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美国农村和偏远地区远程医疗的使用和结果快速回顾。

A Rapid Review of Uses and Outcomes of Telehealth Care in Rural and Remote Regions in the United States.

出版信息

J Hosp Palliat Nurs. 2023 Oct 1;25(5):239-248. doi: 10.1097/NJH.0000000000000964. Epub 2023 Aug 1.

DOI:10.1097/NJH.0000000000000964
PMID:37525370
Abstract

As telehealth expands and becomes an increasingly important provision of palliative care and hospice services, the understanding of the uses and outcomes of this care delivery platform in rural communities is warranted. This rapid review aims to highlight the practice, policy, and research implications of telehealth in rural regions. Using a systematic approach for accessing and synthesizing available publications, this review included 22 articles published between January 2020 and January 2023. Telehealth was used with adult and pediatric populations diagnosed with serious illnesses. Acceptance of this type of care delivery was noted in adults and children, but not all found telehealth a valuable mechanism for care. Telehealth services included but were not limited to direct communication between the provider and the patient/caregiver, medication management, and a peer-to-peer consultant role for rural palliative care and hospice teams. Of those studies addressing provider-centered outcomes, noise level, interruptions, missed appointments, and challenges with providing emotional support were reported. Organizational barriers, such as the lack of financial support, were noted for pediatric hospices. Individuals living in rural communities require more frequent, immediate, and specialized attention over their illness trajectory. Practice, policy, and research implications are identified to consider the next steps for telehealth delivery of palliative care.

摘要

随着远程医疗的扩展并成为姑息治疗和临终关怀服务的重要组成部分,有必要了解这个医疗服务平台在农村社区的使用情况和效果。本快速综述旨在强调远程医疗在农村地区的实践、政策和研究意义。本综述采用系统的方法获取和综合现有出版物,共纳入了 2020 年 1 月至 2023 年 1 月期间发表的 22 篇文章。远程医疗应用于患有严重疾病的成年和儿科人群。成人和儿童都接受了这种护理方式,但并非所有人都认为远程医疗是一种有价值的护理机制。远程医疗服务包括但不限于提供者与患者/照顾者之间的直接沟通、药物管理,以及农村姑息治疗和临终关怀团队的同行咨询角色。那些关注提供者为中心的结果的研究报告了噪音水平、中断、错过预约以及提供情感支持方面的挑战。儿科临终关怀机构存在组织障碍,如缺乏财务支持。居住在农村社区的个人在疾病发展过程中需要更频繁、更及时和更专业的关注。确定了实践、政策和研究意义,以考虑姑息治疗远程医疗服务的下一步发展。

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