骨科康复环境中虚拟会诊的应用：作为患者的体验变化如何影响患者偏好？一项系统综述与定性综合分析。
Use of virtual consultations in an orthopaedic rehabilitation setting: how do changes in the work of being a patient influence patient preferences? A systematic review and qualitative synthesis.
作者信息
Gilbert Anthony W, Jones Jeremy, Jaggi Anju, May Carl R
机构信息
Therapies Department, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
School of Health Sciences, University of Southampton, Southampton, UK.
出版信息
BMJ Open. 2020 Sep 16;10(9):e036197. doi: 10.1136/bmjopen-2019-036197.
OBJECTIVES
To systematically review qualitative studies reporting the use of virtual consultations within an orthopaedic rehabilitation setting and to understand how its use changes the work required of patients.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement, we conducted a systematic review of papers to answer the research question 'How do changes in the work of being a patient when using communication technology influence patient preferences?' Electronic databases were searched for studies meeting the inclusion criteria in April 2020.
RESULTS
The search strategy identified 2057 research articles from the database search. A review of titles and abstracts using the inclusion criteria yielded 21 articles for full-text review. Nine studies were included in the final analysis. Six studies explored real-time video conferencing and three explored telephone consultations. The use of communication technology changes the work required of patients. Such changes will impact on expectations for care, resources required of patients, the environment of receiving care and patient-clinician interactions. This adjustment of the work required of patients who access orthopaedic rehabilitation using communication technology will impact on their experience of receiving care. It is proposed that changes in the work of being a patient will influence preferences for or against the use of communication technology consultations for orthopaedic rehabilitation.
CONCLUSION
We found that the use of communication technology changes the work of being a patient. The change in work required of patients can be both burdensome (it makes it harder for patients to access their care) and beneficial (it makes it easier for patients to access their care). This change will likely to influence preferences. Keeping the concept of patient work at the heart of pathway redesign is likely to be a key consideration to ensure successful implementation.
PROSPERO REGISTRATION NUMBER
CRD42018100896.
目的
系统综述定性研究，这些研究报告了骨科康复环境中虚拟会诊的使用情况，并了解其使用如何改变患者所需的工作。
方法
遵循系统评价和Meta分析的首选报告项目声明，我们对论文进行了系统综述，以回答研究问题“使用通信技术时患者工作的变化如何影响患者偏好？” 于2020年4月在电子数据库中搜索符合纳入标准的研究。
结果
搜索策略从数据库搜索中识别出2057篇研究文章。使用纳入标准对标题和摘要进行审查后，产生了21篇文章进行全文审查。最终分析纳入了9项研究。6项研究探讨了实时视频会议，3项研究探讨了电话会诊。通信技术的使用改变了患者所需的工作。这种变化将影响对护理的期望、患者所需的资源、接受护理的环境以及患者与临床医生的互动。对于使用通信技术进行骨科康复的患者而言，其所需工作的这种调整将影响他们接受护理的体验。有人提出，患者工作的变化将影响对使用通信技术进行骨科康复会诊的支持或反对偏好。
结论
我们发现通信技术的使用改变了患者的工作。患者所需工作的变化既可能带来负担（使患者更难获得护理），也可能带来益处（使患者更容易获得护理）。这种变化可能会影响偏好。将患者工作的概念作为路径重新设计的核心，可能是确保成功实施的关键考虑因素。
PROSPERO注册号：CRD42018100896。
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