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患者和临床医生对远程咨询的体验?一项叙事性综述。

Patients' and clinicians' experiences of remote consultation? A narrative synthesis.

机构信息

Oxford University Hospitals NHS Foundation Trust and Oxford Biomedical Research Centre, Oxford, UK.

Oxford Brookes University and Oxford Biomedical Research Centre, Oxford, UK.

出版信息

J Adv Nurs. 2022 Jul;78(7):1954-1967. doi: 10.1111/jan.15230. Epub 2022 Apr 1.

Abstract

AIMS

To identify, evaluate and summarize evidence of patient and clinician experiences of being involved in video or telephone consultations as a replacement for in-person consultations.

DESIGN

Narrative synthesis.

DATA SOURCES

Medline; EMBASE; EMCARE; CINAHL and BNI. Searching took place from January 2021 to April 2021. Papers included were published between 2013 and 2020.

REVIEW METHODS

Papers were appraised by two independent reviewers for methodological quality. Data extraction was conducted according to the standardized tool from Joanna Briggs Institute.

RESULTS

Seven qualitative studies were included, from five countries and from the perspective of patients, relatives, administrators, nurses, physiotherapists and physicians. We developed two main themes: Pragmatic Concerns and Therapeutic Concerns. Each theme contained two categories: Pragmatic Concerns: (a) the convenience of non-face to face consultations; (b) using technology and equipment in a consultation; Therapeutic Concerns (c) building therapeutic relationships; and (d) embracing benefits and addressing challenges.

CONCLUSION

This narrative synthesis presents the existing evidence on clinician and patient experience of participating in non-face to face consultations. Experiences are varied but largely focus on communication and forming relationships, using the technology successfully and the ability for patients to self-manage with support from clinicians who are not in-person. More high-quality studies are required to explore the experiences of patients and clinicians accessing remote consultations as a result of global implementation post-SARS-CoV-2 pandemic to identify any learning and education opportunities.

IMPACT

Health care staff can provide high-quality care through video or telephone appointments as well as face to face appointments. This review has, however, identified that the evidence is limited and weak in this area and recommends there is research further to inform practice and influence future care.

摘要

目的

确定、评估并总结患者和临床医生参与视频或电话咨询以替代面对面咨询的体验证据。

设计

叙述性综合。

资料来源

Medline、EMBASE、EMCARE、CINAHL 和 BNI。搜索于 2021 年 1 月至 2021 年 4 月进行。纳入的论文发表于 2013 年至 2020 年之间。

综述方法

两篇独立的综述员对方法学质量进行评估。根据 Joanna Briggs 研究所的标准化工具进行数据提取。

结果

纳入了 7 项定性研究,来自 5 个国家,从患者、家属、行政人员、护士、物理治疗师和医生的角度出发。我们提出了两个主要主题:实际问题和治疗问题。每个主题包含两个类别:实际问题:(a)非面对面咨询的便利性;(b)在咨询中使用技术和设备;治疗问题(c)建立治疗关系;(d)接受益处和应对挑战。

结论

本叙述性综述介绍了关于参与非面对面咨询的临床医生和患者体验的现有证据。经验各不相同,但主要集中在沟通和建立关系、成功使用技术以及患者在临床医生不在场的情况下通过支持进行自我管理的能力上。需要更多高质量的研究来探索全球 SARS-CoV-2 大流行后远程咨询的患者和临床医生的体验,以确定任何学习和教育机会。

影响

医疗保健人员可以通过视频或电话预约以及面对面预约提供高质量的护理。然而,本综述确定了该领域证据有限且薄弱,并建议进一步开展研究,以为实践提供信息并影响未来的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b94/9321562/da7b682fc03b/JAN-78-1954-g001.jpg

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