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远程 COVID-19 患者监测系统:定性评估。

Remote COVID-19 patient monitoring system: a qualitative evaluation.

机构信息

The Peter Doherty Institute for Infection and Immunity at the Department of Infectious Diseases, Melbourne Medical School, University of Melbourne, Melbourne, Victoria 3000, Australia

Emergency Department, Royal Melbourne Hospital, Melbourne, Victoria 3050, Australia.

出版信息

BMJ Open. 2022 May 4;12(5):e054601. doi: 10.1136/bmjopen-2021-054601.

Abstract

BACKGROUND

Many COVID-19 patients are discharged home from hospital with instructions to self-isolate. This reduces the burden on potentially overwhelmed hospitals. The Royal Melbourne Hospital (RMH) Home Monitoring Programme (HMP) is a model of care for COVID-19 patients which chiefly tracks pulse oximetry and body temperature readings.

OBJECTIVE

To evaluate the feasibility and acceptability of the HMP from a patient perspective.

DESIGN, SETTINGS AND PARTICIPANTS: Of 46 COVID-19 patients who used the HMP through RMH during April to August 2020, 16 were invited to participate in this qualitative evaluation study; all accepted, including 6 healthcare workers. Attempts were made to recruit a gender-balanced sample across a range of COVID-19 severities and comorbidities. Participants completed a brief semistructured phone interview discussing their experience of using the HMP.

OUTCOME MEASURES AND ANALYSIS

A thematic analysis of interview data was conducted. Feasibility was defined as the HMP's reported ease of use. Acceptability was considered holistically by reviewing themes in the interview data.

RESULTS

The HMP allowed clinical deterioration to be recognised as it occurred enabling prompt intervention. All participants reported a positive opinion of the HMP, stating it was highly acceptable and easy to use. Almost all participants said they found using it reassuring. Patients frequently mentioned the importance of the monitoring clinicians as an information conduit. The most suggested improvement was to monitor a broader set of symptoms.

CONCLUSIONS

The HMP is highly feasible and acceptable to patients. This model of care could potentially be implemented on a mass-scale to reduce the burden of COVID-19 on hospitals. A key benefit of the HMP is the ability to reassure patients they will receive suitable intervention should they deteriorate while isolating outside of hospital settings.

摘要

背景

许多 COVID-19 患者出院回家后需要进行自我隔离。这减轻了可能不堪重负的医院的负担。皇家墨尔本医院(RMH)的家庭监测计划(HMP)是一种针对 COVID-19 患者的护理模式,主要跟踪脉搏血氧饱和度和体温读数。

目的

从患者的角度评估 HMP 的可行性和可接受性。

设计、地点和参与者:在 2020 年 4 月至 8 月期间,通过 RMH 使用 HMP 的 46 名 COVID-19 患者中有 16 名被邀请参加这项定性评估研究;所有参与者均接受了邀请,包括 6 名医护人员。尝试招募了一组性别均衡的样本,涵盖了 COVID-19 的严重程度和合并症的范围。参与者通过简短的电话半结构化访谈,讨论了他们使用 HMP 的经验。

结果测量和分析

对访谈数据进行主题分析。可行性定义为 HMP 的报告易用性。可接受性通过审查访谈数据中的主题来综合考虑。

结果

HMP 允许识别临床恶化情况,以便及时干预。所有参与者都对 HMP 给予了积极的评价,称其高度可接受且易于使用。几乎所有参与者都表示使用它感到安心。患者经常提到监测临床医生作为信息渠道的重要性。最建议的改进是监测更广泛的症状集。

结论

HMP 对患者来说是高度可行和可接受的。这种护理模式可以大规模实施,以减轻 COVID-19 对医院的负担。HMP 的一个关键优势是能够让患者放心,如果他们在医院外隔离时病情恶化,他们将得到适当的干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ef/9072784/01a8f2e5d1bb/bmjopen-2021-054601f01.jpg

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