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远程医疗随访促进更全面的糖尿病足溃疡护理:基于家庭和专科医疗的定性研究。

Telemedicine follow-up facilitates more comprehensive diabetes foot ulcer care: A qualitative study in home-based and specialist health care.

机构信息

Faculty of Health and Social Science, Centre for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway.

School of Nursing, University of British Columbia, Vancouver, BC, Canada.

出版信息

J Clin Nurs. 2018 Mar;27(5-6):e1134-e1145. doi: 10.1111/jocn.14193. Epub 2018 Jan 30.

Abstract

AIMS AND OBJECTIVES

To investigate the application of a telemedicine intervention in diabetes foot ulcer care, and its implications for the healthcare professionals in the clinical field.

BACKGROUND

Contextual factors are found to be important when applying technology in health care and applying telemedicine in home-based care has been identified as particularly complex.

DESIGN AND METHODS

We conducted field observations and individual interviews among healthcare professionals in home-based care and specialist health care in a diabetes foot care telemedicine RCT (Clin.Trial.gov: NCT01710774) during 2016. This study was guided by Interpretive Description, an inductive qualitative methodology.

RESULTS

Overall, we identified unequal possibilities for applying telemedicine in diabetes foot ulcer care within the hospital and home care contexts. Different circumstances and possibilities in home-based care made the application of telemedicine as intended more difficult. The healthcare professionals in both care contexts perceived the application of telemedicine to facilitate a more comprehensive approach towards the patients, but with different possibilities to enact it.

CONCLUSIONS

Application of telemedicine in home-based care was more challenging than in the outpatient clinic setting. Introducing more updated equipment and minor structural adjustments in consultation time and resources could make the use of telemedicine in home-based care more robust.

RELEVANCE TO CLINICAL PRACTICE

Application of telemedicine in diabetes foot ulcer follow-up may enhance the nursing staff's ability to conduct comprehensive assessment and care of the foot ulcer as well as the patient's total situation. Access to adequate equipment and time, particularly in home-based care, is necessary to capitalise on this new technology.

摘要

目的和目标

调查远程医疗干预在糖尿病足溃疡护理中的应用,及其对临床医护人员的影响。

背景

在医疗保健中应用技术时,发现情境因素很重要,而在家中应用远程医疗被认为特别复杂。

设计和方法

我们在 2016 年对参与糖尿病足护理远程医疗 RCT(Clin.Trial.gov:NCT01710774)的家庭护理和专科保健医护人员进行了实地观察和个人访谈。本研究以解释性描述为指导,这是一种归纳性定性方法。

结果

总体而言,我们发现医院和家庭护理环境中应用远程医疗治疗糖尿病足溃疡的可能性不平等。家庭护理中不同的情况和可能性使远程医疗的应用变得更加困难。两种护理环境中的医护人员都认为远程医疗的应用有助于更全面地治疗患者,但实施的可能性不同。

结论

远程医疗在家庭护理中的应用比在门诊环境中更具挑战性。引入更现代化的设备,并在咨询时间和资源方面进行微小的结构性调整,可以使远程医疗在家庭护理中的应用更加稳健。

临床实践的相关性

远程医疗在糖尿病足溃疡随访中的应用可以提高护理人员全面评估和护理足溃疡以及患者整体情况的能力。为了充分利用这项新技术,需要有足够的设备和时间,尤其是在家庭护理中。

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