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将电子健康技术引入常规白内障护理:患者对基于网络的术后远程监测眼测试的看法。

Introducing e-health technology to routine cataract care: patient perspectives on web-based eye test for postoperative telemonitoring.

机构信息

From the Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands (Claessens, Wisse); Julius Center for Health Sciences and Primary Care, Department of Medical Humanities, University Medical Center Utrecht, Utrecht, the Netherlands (Maats, Jongsma); Department of Industrial Engineering and Business Information Systems, University of Twente, Enschede, the Netherlands (Iacob); Xpert Clinics Oogzorg, Zeist, the Netherlands (Wisse).

出版信息

J Cataract Refract Surg. 2023 Jul 1;49(7):659-665. doi: 10.1097/j.jcrs.0000000000001189. Epub 2023 Mar 29.

Abstract

PURPOSE

To explore cataract patients' experiences with an e-health tool for self-assessing visual function (ie, a web-based eye test), and to formulate recommendations for its successful adoption in routine cataract care.

SETTING

Clinics in the Netherlands, Germany, and Austria.

DESIGN

Mixed-methods study.

METHODS

22 participants were included in this study; in-depth interviews were conducted with 12. Questionnaires and in-depth semi-structured interviews were conducted alongside a multicenter randomized controlled trial evaluating the validity, safety and cost-effectiveness of remote care after cataract surgery (Cataract Online Refraction Evaluation, a Randomized Controlled Trial). Results were analyzed thematically.

RESULTS

Participants reported positively about performing the web-based eye test at home. 4 overarching themes were identified in the interviews. First, participants were inventive in overcoming practical barriers encountered while conducting the test. Second, participants desired a clear presentation of test results and their meaning. Third, the ability to self-monitor visual function was appreciated. Fourth, most participants preferred to keep the option to contact their eyecare professional (ECP) postoperatively, especially when experiencing symptoms. Most would be satisfied with a phone consultation or an e-consult. Participants reported positive experiences with the web-based eye test. Barriers for successful adoption were identified, including insecurity about correctly performing the test, incomplete information on how to interpret test results, and a feeling that in-hospital assessments were superior to remote assessments.

CONCLUSIONS

It is recommended to focus on building trust in remote eyecare delivery and that access to the ECP be retained when medically indicated or deemed necessary by the patient.

摘要

目的

探索白内障患者使用电子健康工具自我评估视觉功能(即基于网络的眼测试)的体验,并为其在常规白内障护理中的成功采用提出建议。

设置

荷兰、德国和奥地利的诊所。

设计

混合方法研究。

方法

本研究纳入了 22 名参与者;对 12 名参与者进行了深入访谈。在评估白内障手术后远程护理的有效性、安全性和成本效益的多中心随机对照试验(白内障在线折射评估,一项随机对照试验)中,同时进行了问卷调查和深入半结构化访谈。结果进行了主题分析。

结果

参与者对在家中进行基于网络的眼测试报告了积极的体验。访谈中确定了 4 个总体主题。首先,参与者在进行测试时遇到实际障碍时富有创造力。其次,参与者希望清晰呈现测试结果及其含义。第三,自我监测视觉功能的能力受到赞赏。第四,大多数参与者更喜欢在手术后保留与眼科专业人员(ECP)联系的选择,特别是当出现症状时。大多数人对电话咨询或电子咨询感到满意。参与者报告了基于网络的眼测试的积极体验。确定了成功采用的障碍,包括对正确进行测试的不安全感、对如何解释测试结果的信息不完整,以及对住院评估优于远程评估的感觉。

结论

建议专注于建立对远程眼科护理的信任,并在医学上需要或患者认为必要时保留与 ECP 的联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/259c/10284124/b50f8a08c2d8/jcrs-49-659-g001.jpg

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