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澳大利亚农村/地区以远程医疗加强妊娠糖尿病管理:女性、临床医生和 IT 员工的观点。

Women, clinician and IT staff perspectives on telehealth for enhanced gestational diabetes mellitus management in an Australian rural/regional setting.

机构信息

John Richards Centre for Rural Ageing Research, La Trobe University, Wodonga, Victoria, Australia

Rural Department of Nursing & Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia

出版信息

Rural Remote Health. 2021 Jan;21(1):5983. doi: 10.22605/RRH5983. Epub 2021 Jan 22.

Abstract

INTRODUCTION

Women in rural and regional areas encounter challenges when accessing care for gestational diabetes mellitus (GDM). A telehealth initiative for GDM care in an urban setting demonstrated positive effects on achieving glycaemic targets without compromising quality of care, but consumer and health service staff perspectives have not been explored. This research aimed to identify the profiles of women accessing care for GDM in a large regional hospital with a rural catchment in Victoria, Australia as well as gain insight into the views of the women with GDM, clinicians and IT staff on the acceptability and feasibility of a GDM telehealth in this setting.

METHODS

Clinical and demographic characteristics of women accessing the GDM service between October 2016 and October 2017 were audited. Semi-structured interviews were completed with nine patients, three clinical staff and two IT service staff. Quantitative and qualitative data were analysed descriptively and thematically, respectively.

RESULTS

Telehealth was viewed favourably by women and staff, with many perceived benefits identified around mitigating challenges of accessing care, and service capacity and provision. Concerns were raised around potential costs incurred by women and health services in accessing telehealth initiatives. Staff highlighted that moderation of workloads and coordination of telehealth services would be essential to the success of a future telehealth initiative.

CONCLUSION

This article contributes important knowledge around GDM care in rural and regional settings and the perspectives of women with GDM, clinicians and technical support staff. Women and health services staff consider telehealth a feasible and acceptable alternative to current GDM care and address many of the barriers and impacts of attending care in person. Perceived benefits to patients and health services need to be balanced against the concerns around the work and costs to deliver GDM telehealth services.

摘要

简介

农村和偏远地区的女性在获得妊娠糖尿病(GDM)护理时会遇到挑战。在城市环境中开展的 GDM 护理远程医疗计划证明,在不影响护理质量的情况下,实现血糖目标具有积极影响,但尚未探讨消费者和卫生服务人员的观点。本研究旨在确定在澳大利亚维多利亚州一个具有农村服务范围的大型地区医院中接受 GDM 护理的女性的特征,并深入了解 GDM 患者、临床医生和 IT 工作人员对该地区 GDM 远程医疗的可接受性和可行性的看法。

方法

对 2016 年 10 月至 2017 年 10 月期间接受 GDM 服务的女性的临床和人口统计学特征进行了审核。对 9 名患者、3 名临床工作人员和 2 名 IT 服务人员进行了半结构式访谈。对定量和定性数据分别进行了描述性和主题分析。

结果

远程医疗受到了女性和工作人员的好评,许多人认为可以缓解获得护理的挑战,提高服务能力和服务提供。有人担心女性和卫生服务机构在使用远程医疗服务时会产生潜在费用。工作人员强调,要使未来的远程医疗计划取得成功,必须适度减轻工作量和协调远程医疗服务。

结论

本文为农村和偏远地区的 GDM 护理以及 GDM 患者、临床医生和技术支持人员的观点提供了重要知识。女性和卫生服务机构工作人员认为远程医疗是当前 GDM 护理的一种可行且可接受的替代方案,可以解决许多亲自就诊的障碍和影响。需要权衡患者和卫生服务机构的预期利益与提供 GDM 远程医疗服务的工作和成本问题。

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