Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.
National Disability Insurance Agency, Melbourne, Victoria, Australia.
BMJ Open. 2022 Sep 14;12(9):e065600. doi: 10.1136/bmjopen-2022-065600.
In people with a disability, or their caregivers, who reported suboptimal experiences, the objectives were to explore: (1) challenges with telehealth-delivered allied health services during the COVID-19 pandemic and (2) suggestions to improve such services.
Qualitative study based on an interpretivist paradigm and a phenomenological approach.
Participants who accessed allied healthcare via telehealth during the pandemic.
Data saturation was achieved after 12 interviews. The sample comprised three people with permanent or significant disabilities, and nine carers/partners/family members of people with permanent or significant disabilities, who were funded by the Australian National Disability Insurance Scheme and had suboptimal experiences with telehealth. Semistructured one-on-one interviews explored experiences with telehealth and suggestions on how such services could be improved. An inductive thematic analysis was performed.
Six themes relating to the first study objective (challenges with telehealth) were developed: (1) evoked behavioural issues in children; (2) reliant on caregiver facilitation; (3) inhibits clinician feedback; (4) difficulty building rapport and trust; (5) lack of access to resources and (6) children disengaged/distracted. Five themes relating to the second study objective (suggestions to improve telehealth services) were developed: (1) establish expectations; (2) increase exposure to telehealth; (3) assess suitability of specific services; (4) access to support workers and (5) prepare for telehealth sessions.
Some people with permanent and significant disabilities who accessed allied healthcare via telehealth during the pandemic experienced challenges, particularly children. These unique barriers to telehealth need customised solutions so that people with disabilities are not left behind when telehealth services become more mainstream. Increasing experience with telehealth, setting expectations before consultations, supplying resources for therapy and assessing the suitability of clients for telehealth may help overcome some of the challenges experienced.
在有残疾的个人或其照顾者报告体验不佳的情况下，本研究旨在探索：（1）在 COVID-19 大流行期间远程医疗提供的辅助医疗服务所面临的挑战；（2）改善此类服务的建议。
基于解释主义范式和现象学方法的定性研究。
在大流行期间通过远程医疗获取辅助医疗保健的参与者。
共有 12 名参与者接受了访谈。样本由 3 名有永久性或严重残疾的个人和 9 名照顾者/伙伴/家庭成员组成，这些人都是澳大利亚国家残疾保险计划资助的对象，他们在远程医疗方面的体验不佳。半结构化的一对一访谈探讨了他们在远程医疗方面的体验，以及如何改进此类服务的建议。采用归纳主题分析。
针对第一个研究目标（远程医疗的挑战）开发了六个主题：（1）引发儿童行为问题；（2）依赖照顾者的协助；（3）抑制临床医生的反馈；（4）难以建立融洽关系和信任；（5）无法获得资源；（6）儿童分心。针对第二个研究目标（改善远程医疗服务的建议）开发了五个主题：（1）建立期望；（2）增加对远程医疗的了解；（3）评估特定服务的适用性；（4）获得支持工作人员的帮助；（5）为远程医疗会议做准备。
在大流行期间通过远程医疗获取辅助医疗保健的一些有永久性和严重残疾的个人经历了挑战，尤其是儿童。远程医疗存在这些独特的障碍，需要定制解决方案，以确保当远程医疗服务变得更加主流时，残疾人士不会被落下。增加远程医疗的经验，在咨询前设定期望，提供治疗资源，并评估客户对远程医疗的适用性，可能有助于克服所面临的一些挑战。
