了解老年护理专业人员在应对新冠疫情时使用远程医疗护理老年患者的经历：混合方法研究
Understanding the Experience of Geriatric Care Professionals in Using Telemedicine to Care for Older Patients in Response to the COVID-19 Pandemic: Mixed Methods Study.
作者信息
Chen Wenwen, Flanagan Ashley, Nippak Pria Md, Nicin Michael, Sinha Samir K
机构信息
School of Health Services Management, Ted Rogers School of Management, Toronto Metropolitan University, Toronto, ON, Canada.
National Institute on Ageing, Ted Rogers School of Management, Toronto Metropolitan University, Toronto, ON, Canada.
出版信息
JMIR Aging. 2022 Aug 10;5(3):e34952. doi: 10.2196/34952.
BACKGROUND
Geriatric care professionals were forced to rapidly adopt the use of telemedicine technologies to ensure the continuity of care for their older patients in response to the COVID-19 pandemic. However, there is little current literature that describes how telemedicine technologies can best be used to meet the needs of geriatric care professionals in providing care to frail older patients, their caregivers, and their families.
OBJECTIVE
This study aims to identify the benefits and challenges geriatric care professionals face when using telemedicine technologies with frail older patients, their caregivers, and their families and how to maximize the benefits of this method of providing care.
METHODS
This was a mixed methods study that recruited geriatric care professionals to complete an online survey regarding their personal demographics and experiences with using telemedicine technologies and participate in a semistructured interview. Interview responses were analyzed using the Consolidated Framework for Implementation Research (CFIR).
RESULTS
Quantitative and qualitative data were obtained from 30 practicing geriatric care professionals (22, 73%, geriatricians, 5, 17%, geriatric psychiatrists, and 3, 10%, geriatric nurse practitioners) recruited from across the Greater Toronto Area. Analysis of interview data identified 5 CFIR contextual barriers (complexity, design quality and packaging, patient needs and resources, readiness for implementation, and culture) and 13 CFIR contextual facilitators (relative advantage, adaptability, tension for change, available resources, access to knowledge, networks and communications, compatibility, knowledge and beliefs, self-efficacy, champions, external agents, executing, and reflecting and evaluating). The CFIR concept of external policy and incentives was found to be a neutral construct.
CONCLUSIONS
This is the first known study to use the CFIR to develop a comprehensive narrative to characterize the experiences of Ontario geriatric care professionals using telemedicine technologies in providing care. Overall, telemedicine can significantly enable most of the geriatric care that is traditionally provided in person but is less useful in providing specific aspects of geriatric care to frail older patients, their caregivers, and their families.
背景
为应对新冠疫情，老年护理专业人员被迫迅速采用远程医疗技术，以确保老年患者护理的连续性。然而，目前几乎没有文献描述如何最好地利用远程医疗技术来满足老年护理专业人员在为体弱的老年患者、其护理人员及其家人提供护理方面的需求。
目的
本研究旨在确定老年护理专业人员在与体弱的老年患者、其护理人员及其家人使用远程医疗技术时所面临的益处和挑战，以及如何最大限度地发挥这种护理方式的益处。
方法
这是一项混合方法研究，招募老年护理专业人员完成一份关于其个人人口统计学信息以及使用远程医疗技术的经历的在线调查，并参与一次半结构化访谈。访谈回复使用实施研究综合框架（CFIR）进行分析。
结果
从大多伦多地区招募了30名执业老年护理专业人员（22名，73%，老年病科医生；5名，17%，老年精神科医生；3名，10%，老年护理执业医师），获得了定量和定性数据。对访谈数据的分析确定了5个CFIR情境障碍（复杂性、设计质量与包装、患者需求与资源、实施准备情况以及文化）和13个CFIR情境促进因素（相对优势、适应性、变革压力、可用资源、知识获取、网络与沟通、兼容性、知识与信念、自我效能感、倡导者、外部因素、执行以及反思与评估）。发现CFIR的外部政策与激励概念是一个中性结构。
结论
这是已知的第一项使用CFIR来全面描述安大略省老年护理专业人员在提供护理时使用远程医疗技术的经历的研究。总体而言，远程医疗能够显著实现传统上大多亲自提供的老年护理，但在为体弱的老年患者、其护理人员及其家人提供老年护理特定方面的服务时作用较小。
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