Brady Bernadette, Saberi Golsa, Santalucia Yvonne, Gorgees Paul, Nguyen Tran Thao, Le Hien, Sidhu Balwinder
Liverpool Hospital, South Western Sydney Local Health District, Liverpool, Australia.
School of Health Sciences, Western Sydney University, Campbelltown, Australia.
J Telemed Telecare. 2024 Oct;30(9):1493-1506. doi: 10.1177/1357633X231154943. Epub 2023 Feb 16.
The rapid adoption of telehealth during the global pandemic has the potential to widen disparities for culturally and linguistically diverse (CALD) consumers. We explored the perspectives and experiences of CALD consumers accessing telehealth during the global pandemic and those of their healthcare providers.
A multistakeholder mixed-methods study involving two parallel samples comprising consumer-participants ( = 56) and healthcare provider-participants ( = 81). Multicultural consumer-participants, recruited from consecutive referrals to Health Language Services for telehealth support, were assisted to complete two surveys (before and after their clinical telehealth appointment) in their preferred language. A purposive sample of consumer-participants was interviewed to understand their perceived barriers and enablers of successful telehealth consultations. Simultaneously, all healthcare providers within the local health district were eligible to participate in an online survey if they had provided telehealth care to a consumer during the recruitment period. Closed-ended responses were descriptively summarised, while open-ended responses and interview transcripts were analysed thematically.
Despite 86% of consumer-participants inexperienced with telehealth, 80% achieved a successful appointment with a healthcare provider. Consumer perceptions were shaped by cultural and diagnostic concepts of legitimacy, in the context of known accessibility and technology literacy challenges. Healthcare provider perspectives were less favourable towards telehealth, with equity of healthcare delivery a major concern.
Our findings highlight unintended consequences arising from a rapid transition to telehealth. Adopting collaborative approaches to the design and implementation of telehealth is imperative to mitigate health inequities faced by CALD communities and maximise their opportunity to realise potential health benefits associated with telehealth.
在全球大流行期间远程医疗的迅速采用有可能扩大文化和语言多样化（CALD）消费者之间的差距。我们探讨了CALD消费者在全球大流行期间使用远程医疗的观点和经历以及他们的医疗服务提供者的观点和经历。
一项多利益相关方混合方法研究，涉及两个平行样本，包括消费者参与者（n = 56）和医疗服务提供者参与者（n = 81）。从连续转介至健康语言服务机构寻求远程医疗支持的人群中招募多元文化消费者参与者，协助他们用自己喜欢的语言完成两份调查问卷（临床远程医疗预约之前和之后）。对消费者参与者的一个目的抽样进行访谈，以了解他们认为成功进行远程医疗咨询的障碍和促进因素。同时，当地卫生区的所有医疗服务提供者如果在招募期间为消费者提供了远程医疗服务，就有资格参与在线调查。对封闭式回答进行描述性总结，而对开放式回答和访谈记录进行主题分析。
尽管86%的消费者参与者没有远程医疗经验，但80%的人成功预约了医疗服务提供者。在已知的可及性和技术素养挑战背景下，消费者的认知受到文化和合法性诊断概念的影响。医疗服务提供者对远程医疗的看法不太乐观，医疗服务提供的公平性是一个主要问题。
我们的研究结果突出了向远程医疗快速转变所产生的意外后果。采取协作方法来设计和实施远程医疗对于减轻CALD社区面临的健康不平等现象并最大限度地增加他们实现与远程医疗相关潜在健康益处的机会至关重要。
