“这不是亲身实践的治疗,所以非常有限”:冠状病毒大流行期间,联合健康临床医生对远程医疗的使用和看法。
'It's not hands-on therapy, so it's very limited': Telehealth use and views among allied health clinicians during the coronavirus pandemic.
机构信息
Physiotherapy Department, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Australia.
Centre for Health, Exercise, and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Australia; Centre for Digital Transformation of Health, Melbourne Medical School, The University of Melbourne, Australia.
出版信息
Musculoskelet Sci Pract. 2021 Apr;52:102340. doi: 10.1016/j.msksp.2021.102340. Epub 2021 Feb 5.
BACKGROUND
Telehealth services have helped enable continuity of care during the coronavirus pandemic. We aimed to investigate use and views towards telehealth among allied health clinicians treating people with musculoskeletal conditions during the pandemic.
METHODS
Cross-sectional international survey of allied health clinicians who used telehealth to manage musculoskeletal conditions during the coronavirus pandemic. Questions covered demographics, clinician-related factors (e.g. profession, clinical experience and setting), telehealth use (e.g. proportion of caseload, treatments used), attitudes towards telehealth (Likert scale), and perceived barriers and enablers (open questions). Data were presented descriptively, and an inductive thematic content analysis approach was used for qualitative data, based on the Capability-Opportunity-Motivation Behavioural Model.
RESULTS
827 clinicians participated, mostly physiotherapists (82%) working in Australia (70%). Most (71%, 587/827) reported reduced revenue (mean (SD) 62% (24.7%)) since the pandemic commenced. Median proportion of people seen via telehealth increased from 0% pre (IQR 0 to 1) to 60% during the pandemic (IQR 10 to 100). Most clinicians reported managing common musculoskeletal conditions via telehealth. Less than half (42%) of clinicians surveyed believed telehealth was as effective as face-to-face care. A quarter or less believed patients value telehealth to the same extent (25%), or that they have sufficient telehealth training (21%). Lack of physical contact when working through telehealth was perceived to hamper accurate and effective diagnosis and management.
CONCLUSION
Although telehealth was adopted by allied health clinicians during the coronavirus pandemic, we identified barriers that may limit continued telehealth use among allied health clinicians beyond the current pandemic.
背景
远程医疗服务有助于在冠状病毒大流行期间实现医疗服务的连续性。我们旨在调查在大流行期间治疗肌肉骨骼疾病患者的治疗师对远程医疗的使用情况和看法。
方法
对在冠状病毒大流行期间使用远程医疗管理肌肉骨骼疾病的治疗师进行了一项国际性的横断面调查。问题涵盖了人口统计学、临床医生相关因素(例如,专业、临床经验和环境)、远程医疗的使用情况(例如,患者比例、使用的治疗方法)、对远程医疗的态度(李克特量表),以及感知到的障碍和促进因素(开放问题)。数据以描述性方式呈现,并根据能力-机会-动机-行为模型,对定性数据采用了归纳主题内容分析方法。
结果
共有 827 名治疗师参与了研究,其中大多数(82%)是在澳大利亚工作的物理治疗师。自大流行开始以来,大多数治疗师(71%,587/827)报告收入减少(平均(SD)为 62%(24.7%))。通过远程医疗治疗的患者比例中位数从大流行前的 0%(IQR 0 到 1)增加到 60%(IQR 10 到 100)。大多数治疗师报告通过远程医疗管理常见的肌肉骨骼疾病。不到一半(42%)的调查治疗师认为远程医疗与面对面护理一样有效。不到四分之一(25%)或更少的人认为患者同样重视远程医疗,或者他们有足够的远程医疗培训(21%)。通过远程医疗工作时缺乏身体接触被认为会阻碍准确和有效的诊断和管理。
结论
尽管在冠状病毒大流行期间,治疗师采用了远程医疗,但我们发现了一些障碍,这些障碍可能会限制治疗师在大流行后继续使用远程医疗。