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瑞典初级保健医生对远程医疗的看法:一项定性研究

, , and Regarding Telemedicine Among Swedish Primary Care Physicians: A Qualitative Study.

作者信息

Glock Hanna, Milos Nymberg Veronica, Borgström Bolmsjö Beata, Holm Jonas, Calling Susanna, Wolff Moa, Pikkemaat Miriam

机构信息

Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.

出版信息

Int J Gen Med. 2021 Dec 1;14:9237-9246. doi: 10.2147/IJGM.S334782. eCollection 2021.

Abstract

PURPOSE

The primary care physician's traditional patient contacts are challenged by the rapidly accelerating digital transformation. In a quantitative survey analysis based on the theory of planned behavior, we found high behavioral intention to use telemedicine among Swedish primary care physicians, but low reported use. The aim of this study was to further examine the physicians' experiences regarding telemedicine, with a focus on possible explanations for the gap between intention and use, through analysis of the free-text comments supplied in the survey.

MATERIAL AND METHODS

The material was collected through a web-based survey which was sent out to physicians at 160 primary health care centers in southern Sweden from May to August 2019. The survey covered four areas: general experiences of telemedicine, digital contacts, chronic disease monitoring with digital tools, and artificial intelligence. A total of 100 physicians submitted one or more free-text comments. These were analyzed using qualitative content analysis with an inductive approach.

RESULTS

The primary care physicians expressed towards telemedicine that focused on clinical usefulness. to use were the loss of personal contact with patients and a deficient technological infrastructure. The major were that these factors would result in patient harm and an increased workload. The connection between intention and use postulated by the theory of planned behavior was not applicable in this context, as external factors in the form of availability and clinical usefulness of the specific technology were major impediments to use despite a generally positive attitude.

CONCLUSION

All telemedicine tools must be evaluated regarding clinical usefulness, patient safety, and effects on staff workload, and end users should be included in this process. Utmost consideration is needed regarding how to retain the benefits of personal contact between patient and provider when digital solutions are introduced.

摘要

目的

基层医疗医生传统的患者接触方式正受到快速加速的数字转型的挑战。在一项基于计划行为理论的定量调查分析中,我们发现瑞典基层医疗医生使用远程医疗的行为意向较高,但报告的使用情况较低。本研究的目的是通过分析调查中提供的自由文本评论,进一步考察医生对远程医疗的体验,重点关注意向与使用之间差距的可能解释。

材料与方法

材料通过基于网络的调查收集,于2019年5月至8月发送给瑞典南部160个初级卫生保健中心的医生。该调查涵盖四个领域:远程医疗的总体体验、数字接触、使用数字工具进行慢性病监测以及人工智能。共有100名医生提交了一条或多条自由文本评论。使用归纳法的定性内容分析法对这些评论进行了分析。

结果

基层医疗医生对远程医疗表达了关注临床实用性的看法。使用方面的障碍是与患者失去个人接触以及技术基础设施不足。主要担忧是这些因素会导致患者受到伤害并增加工作量。计划行为理论假设的意向与使用之间的联系在这种情况下并不适用,因为尽管总体态度积极,但特定技术的可用性和临床实用性等外部因素是使用的主要障碍。

结论

所有远程医疗工具都必须在临床实用性、患者安全以及对工作人员工作量的影响方面进行评估,并且最终用户应参与到这一过程中。在引入数字解决方案时,对于如何保留患者与提供者之间个人接触的益处需要给予最大程度的考虑。

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