Department of Speech-Language Pathology, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada.
Krembil Research Institute, University Health Network, Toronto, ON, Canada.
BMC Health Serv Res. 2022 Sep 30;22(1):1218. doi: 10.1186/s12913-022-08554-6.
Following the COVID-19 directive to cease non-essential services, a rapid shift was made in the delivery of Speech Language Pathology (SLP) dysphagia management in the 3-arm, randomized PRO-ACTIVE trial. To inform future programs, this study explored patients' experiences with telehealth when the planned in-person SLP intervention was moved to a telehealth modality.
A theory-guided qualitative descriptive approach was used. Willing participants who had received at least one telehealth swallowing therapy session participated in a one-time semi-structured interview. Interview transcripts were subjected to a standard qualitative content/theme analysis. Researchers reviewed all transcripts and used a multi-step analysis process to build a coding framework through consensus discussion. Summaries and key messages were generated for each code.
Eleven participants recounted their telehealth experiences and reported feeling satisfied, comfortable and confident with the session(s). They identified that previous experience with teleconferencing, access to optimal technical equipment, clinician skill, and caregiver assistance facilitated their telehealth participation. Participants highlighted that telehealth was beneficial as it reduced commuting time, COVID-19 exposure and fatigue from travel; and also allowed caregiver participation particularly during COVID. In comparing their in-person SLP sessions to telehealth sessions, limitations were also identified, including: lack of previous experience with and/or poor access to technology, and less opportunity for personalization. Participants indicated that use of phone alone was less preferred than an audio/video platform.
Patients reported that overall, telehealth sessions did not compromise their learning experience when compared to in-person sessions. Patients benefited from use of telehealth in several ways despite some limitations of the use of technology. Patient feedback about telehealth provides an important perspective that may be critical to inform best practices for care delivery.
在 COVID-19 停止非必要服务的指令之后，3 臂随机 PRO-ACTIVE 试验中，言语病理学（SLP）吞咽障碍管理的服务迅速转变为远程医疗模式。为了为未来的项目提供信息，本研究探讨了患者在计划中的 SLP 干预措施转移到远程医疗模式时对远程健康的体验。
采用理论指导的定性描述方法。愿意参与的参与者至少接受了一次远程吞咽治疗，即可参与一次性半结构化访谈。采访记录接受了标准的定性内容/主题分析。研究人员审查了所有记录，并通过共识讨论使用多步分析过程来构建编码框架。为每个代码生成摘要和关键信息。
11 名参与者讲述了他们的远程健康体验，并报告说对会议感到满意、舒适和自信。他们认为，以前使用电话会议的经验、获得最佳技术设备、临床医生的技能和护理人员的协助促进了他们的远程健康参与。参与者强调，远程医疗的好处是减少了通勤时间、COVID-19 暴露和旅行疲劳；并且还允许护理人员参与，尤其是在 COVID 期间。在将他们的面对面 SLP 会议与远程健康会议进行比较时，还确定了一些限制，包括：缺乏以前的技术经验和/或技术获取较差，以及个性化的机会较少。参与者表示，与音频/视频平台相比，单独使用电话的效果较差。
与面对面会议相比，患者报告说总体而言，远程健康会议并没有影响他们的学习体验。尽管存在技术使用的一些限制，但患者仍从远程健康的使用中受益。患者对远程健康的反馈提供了一个重要的视角，这可能对为护理提供提供最佳实践提供信息至关重要。
