Straw Isabel, Tanczer Leonie
Institute of Health Informatics, University College London, London, United Kingdom.
Gender and IoT, UCL Department of Science, Technology, Engineering and Public Policy (UCL STEaPP), London, United Kingdom.
PLOS Digit Health. 2023 Jan 4;2(1):e0000089. doi: 10.1371/journal.pdig.0000089. eCollection 2023 Jan.
Safeguarding vulnerable patients is a key responsibility of healthcare professionals. Yet, existing clinical and patient management protocols are outdated as they do not address the emerging threats of technology-facilitated abuse. The latter describes the misuse of digital systems such as smartphones or other Internet-connected devices to monitor, control and intimidate individuals. The lack of attention given to how technology-facilitated abuse may affect patients in their lives, can result in clinicians failing to protect vulnerable patients and may affect their care in several unexpected ways. We attempt to address this gap by evaluating the literature that is available to healthcare practitioners working with patients impacted by digitally enabled forms of harm. A literature search was carried out between September 2021 and January 2022, in which three academic databases were probed using strings of relevant search terms, returning a total of 59 articles for full text review. The articles were appraised according to three criteria: (a) the focus on technology-facilitated abuse; (b) the relevance to clinical settings; and (c) the role of healthcare practitioners in safeguarding. Of the 59 articles, 17 articles met at least one criterion and only one article met all three criteria. We drew additional information from the grey literature to identify areas for improvement in medical settings and at-risk patient groups. Technology-facilitated abuse concerns healthcare professionals from the point of consultation to the point of discharge, as a result clinicians need to be equipped with the tools to identify and address these harms at any stage of the patient's journey. In this article, we offer recommendations for further research within different medical subspecialities and highlight areas requiring policy development in clinical environments.
保护弱势患者是医护人员的一项关键职责。然而，现有的临床和患者管理方案已经过时，因为它们没有应对技术助长的虐待行为所带来的新威胁。后者指的是滥用智能手机或其他联网设备等数字系统来监视、控制和恐吓个人。对技术助长的虐待行为如何影响患者生活缺乏关注，可能导致临床医生无法保护弱势患者，并可能以几种意想不到的方式影响他们的治疗。我们试图通过评估可供治疗受数字形式伤害影响的患者的医护人员参考的文献来填补这一空白。在2021年9月至2022年1月期间进行了文献检索，使用相关搜索词串对三个学术数据库进行了检索，共返回59篇文章进行全文审查。根据三个标准对这些文章进行评估：(a) 对技术助长的虐待行为的关注；(b) 与临床环境的相关性；(c) 医护人员在保护方面的作用。在这59篇文章中，17篇文章至少符合一个标准，只有一篇文章符合所有三个标准。我们从灰色文献中获取了更多信息，以确定医疗环境和高危患者群体中需要改进的领域。技术助长的虐待行为从咨询阶段到出院阶段都让医护人员担忧，因此临床医生需要具备在患者就医的任何阶段识别和应对这些伤害的工具。在本文中，我们为不同医学亚专业的进一步研究提供了建议，并强调了临床环境中需要制定政策的领域。
