Kolltveit Beate-Christin Hope, Gjengedal Eva, Graue Marit, Iversen Marjolein M, Thorne Sally, Kirkevold Marit
Faculty of Health and Social Science, Centre for Evidence-Based Practice, Bergen University College, Bergen, Norway.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
BMC Health Serv Res. 2016 Apr 18;16:134. doi: 10.1186/s12913-016-1377-7.
Introducing new technology in health care is inevitably a challenge. More knowledge is needed to better plan future telemedicine interventions. Our aim was therefore to explore health care professionals' experience in the initial phase of introducing telemedicine technology in caring for people with diabetic foot ulcers.
Our methodological strategy was Interpretive Description. Data were collected between 2014 and 2015 using focus groups (n = 10). Participants from home-based care, primary care and outpatient hospital clinics were recruited from the intervention arm of an ongoing cluster randomized controlled trial (RCT) (Clinicaltrials.gov: NCT01710774). Most were nurses (n = 29), but the sample also included one nurse assistant, podiatrists (n = 2) and physicians (n = 2).
The participants reported experiencing meaningful changes to their practice arising from telemedicine, especially associated with increased wound assessment knowledge and skills and improved documentation quality. They also experienced more streamlined communication between primary health care and specialist health care. Despite obstacles associated with finding the documentation process time consuming, the participants' attitudes to telemedicine were overwhelmingly positive and their general enthusiasm for the innovation was high.
Our findings indicate that using a telemedicine intervention enabled the participating health care professionals to approach their patients with diabetic foot ulcer with more knowledge, better wound assessment skills and heightened confidence. Furthermore, it streamlined the communication between health care levels and helped seeing the patients in a more holistic way.
在医疗保健领域引入新技术必然是一项挑战。需要更多知识来更好地规划未来的远程医疗干预措施。因此,我们的目的是探讨医疗保健专业人员在为糖尿病足溃疡患者提供护理时引入远程医疗技术初始阶段的经验。
我们的方法策略是诠释性描述。2014年至2015年期间,通过焦点小组(n = 10)收集数据。来自居家护理、初级护理和门诊医院诊所的参与者是从一项正在进行的整群随机对照试验(RCT)(Clinicaltrials.gov:NCT01710774)的干预组中招募的。大多数是护士(n = 29),但样本中也包括一名护士助理、足病医生(n = 2)和医生(n = 2)。
参与者报告称,远程医疗给他们的实践带来了有意义的变化,特别是与伤口评估知识和技能的提高以及文档质量的改善有关。他们还体验到初级卫生保健和专科卫生保健之间的沟通更加顺畅。尽管发现文档处理过程耗时存在障碍,但参与者对远程医疗的态度总体上是积极的,他们对这项创新的热情很高。
我们的研究结果表明,使用远程医疗干预使参与的医疗保健专业人员能够以更多的知识、更好的伤口评估技能和更高的信心来治疗糖尿病足溃疡患者。此外,它简化了不同医疗保健层面之间的沟通,并有助于以更全面的方式看待患者。