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新冠疫情期间的远程医疗:酒精和其他药物护士的观点。

Telehealth during COVID-19: The perspective of alcohol and other drug nurses.

机构信息

Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Burwood, Vic.,, Australia.

出版信息

J Adv Nurs. 2021 Sep;77(9):3829-3841. doi: 10.1111/jan.14939. Epub 2021 Jun 16.

Abstract

AIM

This study aimed to explore the experiences of alcohol and other drug nurses transitioning to telehealth due to the COVID-19 pandemic.

BACKGROUND

COVID-19 has caused immense disruption to healthcare services, and to reduce viral transmission, many services moved to off-site care delivery modalities such as telehealth.

DESIGN

We used a qualitative descriptive design for this study.

METHODS

Secondary analysis of semistructured interviews with alcohol and other drug nurses from Australia and New Zealand (n = 19) was conducted in July and August 2020. Data were analysed using thematic analysis and reported using COREQ guidelines.

RESULTS

Three were identified: '"All our face-to-face contact ceased with clients": Changing service delivery', '"How do I do my job when I can't see you?": An anxious shift in service delivery' and '"A lot of Indigenous people don't like the FaceTiming and all that": Challenges to delivery of services through telehealth'.

CONCLUSION

Participants in our study reported challenges in transitioning to telehealth modalities. The perceived loss of therapeutic communication, difficulties in assessing risks to healthcare consumers such as domestic violence and challenges delivering telehealth care to a marginalized consumer cohort need to be overcome before telehealth is considered successful in alcohol and other drug treatment. However, telehealth was a successful adjunct to existing practices for nurses working with consumers in regional or remote areas or where consumers preferred this method of service delivery.

IMPACT

Nurses in this study described substantial issues with the delivery of alcohol and other drug treatment via telehealth, including a perception that telehealth was a barrier to addressing risks to consumers who use alcohol and other drugs, and difficulties working in a therapeutically beneficial way via telehealth. Telehealth is a means to reduce viral transmission through a reduction in face-to-face contact, and although it may be useful for some service functions, it may be detrimental to the clinical services nurses provide.

摘要

目的

本研究旨在探讨因 COVID-19 大流行而转向远程医疗的酒精和其他药物护士的经验。

背景

COVID-19 对医疗服务造成了巨大的干扰,为了减少病毒传播,许多服务转向远程医疗等场外护理提供模式。

设计

本研究采用定性描述设计。

方法

2020 年 7 月至 8 月,对来自澳大利亚和新西兰的酒精和其他药物护士(n=19)进行了半结构化访谈的二次分析。使用主题分析对数据进行分析,并按照 COREQ 指南进行报告。

结果

确定了三个主题:“我们与客户的所有面对面接触都停止了”:改变服务提供方式、“当我看不到你时,我怎么能完成我的工作?”:服务提供方式的焦虑转变以及“很多原住民不喜欢视频通话和所有这些”:通过远程医疗提供服务的挑战。

结论

本研究的参与者报告了在转向远程医疗模式方面的挑战。在评估医疗消费者(如家庭暴力)风险以及向边缘化消费者群体提供远程医疗护理方面的困难方面,需要克服远程医疗在酒精和其他药物治疗中被认为成功之前,远程医疗是一种成功的辅助手段。然而,对于在区域或偏远地区或消费者更喜欢这种服务提供方式的情况下工作的护士来说,远程医疗是现有实践的有效补充。

影响

本研究中的护士描述了通过远程医疗提供酒精和其他药物治疗的重大问题,包括远程医疗被认为是解决使用酒精和其他药物的消费者风险的障碍的看法,以及通过远程医疗以治疗性有益的方式工作的困难。远程医疗是通过减少面对面接触来减少病毒传播的一种手段,尽管它可能对某些服务功能有用,但它可能对护士提供的临床服务有害。

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