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远程初级保健咨询在 COVID-19 大流行期间为痴呆症患者提供:痴呆症患者及其护理人员的体验。

Remote primary care consultations for people living with dementia during the COVID-19 pandemic: experiences of people living with dementia and their carers.

机构信息

Research Department of Primary Care and Population Health, University College London, London.

The Policy Institute, King's College London, London.

出版信息

Br J Gen Pract. 2021 Jul 29;71(709):e574-e582. doi: 10.3399/BJGP.2020.1094. Print 2021 Aug.

Abstract

BACKGROUND

COVID-19 has accelerated remote healthcare provision in primary care, with changes potentially permanent. The implementation of remote provision of health care needs to be informed by vulnerable populations, such as people living with dementia.

AIM

To understand the remote healthcare experiences of patients living with dementia and their family carers during the COVID-19 pandemic.

DESIGN AND SETTING

Qualitative interviews with community-based patients living with dementia and their carers were carried out between May-August 2020, while the COVID-19 pandemic was ongoing in England.

METHOD

Semi-structured interviews were conducted remotely by telephone or video call with 30 patients living with dementia and 31 carers. Data were analysed using thematic analysis.

RESULTS

Three main themes were derived relating to: proactive care at the onset of COVID-19 restrictions; avoidance of healthcare settings and services; and difficulties with remote healthcare encounters. People living with dementia and their carers felt check-up calls were reassuring but limited in scope and content. Some avoided healthcare services, wishing to minimise COVID-19 risk or reduce NHS burden, or encountering technological barriers. Difficulties in remote consultations included lack of prompts to remember problems, dealing with new emerging difficulties, rescheduling/missed calls, and inclusion of the voice of the person with dementia.

CONCLUSION

While remote consultations could be effective, proactive calls could be more structured around needs. Consideration should be given to replace non-verbal prompts to describe problems, particularly for new health concerns. In continuing remote consultations, it is important to facilitate engagement with patients living with dementia and their carers to ensure good practice.

摘要

背景

COVID-19 加速了初级保健中的远程医疗服务,这些变化可能是永久性的。远程医疗服务的实施需要考虑到弱势群体,如痴呆症患者。

目的

了解 COVID-19 大流行期间痴呆症患者及其家庭照顾者的远程医疗体验。

设计与设置

2020 年 5 月至 8 月,在 COVID-19 大流行期间,在英格兰,对社区内的痴呆症患者及其照顾者进行了基于社区的定性访谈。

方法

通过电话或视频通话对 30 名痴呆症患者和 31 名照顾者进行了半结构化访谈。使用主题分析对数据进行分析。

结果

得出了三个与以下内容相关的主要主题:在 COVID-19 限制开始时主动护理;避免医疗保健场所和服务;以及远程医疗服务困难。痴呆症患者及其照顾者感到电话随访令人安心,但范围和内容有限。一些人避免使用医疗服务,希望尽量减少 COVID-19 风险或减轻 NHS 负担,或遇到技术障碍。远程咨询的困难包括缺乏提示以记住问题、处理新出现的困难、重新安排/错过电话以及包括痴呆症患者的声音。

结论

虽然远程咨询可能有效,但主动电话可以围绕需求进行更结构化的安排。应考虑用非语言提示来描述问题,特别是对于新的健康问题。在继续进行远程咨询时,必须为痴呆症患者及其照顾者提供便利,以确保良好的实践。

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