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医生对老年人特殊群体远程医疗的看法:初步研究结果

Physician Views of Telehealth for Special Populations of Older Adults: Preliminary Findings.

作者信息

Serina Peter T, Davoodi Natalie M, Guthrie Kate M, Merchant Roland C, Goldberg Elizabeth M

机构信息

Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA.

Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI, USA.

出版信息

J Patient Exp. 2023 Mar 14;10:23743735231160418. doi: 10.1177/23743735231160418. eCollection 2023.

Abstract

This study's objective was to determine how frontline physicians perceived telehealth for older adults with sensory impairments, cognitive impairments, mobility challenges, or those receiving end-of-life care. We conducted a multiple-methods study of US emergency, geriatric, and primary care physicians. Phase 1 involved semi-structured interviews with 48 physicians on their experiences using telehealth with older adults. In phase 2, we used those qualitative findings to generate a web-based survey administered to 74 physicians. In phase 3, we reintegrated qualitative data to enrich survey results. We identified 3 key findings: (1) 50% of emergency physicians, 33% of geriatricians, and 18% of primary care physicians considered telehealth to be a poor substitute for providing end-of-life care ( = .68); (2) for hearing, vision, and cognitive impairments, 61%, 58%, and 54%, respectively, saw telehealth as a good or fair substitute for providing care ( = .14); and (3) 98% indicated that telehealth was a good or fair substitute for in-person care for those with mobility impairment ( < .001). Preferences and comfort using telehealth with older adults vary by clinical context, patient population, and physician specialty, requiring tailored adaptations.

摘要

本研究的目的是确定一线医生如何看待针对有感官障碍、认知障碍、行动不便或接受临终关怀的老年人的远程医疗。我们对美国的急诊、老年病和初级保健医生进行了一项多方法研究。第一阶段包括对48名医生进行半结构化访谈,了解他们使用远程医疗服务老年人的经历。在第二阶段,我们利用这些定性研究结果生成了一项针对74名医生的网络调查。在第三阶段,我们重新整合定性数据以丰富调查结果。我们确定了3个关键发现:(1)50%的急诊医生、33%的老年病医生和18%的初级保健医生认为远程医疗是提供临终关怀的糟糕替代方式(P = 0.68);(2)对于听力、视力和认知障碍,分别有61%、58%和54%的人认为远程医疗是提供护理的良好或尚可替代方式(P = 0.14);(3)98%的人表示,对于行动不便的人,远程医疗是面对面护理的良好或尚可替代方式(P < 0.001)。在使用远程医疗服务老年人方面的偏好和舒适度因临床背景、患者群体和医生专业而异,需要进行量身定制的调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7333/10017932/696f863d5f12/10.1177_23743735231160418-fig1.jpg

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