School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.
Department of General Practice, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia.
BMJ Open. 2021 Aug 6;11(8):e049095. doi: 10.1136/bmjopen-2021-049095.
This study sought to explore the experiences of Australian primary healthcare (PHC) nurses in the use of telehealth during COVID-19. Telehealth was defined as the use of any telecommunications mode (eg, telephone and videoconferencing) to deliver healthcare.
Thematic analysis of qualitative interviews undertaken in Australian PHC.
Twenty-five PHC nurses who had participated in a national survey about their experiences during COVID-19 were recruited using purposive sampling.
Semistructured telephone interviews were conducted from June to August 2020. Interviews lasted a mean of 38.5 min. They were audio-recorded and transcribed before thematic analysis was undertaken. The consolidated criteria for reporting qualitative research were followed.
Four overarching themes were identified: preparedness, accessibility of telehealth, care experience and impacts on the PHC nurses' role. Some nurses were experienced in the use of telehealth, while others indicated a lack of preparation and limited appropriate technology to support its use. Telehealth enabled patients to access care but did not support complex clinical assessment. Participants indicated that patient engagement in telehealth was dependent on access and confidence using technology, perceived safety when physically attending the practice and the value they placed on care via telehealth. Many participants expressed frustration about telehealth funding and its impact on facilitating nurses to practise to their full scope.
Telehealth has provided a means to continue PHC service delivery during COVID-19. While there are advantages to adopting this technology, considerations of the challenges and lessons from this experience are important to inform the future implementation of telehealth initiatives.
本研究旨在探讨澳大利亚初级保健（PHC）护士在 COVID-19 期间使用远程医疗的经验。远程医疗被定义为使用任何电信模式（例如电话和视频会议）提供医疗保健。
在澳大利亚 PHC 进行的定性访谈的主题分析。
使用目的抽样法招募了 25 名曾参与过关于 COVID-19 期间经验的全国调查的 PHC 护士。
2020 年 6 月至 8 月进行半结构化电话访谈。访谈平均持续 38.5 分钟。在进行主题分析之前，对其进行了音频录制和转录。遵循了定性研究报告的综合标准。
确定了四个总体主题：准备情况、远程医疗的可及性、护理体验以及对 PHC 护士角色的影响。一些护士在使用远程医疗方面经验丰富，而另一些护士则表示准备不足，缺乏支持其使用的适当技术。远程医疗使患者能够获得护理，但无法支持复杂的临床评估。参与者表示，患者对远程医疗的参与程度取决于使用技术的机会和信心、亲自到诊所就诊时的安全感以及他们对远程医疗的重视程度。许多参与者对远程医疗的资金及其对促进护士充分发挥其执业范围的影响感到不满。
远程医疗为在 COVID-19 期间继续提供 PHC 服务提供了一种手段。虽然采用这项技术有优势，但考虑到这方面的挑战和经验教训，对于为远程医疗计划的未来实施提供信息是很重要的。
