University of Montpellier.
KEDGE Business
Int J Technol Assess Health Care. 2017 Jan;33(2):147-154. doi: 10.1017/S0266462317000319. Epub 2017 May 30.
The evaluation of telemedicine from the patient's point of view has focused on the patient pathway and patient satisfaction. However, research in this field does not provide us with the means to assess a patient's perception of the procedure if their reasoning ability is impaired. In this study, we use direct observation of a patient's behavior and mood to assess their perception of an oral teleconsultation procedure.
This study has been conducted in the context of a pilot project using an asynchronous teleconsultation to improve access to dental care for the dependent elderly, disabled people, and prisoners, some of whom may be cognitively impaired. We use a direct observation form consisting of five behavioral variables and eight affect variables to reflect the patient's experience of the oral teleconsultation procedure.
A total of 135 patients were evaluated; 10 refused the procedure. Psychotic patients (n = 33) had a somewhat negative experience during the oral teleconsultation procedure. Patients who were not psychotic had a positive experience; this decreased as we moved from the autonomous to the semi-autonomous and then to the dependent sub-group. Some gender differences were also noted.
Improving evidence on evaluating the acceptance of the cognitively impaired is required to improve the technology development process so that it can be translated into an improved patient experience and adherence. Although the study was specifically focused on teledentistry, the approach described in this study could be adapted to other forms of teleconsultation.
从患者角度评估远程医疗，主要集中在患者路径和患者满意度上。然而，该领域的研究并没有为我们提供一种评估患者对程序认知能力受损的方法。在这项研究中，我们通过直接观察患者的行为和情绪来评估他们对口腔远程咨询程序的感知。
该研究是在一个使用异步远程咨询来改善依赖型老年人、残疾人和囚犯的牙科护理获取的试点项目背景下进行的，其中一些人可能存在认知障碍。我们使用直接观察表，其中包含五个行为变量和八个情感变量，以反映患者对口腔远程咨询程序的体验。
共评估了 135 名患者，其中 10 名拒绝了该程序。精神病患者（n=33）在口腔远程咨询过程中有一定的负面体验。非精神病患者的体验是积极的，但随着从自主组到半自主组再到依赖组，这种体验逐渐减少。还注意到了一些性别差异。
需要提高评估认知障碍患者接受程度的证据，以改进技术开发过程，从而改善患者体验和依从性。虽然该研究专门针对远程牙科，但本研究中描述的方法可以适应其他形式的远程咨询。
