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采用参与式设计方法评估通过远程医疗提供肿瘤康复服务的情况。

An evaluation of the provision of oncology rehabilitation services via telemedicine using a participatory design approach.

机构信息

Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK.

Department of Surgery & Cancer, Imperial College London, London, UK.

出版信息

Support Care Cancer. 2022 Feb;30(2):1655-1662. doi: 10.1007/s00520-021-06552-8. Epub 2021 Sep 23.

Abstract

BACKGROUND

The COVID-19 pandemic has fundamentally impacted the delivery of healthcare services globally. In line with UK government guidelines on social distancing, the use of telemedicine was implemented to facilitate the ongoing provision of cancer rehabilitation.

PURPOSE

We sought to evaluate and co-design telemedicine services to meet the complex needs of our patients and carers at a tertiary cancer centre.

METHODS

Experience-based co-design methodology was adapted to include virtual methods. Staff members (n = 12) and patients (n = 11) who had delivered or received therapies services at our UK cancer centre since March 2020 were recruited to take part in one-to-one virtual interviews. Patient interviews were video recorded, analysed and edited to a 30-min "trigger film". Patient and staff virtual events were undertaken thereafter. A joint virtual patient and staff event occurred. Staff and patients watched the trigger film and as partners, agreed areas for change and developed groups for service co-design.

RESULTS

Positive aspects regarding telemedicine provision were highlighted including reduced financial and time burden on patients, and increased flexibility for both staff and patients. The key concerns included digital exclusion, safety, communication and patient choice. Four co-design groups have been established to enact changes in these priority areas.

CONCLUSION

Using a participatory design approach, we have worked in partnership with patients and staff to ensure the safe, acceptable and effective delivery of rehabilitation services with integrated telemedicine.

摘要

背景

COVID-19 大流行从根本上影响了全球医疗保健服务的提供。为了遵循英国政府关于保持社交距离的指导方针,我们采用了远程医疗来促进癌症康复的持续开展。

目的

我们旨在评估和共同设计远程医疗服务,以满足我们在一家三级癌症中心的患者和护理人员的复杂需求。

方法

我们采用了基于经验的共同设计方法,并将虚拟方法纳入其中。自 2020 年 3 月以来,在我们的英国癌症中心提供或接受过治疗服务的工作人员(n=12)和患者(n=11)被招募来参加一对一的虚拟访谈。对患者访谈进行了视频记录、分析和编辑,制作成一个 30 分钟的“触发电影”。之后,我们还举办了患者和工作人员的虚拟活动。举行了一次联合的患者和工作人员虚拟活动。工作人员和患者观看了触发电影,作为合作伙伴,他们就需要改变的领域达成一致,并为服务共同设计成立了小组。

结果

突出强调了远程医疗服务提供的积极方面,包括减少了患者的经济和时间负担,同时提高了工作人员和患者的灵活性。主要关注点包括数字排斥、安全、沟通和患者选择。已经成立了四个共同设计小组,以解决这些优先领域的问题。

结论

通过采用参与式设计方法,我们与患者和工作人员合作,确保了康复服务的安全、可接受和有效开展,同时整合了远程医疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fa7/8727425/15900cb5c2cc/520_2021_6552_Fig1_HTML.jpg

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