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远程会诊对基层医疗中首诊物理治疗师健康与福祉的影响:一项混合方法研究。

The impact of remote consultations on the health and wellbeing of first contact physiotherapists in primary care: A mixed methods study.

作者信息

Anchors Zoe, Jones Bethan, Thomas Rachel, Berry Alice, Walsh Nicola

机构信息

School of Health and Social Wellbeing, University of the West of England, Bristol, UK.

NIHR ARC West, Bristol, UK.

出版信息

Musculoskeletal Care. 2023 Sep;21(3):655-666. doi: 10.1002/msc.1737. Epub 2023 Feb 10.


DOI:10.1002/msc.1737
PMID:36762885
Abstract

BACKGROUND: First Contact Physiotherapists (FCPs) were introduced to reduce demands on GPs by providing improving access to expert musculoskeletal care. FCPs experience similar workplace stressors to GPs and there is an emerging concern that remote consultations are causing further impacts to their wellbeing. AIM: To explore the impact of remote consultations on FCPs. METHODS: A mixed methods sequential explanatory study with FCPs was conducted. An online survey measured the usage and impact of remote consultations. Semi-structured interviews explored the lived experiences of using remote consultations. RESULTS: The online survey was completed by 109 FCPs. A key benefit of remote consultations was patient convenience; perceived challenges included IT issues, poor efficacy, FCP anxiety, isolation, and increased workload. FCPs viewed remote consultations as a 'challenge' rather than a 'threat'. Nearly two thirds of the FCPs had not received relevant training, yet over half were interested. Follow-up interviews with 16 FCPs revealed 4 themes: (1) Remote consultations provide logistical benefits to the patient; (2) Compromised efficacy is the key challenge of remote consultations; (3) Challenges for FCPs working in areas of high deprivation; and (4) Remote consultations impact the health, wellbeing and work satisfaction of FCPs. CONCLUSIONS: Remote consultations offer a convenient alternative for patients, but may add to FCP stress particularly in areas of high socioeconomic deprivation. Further research is required to understand how remote consultations can be enhanced when communication barriers and lower levels of digital literacy exist. Continued monitoring of job satisfaction and resilience levels is important to ensure FCPs remain in their role.

摘要

背景:首次接触物理治疗师(FCPs)的引入是为了通过改善获得专家肌肉骨骼护理的机会来减少全科医生的工作负担。FCPs经历与全科医生类似的工作场所压力源,并且人们越来越担心远程会诊正在对他们的健康产生进一步影响。 目的:探讨远程会诊对FCPs的影响。 方法:对FCPs进行了一项混合方法的顺序解释性研究。一项在线调查测量了远程会诊的使用情况和影响。半结构化访谈探讨了使用远程会诊的实际经历。 结果:109名FCPs完成了在线调查。远程会诊的一个关键好处是方便患者;感知到的挑战包括信息技术问题、效果不佳、FCPs焦虑、孤立感和工作量增加。FCPs将远程会诊视为一种“挑战”而非“威胁”。近三分之二的FCPs没有接受过相关培训,但超过一半的人对此感兴趣。对16名FCPs的后续访谈揭示了4个主题:(1)远程会诊为患者提供了后勤便利;(2)效果受损是远程会诊的关键挑战;(3)在高贫困地区工作的FCPs面临的挑战;(4)远程会诊影响FCPs的健康、福祉和工作满意度。 结论:远程会诊为患者提供了一种方便的选择,但可能会增加FCPs的压力,特别是在社会经济贫困程度高的地区。需要进一步研究,以了解在存在沟通障碍和数字素养较低的情况下如何加强远程会诊。持续监测工作满意度和恢复力水平对于确保FCPs继续履行职责很重要。

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