McKenzie Kirsty, Lowres Nicole, Orchard Jessica, Hespe Charlotte, Freedman Ben, Giskes Katrina
Heart Research Institute, The University of Sydney, Sydney, Australia.
Faculty of Medicine and Health and Charles Perkins Centre, University of Sydney, Sydney, Australia.
Cardiovasc Digit Health J. 2022 Aug 4;3(5):212-219. doi: 10.1016/j.cvdhj.2022.07.073. eCollection 2022 Oct.
Current Australian and European guidelines recommend opportunistic screening for atrial fibrillation (AF) among patients ≥65 years, but general practitioners (GPs) report time constraints as a major barrier to achieving this. Patient self-screening stations in GP waiting rooms may increase screening rates and case detection of AF, but the acceptability of patient self-screening from the practice staff perspective, and the usability by patients, is unknown.
To determine staff perspectives on AF self-screening stations and factors impacting acceptability, usability by patients, and sustainability.
We performed semi-structured interviews with 20 general practice staff and observations of 22 patients while they were undertaking self-screening. Interviews were coded and data analyzed using an iterative thematic analysis approach.
GPs indicated high levels of acceptance of self-screening, and reported little impact on their workflow. Reception staff recognized the importance of screening for AF, but reported significant impacts on their workflow because some patients were unable to perform screening without assistance. Patient observations corroborated these findings and suggested some potential ways to improve usability.
AF self-screening in GP waiting rooms may be a viable method to increase opportunistic screening by GPs, but the impacts on reception workflow need to be mitigated for the method to be upscaled for more widespread screening. Furthermore, more age-appropriate station design may increase patient usability and thereby also reduce impact on reception workflow.
澳大利亚和欧洲现行指南建议对65岁及以上患者进行机会性房颤筛查，但全科医生（GP）报告称时间限制是实现这一目标的主要障碍。全科医生候诊室中的患者自我筛查站可能会提高房颤筛查率和病例检出率，但从执业人员角度来看患者自我筛查的可接受性以及患者的易用性尚不清楚。
确定工作人员对房颤自我筛查站的看法以及影响可接受性、患者易用性和可持续性的因素。
我们对20名全科医疗工作人员进行了半结构化访谈，并观察了22名患者进行自我筛查的情况。使用迭代主题分析方法对访谈进行编码和数据分析。
全科医生表示对自我筛查接受程度很高，并报告称对其工作流程影响很小。接待人员认识到房颤筛查的重要性，但报告称对其工作流程有重大影响，因为一些患者在没有帮助的情况下无法进行筛查。对患者的观察证实了这些发现，并提出了一些提高易用性的潜在方法。
在全科医生候诊室进行房颤自我筛查可能是增加全科医生机会性筛查的一种可行方法，但要扩大该方法以进行更广泛的筛查，就需要减轻对接待工作流程的影响。此外，更适合年龄的筛查站设计可能会提高患者的易用性，从而也减少对接待工作流程的影响。
