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高满意度:以患者为中心的丙型肝炎病毒远程医疗服务在物质使用障碍患者中的应用:一项混合方法研究。

High Satisfaction with Patient-Centered Telemedicine for Hepatitis C Virus Delivered to Substance Users: A Mixed-Methods Study.

机构信息

Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University at Buffalo, Buffalo, New York, USA.

Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA.

出版信息

Telemed J E Health. 2023 Mar;29(3):395-407. doi: 10.1089/tmj.2022.0189. Epub 2022 Aug 4.

Abstract

While telemedicine may increase health care access for vulnerable populations, data are limited on whether people with opioid use disorder (PWOUD) are satisfied with telemedicine. We assessed PWOUD satisfaction with telemedicine and identified factors that increase telemedicine satisfaction. We conducted a mixed-methods study among hepatitis C virus (HCV)-infected persons enrolled at 12 opioid treatment programs (OTPs) throughout New York State. Participants successfully completed HCV treatment either through telemedicine integrated into OTPs ( = 238) or through offsite referral ( = 106). We evaluated Patient Satisfaction Questionnaire (PSQ) response scores at the initial and final health care encounters and subsequently interviewed telemedicine study participants ( = 25) to assess their experiences with telemedicine. All participants ( = 344) successfully completed HCV treatment. We observed no differences in PSQ scores between telemedicine and in-person encounters (98.3% and 98.7% of telemedicine participants provided PSQ scores of satisfied or highly satisfied at each timepoint, respectively). Study participants indicated that attributes associated with high telemedicine encounter satisfaction included: (1) communicating study information, (2) gaining trust, and (3) delivering patient-centered care. Participants weighted "General Satisfaction" and "Time Spent with Doctor" higher than "Accessibility and Convenience," and female participants were significantly more satisfied than males. Satisfaction with health care delivery among all participants increased significantly comparing timepoints. Participants were highly satisfied with HCV telemedicine encounters equivalent to in-person encounters. Communication augments trust facilitating delivery of patient-centered care through telemedicine. Participants value empathy and trust with providers over accessibility and convenience. In summary, PWOUD are highly satisfied with the facilitated telemedicine model and value empathetic and trusting providers. ClinicalTrials.gov Identifier: NCT02933970.

摘要

虽然远程医疗可能会增加弱势群体的医疗服务机会,但关于是否患有阿片类药物使用障碍(PWOUD)的人对远程医疗满意的数据有限。我们评估了 PWOUD 对远程医疗的满意度,并确定了增加远程医疗满意度的因素。我们在纽约州 12 个阿片类药物治疗项目(OTP)中的 HCV 感染人群中进行了一项混合方法研究。参与者通过 OTP 中整合的远程医疗( = 238)或场外转诊( = 106)成功完成 HCV 治疗。我们评估了初始和最终医疗保健就诊时的患者满意度问卷(PSQ)响应评分,随后对 25 名远程医疗研究参与者进行了访谈( = 25),以评估他们的远程医疗体验。所有参与者( = 344)均成功完成 HCV 治疗。我们在远程医疗和面对面就诊之间观察到 PSQ 评分没有差异(分别有 98.3%和 98.7%的远程医疗参与者在每个时间点提供了满意或非常满意的 PSQ 评分)。研究参与者表示,与高远程医疗就诊满意度相关的属性包括:(1)传达研究信息,(2)建立信任,以及(3)提供以患者为中心的护理。参与者对“总体满意度”和“与医生相处的时间”的重视程度高于“可及性和便利性”,女性参与者的满意度明显高于男性。与比较时间点相比,所有参与者的医疗服务提供满意度均显著提高。参与者对 HCV 远程医疗就诊非常满意,与面对面就诊相当。沟通增强了信任,通过远程医疗提供了以患者为中心的护理。参与者更看重提供者的同理心和信任,而不是可及性和便利性。总之,PWOUD 对远程医疗模式非常满意,并重视有同理心和值得信任的提供者。ClinicalTrials.gov 标识符:NCT02933970。

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