Northern Illinois University, Wirtz Hall Room 227, Dekalb, IL, USA.
Dean College of Health and Human Sciences, Northern Illinois University, Dekalb, IL, USA.
Adv Health Sci Educ Theory Pract. 2017 Oct;22(4):869-888. doi: 10.1007/s10459-016-9717-2. Epub 2016 Oct 1.
Literature on telehealth care delivery often addresses clinical, cost, technological, system, and organizational impacts. Less is known about interpersonal behaviors such as communication patterns and therapeutic relationship-building, which may have workforce development considerations. The purpose of this study was to conduct a systematic literature review to identify interpersonal health care provider (HCP) behaviors and attributes related to provider-patient interaction during care in telehealth delivery. Electronic searches were conducted using five indexes/databases: CINAHL, ERIC, PsychInfo, ProQuest Dissertations, PubMed; with hand-searching of the immediate past 10 years of five journals. Search concepts included: communication, telehealth, education, and health care delivery. Of 5261 unique article abstracts initially identified, 338 full-text articles remained after exclusion criteria were applied and these were reviewed for eligibility. Finally, data were extracted from 45 articles. Through qualitative synthesis of the 45 articles, we noted that papers encompassed many disciplines and targeted care to people in many settings including: home care, primary and specialist care, mental health/counseling, and multi-site teams. Interpersonal behaviors were observed though not manipulated through study designs. Six themes were identified: HCP-based support for telehealth delivery; provider-patient interactions during the telehealth event; environmental attributes; and guidelines for education interventions or evaluation of HCP behaviors. Although unable to identify current best practices, important considerations for practice and education did emerge. These include: perceptions of the utility of telehealth; differences in communication patterns such as pace and type of discourse, reliance on visual cues by both provider and patient especially in communicating empathy and building rapport; and confidentiality and privacy in telehealth care delivery.
文献中经常提到远程医疗服务的临床、成本、技术、系统和组织影响。对于沟通模式和治疗关系建立等人际行为的了解较少，而这些行为可能与劳动力发展有关。本研究的目的是进行系统文献综述，以确定与远程医疗服务中护理期间医患互动相关的人际医疗保健提供者（HCP）行为和特征。使用五个索引/数据库（CINAHL、ERIC、PsychInfo、ProQuest Dissertations、PubMed）进行电子搜索，并对过去 10 年的五本期刊进行手动搜索。搜索概念包括：沟通、远程医疗、教育和医疗保健提供。在最初确定的 5261 个独特文章摘要中，经过排除标准后，仍有 338 篇全文文章符合入选标准并进行了资格审查。最终，从 45 篇文章中提取数据。通过对 45 篇文章的定性综合分析，我们注意到这些论文涵盖了许多学科，并针对许多环境中的人群提供护理，包括：家庭护理、初级和专科护理、心理健康/咨询以及多站点团队。通过研究设计观察到人际行为，但未进行干预。确定了六个主题：支持远程医疗服务的 HCP；远程医疗事件期间的医患互动；环境属性；以及针对 HCP 行为的教育干预或评估指南。虽然无法确定当前的最佳实践，但确实出现了一些重要的实践和教育考虑因素。这些因素包括：对远程医疗的实用性的看法；沟通模式的差异，例如速度和话语类型，提供者和患者都依赖视觉提示，特别是在传达同理心和建立融洽关系方面；以及远程医疗护理中的保密性和隐私性。
