% of the healthcare providers strongly disagreed. In response to the fourth question that with the help of telemedicine, dementia patients are able to communicate in a better manner with healthcare providers, 9% of the healthcare providers strongly agreed while 41% of them agreed. Moreover, 21% of them neutrally responded to the statement while 24% of them disagreed. In contrast, 5% of the healthcare providers strongly disagreed. 11 The question that telemedicine has been effective for the dementia patients as they are able to connect with healthcare providers while being at their homes was responded strongly agree by 29% of the healthcare providers. In addition, 34% of them agreed to the statement while 14% of them provided neutral response. However, 20% of them disagreed and 3% of them strongly agreed. 12 In response to the question that telemedicine has reduced the risk of Covid-19 among dementia patients, 24% of healthcare providers strongly agreed and 31% agreed. In addition to this, 32% of the healthcare providers responded neutrally to the statement and 13% of them disagreed. 3.2. Correlation Analysis The below table shows the correlation analysis of variables. In this manner, it is evident that there is significant and positive association among telemedicine and behavioural changes among dementia patients during Covid-19. In addition to this, the correlation was determined to be strong as the correlation value was computed to be 0.934. 13 3.3. Regression Analysis The below table shows model summary of the regression analysis on the basis of which, it is evident that R-square for behavioural changes among dementia patients during Covid-19 is 0.872 which shows that variance telemedicine is explaining 87.2% of the variance in behavioural changes among dementia patients during Covid-19. However, this variance is obtained as 87% after the adjustments. The below table shows Anova of the regression model on the basis of which, it is evident that F-statistics is determined to be 665.175 while the sig value is computed to be 0.000. It posits that the overall model is significant as the sig value is computed below the threshold of 0.05. 14 Coefficients of the regression analysis have been determined in the below table. Therefore, it is evident that telemedicine has significant effect over the behavioural changes among dementia patients during Covid-19. It is due to the reason that B= 0.989, p= 0.00< 0.05. It depicts that the change in telemedicine will also cause change in the behavioural changes among dementia patients during Covid-19. 15 Questionnaire Questions S A Telemedicine Telemedicine makes the consultancy easy in this pandemic of Covid-19 Telemedicine helps to save time for patients and doctors. Telemedicine helps to provide instant consultancy to patients. Behavioural changes among Dementia Patients With the help of telemedicine, dementia patients are able to communicate in a better manner with healthcare providers. Telemedicine has been effective for the dementia patients as they are able to connect with healthcare providers while being at their homes. Telemedicine has reduced the risk of Covid-19 among dementia patients. A N D D S 16 Discussion The aim of this research was to analyse the impact of telemedicine on the behavioural changes among the patient of dementia during the pandemic of COVID-19. The aim of the research was to analyse the phenomenon in the nursing home of KSA. Thus, the current section has discussed and critiqued the result by evaluating the significance of the research with the research question. Additionally, this section has analysed potential weakness of the current research along with the association to the prior studies. How research answer the question The research question that was developed for the study was to assess the behavioural impact of utilising telemedicine approaches on the patient of dementia during COVID-19. The result of the study demonstrated that the prevalence rate of dementia is comparatively higher in KSA particularly in the aged population and older adult. Thus, the result of the study demonstrated that the core reason behind increased prevalence of COVID-19 among dementia patient particularly complexities in remembering wearing face mask. Additionally, the finding of this research also demonstrated that the collected data reflects that older population increasingly witness the behavioural impact of telemedicine during the COVID-19. Possible weakness in research The potential weakness in the current research is that the study could have explored the COVID-19 behavioural impact as per different age groups. Additionally, the research could have involved the individual of middle age as well in order to develop a comparative analysis. Association of result to prior literature The finding of the current research demonstrated that that the rate of dementia is growing among older population at exponential rate. However, the utilisation of telemedicine greatly lower depressive behaviour and anxiety among the patient of dementia during COVID19. The finding of the current research contradicts with the finding of Kim et al. (2017) which depicted that the telemedicine result in cognitive decline among dementia patient. On the other 17 hand, the research of Cuffaro et al. (2017) demonstrated that due to COVID-19 pandemic most of the clinic has suspended their activities. Consequently, this situation greatly urges to utilisation of telemedicine for remote care and monitoring. Broader implication for field The current study has increasingly assisted in evaluating the problems being faced by dementia patient during COVID-19. Additionally, it also evaluates the impact of telemedicine on dementia patient during COVID-19. Thus, the study finding will assist the nursing homes in evaluating more about the phenomenon and how to handle such patient during the pandemic situation. Prospect for future progress The finding of the current research was effective, however, it will be significant to evaluate how telemedicine in particular assist in reducing the developmental risk of negative mental health outcome. Conclusion The aim of the study was to evaluate the behavioural change impact of telemedicine on the behavioural changes among the patient of dementia during the pandemic of COVID-19. For this purpose, the telemedicine was evaluated to analyse the way it can affect the patient of dementia during the COVID-19. The finding of the study demonstrated that the collected data increasingly demonstrated that the dementia is increasingly visible particularly in the older age. These older age population are likely to witness the behavioural effect of telemedicine during the COVID-19. The finding further concludes that the increased prevalence of dementia during COVID-19 was due to the fact that patient face difficulties in remembering mask. However, the overall discussion and the finding depicted that approach of telemedicine increasingly assist in reducing depressive behaviour and anxiety among patient. The current 18 research also offer positive path that comprising control group in nursing home of KSA will assist the patient of dementia in recovering from the anxiety and depression. References Azarpazhooh, M.R., Amiri, A., Morovatdar, N., Steinwender, S., Ardani, A.R., Yassi, N., Biller, J., Stranges, S., Belasi, M.T., Neya, S.K. and Khorram, B., 2020. Correlations between COVID-19 and burden of dementia: An ecological study and review of literature. Journal of the Neurological Sciences, 416, p.117013. Dorman, G., Dengra, A.A., Fiorini, A., Failla, B., Vallejos, F., Pontello, N., Roca, M. and Bustin, J., 2020. Experience and results with a telehealth treatment program in patients with cognitive disorders during the COVID?19 pandemic. International Journal of Geriatric Psychiatry. Goodman-Casanova, J.M., Dura-Perez, E., Guzman-Parra, J., Cuesta-Vargas, A. and Mayoral-Cleries, F., 2020. Telehealth home support during COVID-19 confinement for community-dwelling older adults with mild cognitive impairment or mild dementia: survey study. Journal of medical Internet research, 22(5), p.e19434. Lai, F.H.Y., Yan, E.W.H., Yu, K.K.Y., Tsui, W.S., Chan, D.T.H. and Yee, B.K., 2020. The Protective Impact of Telemedicine on Persons With Dementia and Their Caregivers During the COVID-19 Pandemic. The American Journal of Geriatric Psychiatry, 28(11), p.1175. 19 Bajpai, N., 2015. Marketing Research. Pearson Education India. Bloomfield, J. and Fisher, M.J., 2019. Quantitative research design. Journal of the Australasian Rehabilitation Nurses Association, 22(2), p.27. Bryman, A., 2017. Quantitative and qualitative research: further reflections on their integration. In Mixing methods: Qualitative and quantitative research (pp. 57-78). Routledge. Choy, L.T., 2014. The strengths and weaknesses of research methodology: Comparison and complimentary between qualitative and quantitative approaches. IOSR Journal of Humanities and Social Science, 19(4), pp.99-104. Duberley, J., Johnson, P. and Cassell, C., 2012. Philosophies underpinning qualitative research. Qualitative organizational research: Core methods and current challenges, 15. Soiferman, L.K., 2010. Compare and Contrast Inductive and Deductive Research Approaches. Online Submission. Ritchie, C.W., Terrera, G.M. and Quinn, T.J., 2015. Dementia trials and dementia tribulations: methodological and analytical challenges in dementia research. Alzheimer's research & therapy, 7(1), pp.1-11. Cuffaro, L., Di Lorenzo, F., Bonavita, S., Tedeschi, G., Leocani, L. and Lavorgna, L., 2020. Dementia care and COVID-19 pandemic: a necessary digital revolution. Neurological Sciences, 41(8), pp.1977-1979. 20 Kim, H., Jhoo, J.H. and Jang, J.W., 2017. The effect of telemedicine on cognitive decline in patients with dementia. Journal of telemedicine and telecare, 23(1), pp.149-154. 21 Summary of the main changes : Instructions for final paper submission: • • • • • Highlight any changes you make in your final paper from the initial drafts you turned in for HW4 through HW8 o You may want to do this by keeping on "Track Changes" as you revise o Then, before turning in your final paper, highlight where the changes are and "Accept All Changes" (to minimize clutter) Write up a one-page summary of the main things you changed and why in response to the commentary you have received from me and from your peers Turn in the one-page summary with the final paper Please use 11 pt Arial font, single spacing, and one-inch margins Please turn in your final paper as a Word doc, titled, "HW9_[your name].docx" I attached 4 pdf files with my mentor comments in intro, methods, results and discussion I need you help to edit them all following instructions and comments If you need any info send to me on what's up 966561770888 to make it fast PLEASE Instructions for final paper submission: • • • • • Highlight any changes you make in your final paper from the initial drafts you turned in for HW4 through HW8 o You may want to do this by keeping on "Track Changes" as you revise o Then, before turning in your final paper, highlight where the changes are and "Accept All Changes" (to minimize clutter) Write up a one-page summary of the main things you changed and why in response to the commentary you have received from me and from your peers Turn in the one-page summary with the final paper Please use 11 pt Arial font, single spacing, and one-inch margins Please turn in your final paper as a Word doc, titled, "HW9_[your name].docx" I attached 4 pdf files with my mentor comments in intro, methods, results and discussion I need you help to edit them all following instructions and comments If you need any info send to me on what's up 966561770888 to make it fast PLEASE Analysing the impacts of telemedicine on behavioural changes among dementia patients during covid-19 in the KSA nursing homes Discussion The aim of this research was to analyse the impact of telemedicine on the behavioural changes among the patient of dementia during the pandemic of COVID-19. The aim of the research was to analyse the phenomenon in the nursing home of KSA. Thus, the current section has discussed and critiqued the result by evaluating the significance of the research with the research question. Additionally, this section has analysed potential weakness of the current research along with the association to the prior studies. Commented [s1]: Remove this entirely – you don’t need to explain what the Discussion section is to the reader How research answer the question Commented [s2]: You don’t need these section headings The research question that was developed for the study was to assess the behavioural impact of utilising telemedicine approaches on the patient of dementia during COVID-19. The result of the study demonstrated that the prevalence rate of dementia is comparatively higher in KSA particularly in the aged population and older adult. Thus, thise result of the study Commented [s3]: Remove demonstrated that the the core reason behind increased prevalence of COVID-19 among dementia Also, I don’t think the prevalence rate of dementia is a key results of this study? This didn’t seem like a surveillance study to me patients is due to issues in particularly complexities in remembering to wearing face masks, and that the. Additionally, the finding of this research also demonstrated that the collected data reflects that older populationaged populations increasingly witnessexperience a greater? the behavioural impact from receivingof telemedicine during the COVID-19 pandemic. Watch grammar!!! Also, I don’t think any of this is particularly consistent with what you proposed to do in your Methods section or the results reported in your Results section. You should schedule a time to meet with me ASAP… - Commented [s4]: You’ve used this phrase twice in the beginning of a sentence – it’s a little too repetitious. Read your writing out loud to yourself to identify areas that are awkwardly written or too repetitious. Also, the first three sentences here don’t flow well together in terms of sentence structure (too similar in length) and in terms of logical flow (unclear how sentence two is a reason behind sentence three, i.e. the use of “thus”) Commented [s5]: This is a better candidate for your first sentence for the Discussion section Formatted: List Paragraph, Bulleted + Level: 1 + Aligned at: 0.25" + Indent at: 0.5" Possible weakness in research The potential limitation is that this study does not examine weakness in the current research is that the study could have explored the COVID-19 behavioural impact of the telemedicine intervention on as per different age groups. Is this really a relevant limitation? Does it impact your results or the interpretation of our results? Or the generalizability of your results? You need to explain why this is a limitation that impacts your study, how it impacts your study and the interpretation of the results, and what should be done about it. Additionally, the research could Commented [s6]: You don’t need thiese section headings have involved the individual of middle age as well in order to develop a comparative analysis. Same comment as before. Association of result to prior literature The finding of the current researchThis study demonstrated that that the rate of dementia is growing among the older population at an exponential rate. < not a good topic sentence for this paragraph However, the utilisation of telemedicine greatly lower depressive behaviour and anxiety among the patient of dementia patients during COVID-19. Thise finding of the current research contradicts with the finding of Kim et al. (2017), which depicted found that the telemedicine Commented [s7]: Your Methods section and your Results section do not suggest that this is a surveillance study! Your initial study proposal proposes to look at the impact of telemedicine on behavioural outcomes in dementia patients during the pandemic, using an intervention and control group. results in cognitive decline among dementia patients. You need to discuss possible reasons for such a contradiction. On the other hand, the research of Cuffaro et al. (2017) demonstrated that due to COVID-19 pandemic, most of the clinics has suspended their activities. It’s not clear how this relates to the previous sentence? Consequently, this situation greatly urges to utilisation of telemedicine for remote care and monitoring. Broader implication for field The current study has increasingly assisted in evaluating the problems being faced by dementia patient during COVID-19. Additionally, it also evaluates the impact of telemedicine on dementia patient during COVID-19. Thus, the study finding will assist the nursing homes in Commented [s8]: This sounds increasingly more and more like a descriptive study instead of a randomized controlled trial. Why? evaluating more about the phenomenon and how to handle such patient during the pandemic situation. Lots of grammar issues throughout – please get a grammar checker or schedule a time with the NYU Writing Center. Prospect for future progress The finding of the current research was effective, however, it will be significant to evaluate how telemedicine in particular assists in reducing the developmental risk of developing negative mental health outcomes. Commented [s9]: This doesn’t make sense Commented [s10]: This is confusing because we don’t know what mental health outcomes you have been looking at, and it hasn’t been discussed or mentioned in this section or any of the previous sections. Conclusion The aim of the study was to evaluate the behavioural change impact of telemedicine on the behavioural changes outcomes among the patient of dementia patients during the pandemic of COVID-19 pandemic. For this purpose, the telemedicine was evaluated to analyse the way it can affect the patient of dementia during the COVID-19. The finding of the study demonstrated that the collected data increasingly demonstrated that the dementia is increasingly visible particularly in the older age. These older age population are likely to witness the behavioural effect of telemedicine during the COVID-19. The finding further concludes that the increased prevalence of dementia during COVID-19 was due to the fact that patient face difficulties in remembering mask. However, the overall discussion and the finding depicted that approach of telemedicine increasingly assist in reducing depressive behaviour and anxiety among patient. The current research also offer positive path that comprising control group in nursing home of KSA will assist the patient of dementia in recovering from the anxiety and depression. References Cuffaro, L., Di Lorenzo, F., Bonavita, S., Tedeschi, G., Leocani, L. and Lavorgna, L., 2020. Dementia care and COVID-19 pandemic: a necessary digital revolution. Neurological Sciences, 41(8), pp.1977-1979. Kim, H., Jhoo, J.H. and Jang, J.W., 2017. The effect of telemedicine on cognitive decline in patients with dementia. Journal of telemedicine and telecare, 23(1), pp.149-154. Grade: 5/10 1. Interprets results to answer research question – -1 it is completely unclear what the results are and how they are being interpreted to answer the initial research question that was proposed 2. Considers possible weaknesses -1 not enough discussion about limitations, why they are of concern, how they impact the study and the interpretation of the results, and what can be done about them 3. Relationship of results to prior literature - -0.5 needs more clarity 4. Broader implications of answering research question -0.5 unclear Commented [s11]: Very confusing, not clear what this means Commented [s12]: Again, this isn’t a surveillance study looking at the prevalence of dementia?? Commented [s13]: Unclear what behavioral outcomes you’re looking at? Commented [s14]: This makes it seem like people have dementia because they forgot to wear their mask, which definitely doesn’t make sense 5. 6. 7. 8. Prospects for future progress -0.5 unclear Appropriate text (nothing belonging in other sections) Writing structure (organization) -1 topic sentences need to be improved Mechanics (spelling/grammar) -1.5 needs extensive grammar checking ANALYZING THE IMPACTS OF TELEMEDICINE ON BEHAVIOURAL CHANGES AMONG DEMENTIA PATIENTS DURING COVID-19 PANDEMIC IN THE KINGDOM OF SAUDI ARABIA (KSA) NURSING HOMES [Name of Writer] [Name of Institute] Abstract “Telemedicine: A Ray of hope for dementia patients in the depressing times of COVID-19 pandemic” Introduction: It is now an established fact that the prevalence of dementia increases significantly with the increase in age. Almost 90 percent of patients diagnosed with dementia suffer from various behavioral symptoms of dementia and this becomes vital in the wake of current pandemic. The recently imposed measures of social distancing and self-isolation in the COVID-19 pandemic increase the risk of behavioral and psychological disturbances among the elderly dementia 2 patients in Saudi Arabia. In the face of this problem, telemedicine comes to be a tool to mitigate the negative impacts of the pandemic. Methods: In this study we discussed the impacts of telemedicine in alleviating the stigma of social isolation in dementia patients as well as the reduction of the risk of Covid-19 infection in such patients. We effectively selected a sample size of 100 patients aged above 60 years and after getting informed consent, allocated them randomly into the control or intervention group. Telemedicine care was provided to the intervention group by the doctors, while the participants of both of the groups continued to receive general health care from their attendants. Data collection was done with the help of a questionnaire. Results: The assembled data depicted that the COVID-19 pandemic has had a disproportionately negative impact on people affected by dementia, However, telemedicine can reduce the risk for development of negative outcomes in mental health precipitated by the reduction of social contact and less access to health services, improving the overall management of dementia symptoms. Conclusion: Telemedicine is an effective tool in management of dementia patients therefore, it is humbly suggested that proper guidelines for the usage of this approach should be designed and practiced specially in the unfortunate circumstances if COVID-19 pandemic. Keywords: dementia, social isolation, social distancing, COVID-19, telemedicine, elderly, challenges of the pandemic, psychological symptoms in dementia. 3 4 1.0. Introduction 1.1. Background In the Kingdom of Saudi Arabia (KSA), the prevalence rate of dementia is significantly higher among the aged population from 1.1% and 2.3% of 70-80 years to 13.5% and 18.5% of 90 and older adults. The dementia patients encountered problems such as lack of cognitive thinking skills, disorientation, confusion, lack of proper communication skills, behavioural issues, memory loss etc. (Azarpazhooh et al., 2020). In this regard, Goodman-Casanova et al. (2020) stated that COVID-19 pandemic significantly affected the behaviour of dementia patients. Due to limited access and the inability to understand all the information regarding COVID-19, the pandemic has negatively impacted patients with dementia, either in nursing homes or at home. The increased prevalence of COVID-19 among dementia patients can be attributed to the difficulties in remembering to wear masks, following safeguarding procedures, and measuring self-quarantine, leading to anxiety and depression among patients. However, the telemedicine approach significantly reduced anxiety and depressive behaviour among dementia patients during COVID-19. The telemedicine approach includes those practices used to provide care to the patients at home in cases when the patients and physician are not physically present with each other. In this approach, the patients used to consult with the doctors using video conferencing and other telecommunication methods (Lai et al., 2020). It was observed that COVID-19 has negatively impacted the behaviour of dementia patients either in nursing homes or at their own houses. The reasons behind the prevalence of COVID-19 among dementia patients are the difficulties in remembering the wearing masks following safeguarding procedures, and measures of self-quarantine that developed anxiety and depression among the patients. However, it was observed that the use of the telemedicine approach significantly reduced anxiety and depression among dementia patients during the COVID-19 (Dorman et al., 2020). Despite the sensitivity of the issue, the behavioural impacts of COVID-19 on dementia patients are not studied in KSA nursing homes. This study will correspondingly help in finding out the problems of dementia patients due to COVID-19. Thus, nursing homes will know how to take care of such patients and how to assist the dementia patients so that the behavioural problems can 5 be reduced and there will be increased health-related outcomes for the patients that will impact on improving the quality of life of the patients. 1.2. Aim of the study Based on the above information, the present study is aimed to analyse the telemedicine impacts on behavioural changes among dementia patients during COVID19 in KSA nursing homes. 1.3. Research Question The research question of the present research study was “What are the behavioural impacts of using telemedicine approaches on dementia patients during COVID-19 pandemics in KSA nursing homes”? 1.4. PICOT Question The PICO template was used to explain the question of this research study: P (Population): Dementia patients in COVID-19 situations I (Intervention): Telemedicine practices for the intervention group C (Comparison): Control group who did not receive or use the practices of telemedicine technology. O (Outcomes): Improvement in the behavioural outcomes of dementia patients in COVID-19 situations after using the telemedicine approaches in the intervention group. 6 Methodology The primary purpose of this research is to investigate the impact of telemedicine on dementia patients in Saudi Arabia in the recent Covid-19 pandemic. Since, the pandemic has imposed restrictions on social interaction throughout the communities, therefore, one of the greatest victims have been patients of long-term care, especially in the nursing homes. In this context, the current study examined how dementia patients are being treated in the nursing homes in Saudi Arabia and the impact of telemedicine in their usual treatment. This research involved data related to the randomized clinical trial phase 3 of behavioral changes in dementia patients due to telemedicine. Data collection and analysis Since this study is pertinent to clinical trials of dementia patients in Saudi Arabia during Covid19, therefore, we conduct primary data collection. In Saudi Arabia (KSA), the prevalence rate of dementia is significantly higher among the aged population from 1.1% and 2.3% of 70-80 years to 13.5% and 18.5% of 90 and older adults. In such scenario, the research covered 1000 patients from five primary health care centers. For the analysis, patients were categorized into two groups i.e., the intervention group and the control group, in order to discern difference induced by the telemedicine approach at homes to the dementia patients. Telemedicine is the practice of medicine using technology to deliver care at a distance. A physician in one location uses a telecommunications infrastructure to deliver care to a patient at a distant site. The clinical trials were blinded and the two groups were not informed about their belonging to either arms of the trials. Telemedicine was used to treat the intervention group only, by the researcher with the help of doctor in those care centers. The process of proper usage of telemedicine approach was described and effectively demonstrated to all the participants. Data collection was done through observing the changes of behaviors and impacts of telemedicine on dementia patients. Observations were made once every week, for a period of 4 months, by the duty doctors in nursing care homes, so that affects of both approaches could be observed without fluctuations of data. The duty doctors were duly explained about the observations so that the data collected was standardized to a 7 maximum limit. Five nursing care homes in Saudi Arabia were selected as the site for experiments, in which a sample of 1000 patients was selected as participants. The statistical technique of power analysis was utilized to ascertain the sample size required to observe changes in behaviors and effectiveness of medicinal approach in the participants group. Selection was done through random sampling, which ensured that no biases enter the selection procedure, and every patient have the equal opportunity for selection. This was in line with the assertions of Ritchie et al. (2015), which propounded for mitigation of errors at every step of the trials. For the experimental treatment, standard telemedicine techniques were utilized which involved online connectivity with the patient and their counseling. Appropriate care was taken to conduct the telemedicine and observation of results by making sure that every step and procedure is recorded without delays. With respect to the experiment, significant challenge was faced in obtaining conscious consent of the patients due to the nature of dementia in memory retention. Further, nursing homes in Saudi Arabia are not sufficiently equipped compared to international levels, to ensure undisturbed conduct of experiment. 8 Results considering the topic "ANALYZING THE IMPACTS OF TELEMEDICINE ON BEHAVIOURAL CHANGES AMONG DEMENTIA PATIENTS DURING COVID-19 IN THE KSA NURSING HOMES", we have to develop survey questionnaire in which there will be two variables including " TELEMEDICINE" and " BEHAVIOURAL CHANGES AMONG DEMENTIA PATIENTS DURING COVID-19". The tests which are required to be conducted include frequency analysis,regressions and correlation analysis. 9 3.1. Frequency Analysis In response to the question that telemedicine makes the consultancy easy in this pandemic of Covid-19, 28% of the healthcare providers in KSA strongly agreed to the statement while 34% of them agree. In addition, 24% of them provided neutral response while 14% of them disagreed. In response to the second question that telemedicine helps to save time for patients and doctors, 17% of the healthcare providers strongly agreed while 39% of them agreed. On the other hand, 28% of the healthcare providers responded neutrally and 13% of them disagreed. However, 3% of them strongly disagreed to the statement. 10 In response to the question that telemedicine helps to provide instant consultancy to patients, 15% of the healthcare providers strongly agreed to the statement while 41% of them agreed. Moreover, 29% of the healthcare providers neutrally responded to the statement and 12% of them disagreed. In contrast, 3% of the healthcare providers strongly disagreed. In response to the fourth question that with the help of telemedicine, dementia patients are able to communicate in a better manner with healthcare providers, 9% of the healthcare providers strongly agreed while 41% of them agreed. Moreover, 21% of them neutrally responded to the statement while 24% of them disagreed. In contrast, 5% of the healthcare providers strongly disagreed. 11 The question that telemedicine has been effective for the dementia patients as they are able to connect with healthcare providers while being at their homes was responded strongly agree by 29% of the healthcare providers. In addition, 34% of them agreed to the statement while 14% of them provided neutral response. However, 20% of them disagreed and 3% of them strongly agreed. 12 In response to the question that telemedicine has reduced the risk of Covid-19 among dementia patients, 24% of healthcare providers strongly agreed and 31% agreed. In addition to this, 32% of the healthcare providers responded neutrally to the statement and 13% of them disagreed. 3.2. Correlation Analysis The below table shows the correlation analysis of variables. In this manner, it is evident that there is significant and positive association among telemedicine and behavioural changes among dementia patients during Covid-19. In addition to this, the correlation was determined to be strong as the correlation value was computed to be 0.934. 13 3.3. Regression Analysis The below table shows model summary of the regression analysis on the basis of which, it is evident that R-square for behavioural changes among dementia patients during Covid-19 is 0.872 which shows that variance telemedicine is explaining 87.2% of the variance in behavioural changes among dementia patients during Covid-19. However, this variance is obtained as 87% after the adjustments. The below table shows Anova of the regression model on the basis of which, it is evident that F-statistics is determined to be 665.175 while the sig value is computed to be 0.000. It posits that the overall model is significant as the sig value is computed below the threshold of 0.05. 14 Coefficients of the regression analysis have been determined in the below table. Therefore, it is evident that telemedicine has significant effect over the behavioural changes among dementia patients during Covid-19. It is due to the reason that B= 0.989, p= 0.00< 0.05. It depicts that the change in telemedicine will also cause change in the behavioural changes among dementia patients during Covid-19. 15 Questionnaire Questions S A Telemedicine Telemedicine makes the consultancy easy in this pandemic of Covid-19 Telemedicine helps to save time for patients and doctors. Telemedicine helps to provide instant consultancy to patients. Behavioural changes among Dementia Patients With the help of telemedicine, dementia patients are able to communicate in a better manner with healthcare providers. Telemedicine has been effective for the dementia patients as they are able to connect with healthcare providers while being at their homes. Telemedicine has reduced the risk of Covid-19 among dementia patients. A N D D S 16 Discussion The aim of this research was to analyse the impact of telemedicine on the behavioural changes among the patient of dementia during the pandemic of COVID-19. The aim of the research was to analyse the phenomenon in the nursing home of KSA. Thus, the current section has discussed and critiqued the result by evaluating the significance of the research with the research question. Additionally, this section has analysed potential weakness of the current research along with the association to the prior studies. How research answer the question The research question that was developed for the study was to assess the behavioural impact of utilising telemedicine approaches on the patient of dementia during COVID-19. The result of the study demonstrated that the prevalence rate of dementia is comparatively higher in KSA particularly in the aged population and older adult. Thus, the result of the study demonstrated that the core reason behind increased prevalence of COVID-19 among dementia patient particularly complexities in remembering wearing face mask. Additionally, the finding of this research also demonstrated that the collected data reflects that older population increasingly witness the behavioural impact of telemedicine during the COVID-19. Possible weakness in research The potential weakness in the current research is that the study could have explored the COVID-19 behavioural impact as per different age groups. Additionally, the research could have involved the individual of middle age as well in order to develop a comparative analysis. Association of result to prior literature The finding of the current research demonstrated that that the rate of dementia is growing among older population at exponential rate. However, the utilisation of telemedicine greatly lower depressive behaviour and anxiety among the patient of dementia during COVID19. The finding of the current research contradicts with the finding of Kim et al. (2017) which depicted that the telemedicine result in cognitive decline among dementia patient. On the other 17 hand, the research of Cuffaro et al. (2017) demonstrated that due to COVID-19 pandemic most of the clinic has suspended their activities. Consequently, this situation greatly urges to utilisation of telemedicine for remote care and monitoring. Broader implication for field The current study has increasingly assisted in evaluating the problems being faced by dementia patient during COVID-19. Additionally, it also evaluates the impact of telemedicine on dementia patient during COVID-19. Thus, the study finding will assist the nursing homes in evaluating more about the phenomenon and how to handle such patient during the pandemic situation. Prospect for future progress The finding of the current research was effective, however, it will be significant to evaluate how telemedicine in particular assist in reducing the developmental risk of negative mental health outcome. Conclusion The aim of the study was to evaluate the behavioural change impact of telemedicine on the behavioural changes among the patient of dementia during the pandemic of COVID-19. For this purpose, the telemedicine was evaluated to analyse the way it can affect the patient of dementia during the COVID-19. The finding of the study demonstrated that the collected data increasingly demonstrated that the dementia is increasingly visible particularly in the older age. These older age population are likely to witness the behavioural effect of telemedicine during the COVID-19. The finding further concludes that the increased prevalence of dementia during COVID-19 was due to the fact that patient face difficulties in remembering mask. However, the overall discussion and the finding depicted that approach of telemedicine increasingly assist in reducing depressive behaviour and anxiety among patient. The current 18 research also offer positive path that comprising control group in nursing home of KSA will assist the patient of dementia in recovering from the anxiety and depression. References Azarpazhooh, M.R., Amiri, A., Morovatdar, N., Steinwender, S., Ardani, A.R., Yassi, N., Biller, J., Stranges, S., Belasi, M.T., Neya, S.K. and Khorram, B., 2020. Correlations between COVID-19 and burden of dementia: An ecological study and review of literature. Journal of the Neurological Sciences, 416, p.117013. Dorman, G., Dengra, A.A., Fiorini, A., Failla, B., Vallejos, F., Pontello, N., Roca, M. and Bustin, J., 2020. Experience and results with a telehealth treatment program in patients with cognitive disorders during the COVID?19 pandemic. International Journal of Geriatric Psychiatry. Goodman-Casanova, J.M., Dura-Perez, E., Guzman-Parra, J., Cuesta-Vargas, A. and Mayoral-Cleries, F., 2020. Telehealth home support during COVID-19 confinement for community-dwelling older adults with mild cognitive impairment or mild dementia: survey study. Journal of medical Internet research, 22(5), p.e19434. Lai, F.H.Y., Yan, E.W.H., Yu, K.K.Y., Tsui, W.S., Chan, D.T.H. and Yee, B.K., 2020. The Protective Impact of Telemedicine on Persons With Dementia and Their Caregivers During the COVID-19 Pandemic. The American Journal of Geriatric Psychiatry, 28(11), p.1175. 19 Bajpai, N., 2015. Marketing Research. Pearson Education India. Bloomfield, J. and Fisher, M.J., 2019. Quantitative research design. Journal of the Australasian Rehabilitation Nurses Association, 22(2), p.27. Bryman, A., 2017. Quantitative and qualitative research: further reflections on their integration. In Mixing methods: Qualitative and quantitative research (pp. 57-78). Routledge. Choy, L.T., 2014. The strengths and weaknesses of research methodology: Comparison and complimentary between qualitative and quantitative approaches. IOSR Journal of Humanities and Social Science, 19(4), pp.99-104. Duberley, J., Johnson, P. and Cassell, C., 2012. Philosophies underpinning qualitative research. Qualitative organizational research: Core methods and current challenges, 15. Soiferman, L.K., 2010. Compare and Contrast Inductive and Deductive Research Approaches. Online Submission. Ritchie, C.W., Terrera, G.M. and Quinn, T.J., 2015. Dementia trials and dementia tribulations: methodological and analytical challenges in dementia research. Alzheimer's research & therapy, 7(1), pp.1-11. Cuffaro, L., Di Lorenzo, F., Bonavita, S., Tedeschi, G., Leocani, L. and Lavorgna, L., 2020. Dementia care and COVID-19 pandemic: a necessary digital revolution. Neurological Sciences, 41(8), pp.1977-1979. 20 Kim, H., Jhoo, J.H. and Jang, J.W., 2017. The effect of telemedicine on cognitive decline in patients with dementia. Journal of telemedicine and telecare, 23(1), pp.149-154. 21 Summary of the main changes : Instructions for final paper submission: • • • • • Highlight any changes you make in your final paper from the initial drafts you turned in for HW4 through HW8 o You may want to do this by keeping on "Track Changes" as you revise o Then, before turning in your final paper, highlight where the changes are and "Accept All Changes" (to minimize clutter) Write up a one-page summary of the main things you changed and why in response to the commentary you have received from me and from your peers Turn in the one-page summary with the final paper Please use 11 pt Arial font, single spacing, and one-inch margins Please turn in your final paper as a Word doc, titled, "HW9_[your name].docx" I attached 4 pdf files with my mentor comments in intro, methods...