Calton Brook, Shibley William Patrick, Cohen Eve, Pantilat Steven Z, Rabow Michael W, O'Riordan David L, Bischoff Kara E
Division of Palliative Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
School of Medicine, University of California, San Francisco, San Francisco, California, USA.
Palliat Med Rep. 2020 Dec 28;1(1):339-346. doi: 10.1089/pmr.2020.0075. eCollection 2020.
Telemedicine visits reduce the physical and financial burdens associated with in-person appointments, especially for patients with serious illness. Little is known about patient and caregiver preferences regarding telemedicine visit timing and the discussion of sensitive topics by telemedicine. To characterize the experience of patients with serious illness and their caregivers receiving palliative care (PC) by telemedicine. Mixed-methods telephone survey. Patients and family caregivers who had at least one telemedicine visit with the outpatient PC team at our urban academic medical center. A total of 35 patients and 15 caregivers were surveyed. Patient mean age was 61 years, 49% had cancer, and 86% were Caucasian. Caregiver mean age was 62 years. Mean satisfaction with PC telemedicine visits was 8.9 out of 10 for patients; 8.8 for caregivers. Patients (97%) and caregivers (100%) felt comfortable discussing sensitive topics over video. Participants felt telemedicine was an acceptable format to discuss most sensitive topics but 53% of caregivers preferred to receive bad news in person. Participants valued the convenience of telemedicine; they had concerns about rapport building and desired a more user-friendly telemedicine platform. Patients with serious illness and their caregivers rated telemedicine visits highly and felt comfortable discussing sensitive topics by video. Concerns included rapport building and telemedicine platform setup and quality. The rapid growth of telemedicine during coronavirus disease 2019 creates an imperative for research to understand the impact on the quality of care and mitigate any negative effects of telemedicine within a diverse population of patients.
远程医疗问诊减轻了与亲自就诊相关的身体和经济负担，尤其是对重症患者而言。关于患者和护理人员对远程医疗问诊时间安排以及通过远程医疗讨论敏感话题的偏好，我们所知甚少。本研究旨在描述重症患者及其护理人员通过远程医疗接受姑息治疗（PC）的体验。采用混合方法进行电话调查。调查对象为在我们城市学术医疗中心的门诊姑息治疗团队至少进行过一次远程医疗问诊的患者和家庭护理人员。共对35名患者和15名护理人员进行了调查。患者的平均年龄为61岁，49%患有癌症，86%为白种人。护理人员的平均年龄为62岁。患者对姑息治疗远程医疗问诊的平均满意度为8.9分（满分10分）；护理人员为8.8分。患者（97%）和护理人员（100%）觉得通过视频讨论敏感话题很自在。参与者认为远程医疗是讨论大多数敏感话题的可接受形式，但53%的护理人员更倾向于亲自接收坏消息。参与者重视远程医疗的便利性；他们担心建立融洽关系的问题，并希望有一个更用户友好的远程医疗平台。重症患者及其护理人员对远程医疗问诊评价很高，并且觉得通过视频讨论敏感话题很自在。担忧包括建立融洽关系以及远程医疗平台的设置和质量。2019年冠状病毒病期间远程医疗的迅速发展使得开展研究以了解其对医疗质量的影响并减轻远程医疗在不同患者群体中的任何负面影响变得势在必行。
