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医护人员使用远程医疗的意愿、感知促进因素和障碍 - 一项横断面研究。

Willingness, perceived facilitators and barriers to use remote care among healthcare professionals - a cross-sectional study.

机构信息

Centre for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.

出版信息

BMC Health Serv Res. 2023 Nov 27;23(1):1307. doi: 10.1186/s12913-023-10301-4.

Abstract

BACKGROUND

Remote care has the potential of improving access to timely care for people with inflammatory joint diseases (IJD), but there is limited knowledge on how this approach is regarded by healthcare professionals (HCP). This study aimed to examine willingness, perceived facilitators, and barriers to use remote care among HCP.

METHODS

Employees at 20 rheumatology departments in Norway received a digital survey containing 16 statements regarding willingness, perceived facilitators and barriers to use remote care. Statements were scored using numeric rating scales (NRS, 0-10, 10 = strongly agree), and analysed in linear regression models. Open-ended responses with participant-defined facilitators and barriers were analysed using qualitative manifest analysis.

RESULTS

A total of 130 participants from 17 departments completed the survey. The majority of participants were 45 years or older (n = 84, 54%), 54 (42%) were medical doctors, 48 (37%) nurses, and 27 (21%) were allied healthcare professionals, clinical leaders, or secretaries. A high willingness to use remote care was observed (median NRS: 9, IQR 8-10). The facilitator statement with the highest score was that patients save time and costs by using remote care, whereas the barrier statement with the highest score was the lack of physical examination. Willingness to use remote care was positively associated with the belief that patients wish to use it (β: 0.18, 95% CI: 0.00, 0.34), that patients in remission need less hospital visits (β: 0.30, 95% CI: 0.16, 0.43), and if remote care is widely adopted by co-workers (β: 0.27, 95% CI: 0.15, 0.39). Willingness was negatively associated with mistrust in the technical aspects of remote care (β: -0.26, 95% CI:-0.40, -0.11), and lack of physical examination (β: -0.24, 95% CI: -0.43, -0.06). The open-ended responses showed that technological equipment, eligible patients, user-friendly software, adequate training and work flow could be facilitators, but also that lack of these factors were considered barriers to use remote care.

CONCLUSION

This study showed that HCP have a high willingness to use remote care, and provides important new knowledge on perceived facilitators and barriers among HCP relevant for implementation of remote care for eligible patients with IJD.

摘要

背景

远程护理有可能改善炎症性关节疾病(IJD)患者及时获得护理的机会,但对于医疗保健专业人员(HCP)对这种方法的看法,我们知之甚少。本研究旨在调查 HCP 使用远程护理的意愿、感知的促进因素和障碍。

方法

挪威 20 个风湿病科的员工收到了一份包含 16 项关于使用远程护理的意愿、感知促进因素和障碍的数字评分量表(NRS,0-10,10=强烈同意)的数字调查。用线性回归模型分析陈述。使用定性显式分析对参与者定义的促进因素和障碍的开放式回答进行分析。

结果

共有 17 个科室的 130 名参与者完成了调查。大多数参与者年龄在 45 岁或以上(n=84,54%),54 人(42%)为医生,48 人(37%)为护士,27 人(21%)为专职医疗保健专业人员、临床领导或秘书。观察到使用远程护理的意愿很高(中位数 NRS:9,IQR 8-10)。得分最高的促进因素陈述是患者通过使用远程护理节省了时间和费用,而得分最高的障碍陈述是缺乏体检。使用远程护理的意愿与认为患者希望使用远程护理的信念呈正相关(β:0.18,95%CI:0.00,0.34),认为缓解期患者需要减少住院次数(β:0.30,95%CI:0.16,0.43),如果远程护理被同事广泛采用(β:0.27,95%CI:0.15,0.39)。意愿与对远程护理技术方面的不信任呈负相关(β:-0.26,95%CI:-0.40,-0.11),与缺乏体检呈负相关(β:-0.24,95%CI:-0.43,-0.06)。开放式回答显示,技术设备、合格患者、用户友好的软件、充分的培训和工作流程可能是促进因素,但也认为缺乏这些因素是使用远程护理的障碍。

结论

本研究表明,HCP 对使用远程护理具有很高的意愿,并为 HCP 实施适合 IJD 患者的远程护理提供了重要的新知识,包括感知的促进因素和障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/091a/10683299/8d6b66f09996/12913_2023_10301_Figa_HTML.jpg

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