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新冠疫情早期以来对远程医疗使用的看法和偏好:对患者和医生的横断面调查。

Perceptions of and Preferences for Telemedicine Use Since the Early Stages of the COVID-19 Pandemic: Cross-Sectional Survey of Patients and Physicians.

机构信息

E-health and Telemedicine Division, Geneva University Hospitals, Geneva, Switzerland.

Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.

出版信息

JMIR Hum Factors. 2023 Nov 7;10:e50740. doi: 10.2196/50740.

Abstract

BACKGROUND

While the use of telemedicine (TLM) increased worldwide during the early phases of the COVID-19 pandemic, little is known about the use and acceptance of TLM post the COVID-19 pandemic.

OBJECTIVE

This study aims to evaluate patients' and physicians' self-reported use, preferences, and acceptability of different types of TLM after the initial phases of the COVID-19 pandemic.

METHODS

We conducted a cross-sectional survey among patients and physicians in Geneva, Switzerland, between September 2021 and January 2022. Patients in waiting rooms of both private and public medical centers and emergency services were invited to answer a web-based questionnaire. Physicians working in private and public settings were invited by email to answer a similar questionnaire. The questionnaires assessed participants' sociodemographics and digital literacy; self-reported use of TLM; as well as preferences and acceptability of TLM for different clinical situations.

RESULTS

A total of 567 patients (309/567, 55% women) and 448 physicians (230/448, 51% women and 225/448, 50% in private practice) responded to the questionnaire. Patients (263/567, 46.5%) and physicians (247/448, 55.2%) generally preferred the phone over other TLM formats and considered it to be acceptable for most medical situations. Email (417/567, 73.6% and 308/448, 68.8%) was acceptable for communicating exam results, and medical certificates (327/567, 67.7% and 297/448, 66.2%) and video (302/567, 53.2% and 288/448, 64.3%) was considered acceptable for psychological support by patients and physicians, respectively. Older age was associated with lower acceptability of video for both patients and physicians (odds ratio [OR] 0.03, 95% CI 0.00-0.33 and OR 0.23, 95% CI 0.08-0.66) while previous use of video was positively associated with video acceptability (OR 3.16, 95% CI 1.84-5.43 and OR 3.34, 95% CI 2.91-5.54). Psychiatrists and hospital physicians were more likely to consider video to be acceptable (OR 10.79, 95% CI 3.96-29.30 and OR 3.97, 95% CI 2.23-7.60).

CONCLUSIONS

Despite the development of video, the acceptability of video remains lower than that of the phone for most health issues or patient requests. There is a need to better define for which patients and in which medical situations video can become safe and efficient.

摘要

背景

在 COVID-19 大流行的早期阶段,远程医疗(TLM)在全球范围内得到了广泛应用,但在 COVID-19 大流行后,人们对 TLM 的使用和接受程度知之甚少。

目的

本研究旨在评估患者和医生在 COVID-19 大流行初期后对不同类型 TLM 的自我报告使用、偏好和接受程度。

方法

我们在瑞士日内瓦的私人和公共医疗中心的候诊室和急诊室对患者和医生进行了横断面调查。邀请等候的患者回答一个基于网络的问卷。通过电子邮件邀请私人和公共医疗机构的医生回答类似的问卷。问卷评估了参与者的社会人口统计学和数字素养;自我报告的 TLM 使用情况;以及对不同临床情况的 TLM 的偏好和接受程度。

结果

共有 567 名患者(309/567,55%为女性)和 448 名医生(230/448,51%为女性和 225/448,50%为私人执业)回答了问卷。患者(263/567,46.5%)和医生(247/448,55.2%)通常更喜欢使用电话而不是其他 TLM 格式,并认为电话对于大多数医疗情况都是可以接受的。电子邮件(417/567,73.6%和 308/448,68.8%)可用于传达检查结果,医疗证明(327/567,67.7%和 297/448,66.2%)和视频(302/567,53.2%和 288/448,64.3%)可用于患者和医生分别接受心理支持。年龄较大与患者和医生对视频的接受程度较低有关(OR 0.03,95%CI 0.00-0.33 和 OR 0.23,95%CI 0.08-0.66),而之前使用过视频与视频接受程度呈正相关(OR 3.16,95%CI 1.84-5.43 和 OR 3.34,95%CI 2.91-5.54)。精神科医生和医院医生更有可能认为视频是可以接受的(OR 10.79,95%CI 3.96-29.30 和 OR 3.97,95%CI 2.23-7.60)。

结论

尽管视频技术得到了发展,但对于大多数健康问题或患者的请求,视频的接受程度仍然低于电话。需要更好地确定视频在哪些患者和哪些医疗情况下可以变得安全和有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dd6/10664018/f10cb2642c2e/humanfactors_v10i1e50740_fig1.jpg

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