Department of Medicine, University of Illinois Chicago, Chicago, IL.
Kiran C. Patel College of Osteopathic Medicine at Nova Southeastern University, Davie, FL.
J Am Assoc Nurse Pract. 2022 May 1;34(5):731-737. doi: 10.1097/JXX.0000000000000708.
During the COVID-19 pandemic, telehealth rapidly emerged as an essential health care service and became particularly important for patients with cancer and chronic conditions. However, the benefits of telehealth have not been fully realized for some of the most vulnerable populations due to inequitable access to telehealth capable technology.
This study aimed to assess accessibility and satisfaction with telehealth technology by vulnerable patients with cancer and pulmonary disease.
A paper survey and internet-based survey were developed and administered to adult (≥18 years) cancer and pulmonary clinic patients (July 1, 2020 to October 30, 2020).
Descriptive statistics and Fisher exact test were performed. Two hundred eleven patients completed the survey. Adults ≥50 years old (older) had reduced access to smartphone video capability and internet connection compared with adults less than 50 years old (59% vs. 90%, p < .01). Older adults reported more challenges with telehealth visits compared with younger adults (50.3%, 28.6%; p < .01). No difference in access to technology and preferences for telehealth versus in-person care was found by race, gender, or education level.
Nearly all patients (95%) who had a previous experience with a telehealth visit felt confident in the quality of care they received via telehealth. Younger adults preferred video visits compared with older adults (75% vs. 50.6%, p < .01). Older adults were less likely to have access to smartphones with internet access, have more challenges with telehealth visits, and were less likely to prefer audio-video telehealth visits compared with younger adults.
Ensuring equitable access to all health care delivery modalities by telehealth, including audio-only visits for patients across the age continuum, is paramount.
在 COVID-19 大流行期间，远程医疗迅速成为一项重要的医疗服务，对于癌症和慢性病患者尤为重要。然而，由于一些弱势群体无法公平地获得远程医疗技术，远程医疗的好处并未完全实现。
本研究旨在评估癌症和肺部疾病脆弱患者对远程医疗技术的可及性和满意度。
开发了纸质问卷和基于互联网的问卷，并于 2020 年 7 月 1 日至 2020 年 10 月 30 日期间对成年（≥18 岁）癌症和肺部诊所患者进行了调查。
采用描述性统计和 Fisher 精确检验进行分析。共有 211 名患者完成了调查。与年龄小于 50 岁的成年人相比，年龄大于等于 50 岁的成年人在智能手机视频功能和互联网连接方面的接入能力较低（59%比 90%，p <.01）。与年轻成年人相比，老年成年人报告在远程医疗就诊方面面临更多挑战（50.3%比 28.6%，p <.01）。按种族、性别或教育程度划分，在获得技术和对远程医疗与面对面护理的偏好方面，差异无统计学意义。
几乎所有（95%）有过远程医疗就诊经验的患者都对通过远程医疗获得的护理质量有信心。与老年成年人相比，年轻成年人更喜欢视频就诊（75%比 50.6%，p <.01）。与年轻成年人相比，老年成年人更不可能拥有具有互联网访问功能的智能手机，在远程医疗就诊方面面临更多挑战，并且不太可能更喜欢音频视频远程医疗就诊。
确保通过远程医疗提供所有医疗服务模式的公平获取，包括跨年龄的患者的仅音频访问，是至关重要的。
