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远程医疗患者信息手册(TILs)的定性研究:我们提供给患者的信息足够吗?

A qualitative study of Telehealth patient information leaflets (TILs): are we giving patients enough information?

作者信息

Kayyali Reem, Hesso Iman, Ejiko Evelyn, Nabhani Gebara Shereen

机构信息

School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Penrhyn Road, KT1 2EE, Kingston upon Thames, UK.

出版信息

BMC Health Serv Res. 2017 May 19;17(1):362. doi: 10.1186/s12913-017-2257-5.

Abstract

BACKGROUND

The provision of patient information leaflets regarding telehealth has been perceived by potential consumers as a strategy to promote awareness and adoption of telehealth services. However, such leaflets need to be designed carefully if adoption and awareness among potential users is to be promoted. Therefore, the aims of this study were: first, to see how telehealth was portrayed in some of the existing telehealth leaflets (THLs). Second, to explore patients' perceptions of the existing THLs and their engagement with the concept and how THLs can be optimised.

METHODS

A two-step approach was employed to address the aims of this study. The first phase involved the use of discourse analysis to compare 12 electronically and publically available THLs, with the existing THL guidance "Involve Yorkshire and Humber". The second phase involved conducting 14 semi-structured interviews with potential telehealth users/patients to gauge their perception and engagement with the concept, using the two leaflets that were mostly matching with the guidance used. Six interviews were audio-recorded and eight had detailed jotted notes. The interviews were transcribed and thematically analysed to identify key themes.

RESULTS

The discourse analysis showed certain gaps and variations within the screened leaflets when addressing the following aspects: cost of the telehealth service, confidentiality, patients' choices in addition to equipment use and technical support. Analysis of the interviews revealed patients' need for having clear and sufficient information about the telehealth service within the THLs; in addition to, patients' preference for the use of simpler terminologies for telehealth description and the provision of clear simple texts with pictorial presentations. The interviews also revealed certain limitations against adoption of telehealth by the participants, such as: lack of privacy and confidentiality of information, fear of technology breakdown and equipment failure, loss of face-to-face contact with healthcare professionals and being too dependent on the telehealth service.

CONCLUSION

The current study showed a great variation among the screened THLs and highlighted certain gaps within the content and presentation of these leaflets. However, the study also highlighted certain key issues to be considered when designing THLs in the future to enhance telehealth uptake and use by patients.

摘要

背景

潜在消费者认为提供有关远程医疗的患者信息手册是提高对远程医疗服务的认识和采用率的一种策略。然而,如果要提高潜在用户的采用率和认知度,此类手册需要精心设计。因此,本研究的目的是:第一,了解在一些现有的远程医疗手册(THL)中远程医疗是如何被描述的。第二,探讨患者对现有THL的看法以及他们对这一概念的参与度,以及如何优化THL。

方法

采用两步法来实现本研究的目的。第一阶段涉及使用话语分析来比较12份电子和公开可用的THL与现有的THL指南《让约克郡和亨伯地区参与进来》。第二阶段涉及对14名潜在的远程医疗用户/患者进行半结构化访谈,以评估他们对这一概念的看法和参与度,使用的是两份与所采用的指南最匹配的手册。6次访谈进行了录音,8次有详细的笔记。对访谈进行转录并进行主题分析以确定关键主题。

结果

话语分析表明,在所筛选的手册中,在以下方面存在一定差距和差异:远程医疗服务的成本、保密性、患者除设备使用和技术支持之外的选择。访谈分析显示,患者需要在THL中获得有关远程医疗服务的清晰且充分的信息;此外,患者更喜欢使用更简单的术语来描述远程医疗,并提供带有图片展示的清晰简单文本。访谈还揭示了参与者采用远程医疗的某些限制因素,例如:信息缺乏隐私和保密性、担心技术故障和设备故障、失去与医疗专业人员的面对面接触以及过度依赖远程医疗服务。

结论

当前研究表明在所筛选的THL之间存在很大差异,并突出了这些手册在内容和呈现方面的某些差距。然而,该研究还强调了未来设计THL时需要考虑的某些关键问题,以提高患者对远程医疗的接受度和使用率。

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