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慢性疾病患者对初级保健诊所新冠疫情后远程咨询延续的看法:一项定性描述性研究。

Chronic conditions patient's perception of post-COVID-19 pandemic teleconsulting continuation in primary care clinics: a qualitative descriptive study.

机构信息

Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada

Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Québec, Canada.

出版信息

BMJ Open. 2022 Dec 15;12(12):e066871. doi: 10.1136/bmjopen-2022-066871.

Abstract

OBJECTIVES

The COVID-19 pandemic has led to the prioritisation of teleconsultation instead of face-to-face encounters. However, teleconsultation revealed some shortcomings and undesirable effects that may counterbalance benefits. This study aims to explore the perspective of patients with chronic diseases on teleconsultation in primary care. This article also proposes recommendations to provide patient-oriented and appropriate teleconsultations.

DESIGN

We conducted a qualitative descriptive study that explored the patients' perception regarding teleconsultation services and the following themes: access, perceived benefits and disadvantages, interprofessional collaboration, patient-centred approach, specific competencies of professionals, and patient's global needs and preferences.

SETTING

Six primary care clinics in three regions of Quebec.

PARTICIPANTS

39 patients were interviewed by telephone through semistructured qualitative interviews.

RESULTS

Patients want to maintain teleconsultation for the postpandemic period as long as their recommendations are followed: be able to choose to come to the clinic if they wish to, feel that their individual and environmental characteristics are considered, feel involved in the choice of the modality of each consultation, feel that interprofessional collaboration and patient-centred approach are promoted, and to maintain the professionalism, which must not be lessened despite the remote context.

CONCLUSION

Patients mainly expressed high satisfaction with teleconsultation. However, several issues must be addressed. Patients do and should contribute to the implementation of teleconsultation in primary care. They wish to be frequently consulted about their preferred consultation modality, which may change over time. The patient perspective must, therefore, be part of the balanced implementation of optimal teleconsultation that is currently taking place.

摘要

目的

COVID-19 大流行导致优先选择远程咨询而不是面对面就诊。然而,远程咨询也暴露出一些缺点和不良影响,可能会抵消其带来的好处。本研究旨在探讨慢性病患者对初级保健中远程咨询的看法。本文还提出了一些建议,旨在提供以患者为中心且合适的远程咨询。

设计

我们进行了一项定性描述性研究,探讨了患者对远程咨询服务的看法,以及以下主题:可及性、感知到的优缺点、跨专业协作、以患者为中心的方法、专业人员的特定能力以及患者的整体需求和偏好。

地点

魁北克三个地区的六家初级保健诊所。

参与者

通过半结构化定性访谈,对 39 名患者进行了电话采访。

结果

只要遵循他们的建议,患者希望在大流行后继续保留远程咨询:能够根据自己的意愿选择到诊所就诊,感到他们的个人和环境特征得到了考虑,感到参与到每次咨询模式的选择中,感到跨专业协作和以患者为中心的方法得到了促进,并且保持专业性,即使是远程环境也不能降低专业性。

结论

患者主要对远程咨询表示高度满意。然而,仍有几个问题需要解决。患者确实应该为初级保健中的远程咨询实施做出贡献。他们希望经常就他们首选的咨询模式进行咨询,而且这种模式可能会随时间而变化。因此,患者的观点必须成为正在进行的最佳远程咨询平衡实施的一部分。

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