University Centre for Palliative Care, Inselspital University Hospital Bern, Switzerland.
Department of Emergency Medicine, Inselspital University Hospital Bern, Switzerland.
Swiss Med Wkly. 2022 Mar 9;152(9-10). doi: 10.4414/smw.2022.w30148. eCollection 2022 Feb 28.
Telemedicine in palliative care was initially developed in countries where geography or resources limit access to care services. Recently, largely owing to the COVID-19 pandemic, this technology is being increasingly used in highly urbanised countries such as Switzerland. However, there is still scepticism regarding whether these tools can be used effectively in palliative care, a relationship-based speciality that is generally highly dependent on compassion, communication and direct human interaction. The objective of this review was to analyse the needs, elements of feasibility, and reasons for acceptance or possible barriers before the implementation of a telemedicine intervention in Switzerland.
The method used was a scoping review, following the PRISMA-ScR reporting guidelines. We searched the PubMed, Ovid SP, Medline, Cochrane and Scopus databases for relevant reports. Charting and analyses of the data were done by a single researcher. A total of 520 records were screened and assessed for eligibility. Finally, 27 studies and 4 registry entries were included. Main reasons for exclusion were wrong population and intervention.
The prevailing study type was the single-arm intervention study. Most studies originated from countries with geographic barriers to access. Feasibility was good in 69% of all studies. Good acceptability (84.1-100%) was confirmed in the majority of the studies. The needs of the patients or the healthcare professionals were directly addressed in only five (16%) studies. Three needs were consistently reported: communication, coordination and technical reliability.
Despite a broad range of studies on telemedicine in palliative care, patients' needs are rarely addressed. Therefore, especially in countries such as Switzerland, a needs assessment is recommended before the implementation of a new telemedicine intervention, to guarantee high feasibility and acceptability.
远程医疗最初是在地理或资源限制医疗服务获取的姑息治疗国家中发展起来的。最近，主要由于 COVID-19 大流行，这项技术在像瑞士这样高度城市化的国家中越来越多地被使用。然而，对于这些工具是否可以在姑息治疗中有效使用，仍存在怀疑，姑息治疗是一种基于关系的专业，通常高度依赖同情、沟通和直接的人际互动。本综述的目的是分析在瑞士实施远程医疗干预之前的需求、可行性要素以及接受或可能存在的障碍的原因。
使用的方法是范围综述，遵循 PRISMA-ScR 报告指南。我们在 PubMed、Ovid SP、Medline、Cochrane 和 Scopus 数据库中搜索了相关报告。由一名研究人员对数据进行了图表制作和分析。共筛选和评估了 520 份记录。最终纳入 27 项研究和 4 项登记。主要排除原因是人群和干预措施错误。
主要研究类型为单臂干预研究。大多数研究来自存在地理障碍的国家。所有研究中，可行性良好的占 69%。在大多数研究中，接受度良好（84.1-100%）。只有 5 项（16%）研究直接解决了患者或医疗保健专业人员的需求。有三个需求被一致报告：沟通、协调和技术可靠性。
尽管姑息治疗中远程医疗的研究范围广泛，但很少关注患者的需求。因此，特别是在瑞士这样的国家，在实施新的远程医疗干预之前，建议进行需求评估，以保证高可行性和接受度。
