Health Information Management and Medical Informatics Department, Tehran University of Medical Sciences, Tehran, Iran.
Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
BMJ Open. 2023 Jun 22;13(6):e073370. doi: 10.1136/bmjopen-2023-073370.
Non-adherence to treatment plans, follow-up visits and healthcare advice is a common obstacle in the management of lung transplant patients. This study aims to investigate experts' views on the needs and main aspects of telecare programmes for lung transplantation.
A qualitative study incorporating an inductive thematic analysis.
Lung transplant clinic and thoracic research centre.
Clinicians: four pulmonologists, two cardiothoracic surgeons, two general physicians, two pharmacotherapists, one cardiologist, one nurse and one medical informatician.
This study adopted a focus group discussion technique to gather experts' opinions on the prerequisites and features of a telecare programme in lung transplantation. All interviews were coded and combined into main categories and themes. Thematic analysis was performed to extract the key concepts using ATLAS.Ti. Ultimately, all extracted themes were integrated to devise a conceptual model.
Ten focus groups with 13 participants were conducted. Forty-six themes and subthemes were extracted through the thematic analysis. The main features of the final programme were extracted from expert opinions through thematic analysis, such as continuous monitoring of symptoms, drug management, providing a specific care plan for each patient, educating patients module, creating an electronic medical record to collect patient information, equipping the system with decision support tools, smart electronic prescription and the ability to send messages to the care team. The prerequisites of the system were summarised in self-care activities, clinician's tasks and required technologies. In addition, the barriers and benefits of using a telecare system to enhance the quality of care were determined.
Our investigation recognised the main factors that must be considered to design a telecare programme to provide ideal continuous care for lung transplant patients. Users should further explore the proposed model to support the development of telecare interventions at the point of care.
肺移植患者在治疗计划、随访和医疗建议方面的依从性差是管理中的常见障碍。本研究旨在调查专家对远程护理计划在肺移植方面的需求和主要方面的看法。
一项纳入归纳主题分析的定性研究。
肺移植诊所和胸科研究中心。
临床医生:四位肺病专家、两位心胸外科医生、两位全科医生、两位药物治疗师、一位心脏病专家、一位护士和一位医学信息专家。
本研究采用焦点小组讨论技术,收集专家对远程护理计划在肺移植中的先决条件和特点的意见。对所有访谈进行编码并组合成主要类别和主题。使用 ATLAS.Ti 进行主题分析以提取关键概念。最终,所有提取的主题都被整合以设计一个概念模型。
进行了十次焦点小组讨论,共有 13 名参与者。通过主题分析提取了 46 个主题和子主题。通过主题分析从专家意见中提取了最终方案的主要特点,例如持续监测症状、药物管理、为每位患者提供特定的护理计划、教育患者模块、创建电子病历以收集患者信息、为系统配备决策支持工具、智能电子处方和向护理团队发送消息的能力。系统的先决条件总结为自我护理活动、临床医生的任务和所需的技术。此外,确定了使用远程护理系统增强护理质量的障碍和益处。
我们的调查认识到必须考虑主要因素来设计远程护理计划,以为肺移植患者提供理想的持续护理。用户应进一步探索所提出的模型,以支持在护理点开发远程护理干预措施。