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社区姑息治疗中视频会诊的患者和临床医生体验探索。

Exploration of Patient and Clinician Experience of Video Consultations in Community Palliative Care.

机构信息

Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.

Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.

出版信息

J Pain Symptom Manage. 2024 Apr;67(4):e321-e331. doi: 10.1016/j.jpainsymman.2023.12.017. Epub 2024 Jan 11.

Abstract

CONTEXT

Telehealth video consultations (VCs) were implemented in the community palliative care team (CPCT) in a regional NSW health district, Australia, as a response to restrictions to the COVID-19 pandemic, using patient's device in the absence of a clinician.

OBJECTIVES

To evaluate patient/carer and clinician satisfaction in using VCs for CPC consultations; to explore advantages and challenges of VCs.

METHODS

Self-reported online questionnaires to community-dwelling patients under care of the CPCT; seeking patients/carers and clinician perspectives on the VCs from April to September 2020.

RESULTS

Of 126 eSurveys completed, (85 clinicians; 41 patients/carers), 97% patient/carers and 97% clinicians indicated they were satisfied with VC. Overall, 93% clinicians agreed they provided same level of care compared to face-to-face review; 85% patients/carers agreed they received same level of care compared to face-to-face consultations and 98% agreed their issues were addressed. Of eSurvey responses 97% clinicians and 78% patients/carers indicated they would continue to use VCs in practice. Comments indicated dissatisfaction with lack of personal examination; some found technological issues to be barriers. Benefits discovered incidentally were empowering patient independence to live out their end-of-life desires while being treated/supported, improved service delivery, increased staff autonomy and upskilling staff.

CONCLUSION

Users in this study perceived VCs to have a place in CPC consultations. Using patient device enabled patient freedom, improved timeliness of clinical assessment, and communication to complement face-to-face consults, while minimizing infection risk. Unexpected, but valuable benefits were revealed. Workable technology is paramount.

摘要

背景

澳大利亚新南威尔士州一个地区的社区姑息治疗团队(CPCT)实施了远程医疗视频咨询(VC),以应对 COVID-19 大流行的限制,在没有临床医生的情况下使用患者的设备。

目的

评估患者/照顾者和临床医生使用 VC 进行 CPC 咨询的满意度;探索 VC 的优势和挑战。

方法

从 2020 年 4 月至 9 月,向 CPCT 护理的社区居住患者进行在线自我报告问卷调查;从患者/照顾者和临床医生的角度探索 VC 的优缺点。

结果

在完成的 126 份电子调查中(85 名临床医生;41 名患者/照顾者),97%的患者/照顾者和 97%的临床医生表示对 VC 满意。总的来说,93%的临床医生认为他们提供的护理水平与面对面检查相同;85%的患者/照顾者认为他们接受的护理水平与面对面咨询相同,98%的人认为他们的问题得到了解决。在电子调查的回复中,97%的临床医生和 78%的患者/照顾者表示他们将在实践中继续使用 VC。评论表明对缺乏个人检查不满意;一些人发现技术问题是障碍。意外发现的好处是增强了患者在接受治疗/支持的同时独立实现临终愿望的能力,改善了服务提供,增加了员工的自主权和提高了员工的技能。

结论

本研究的使用者认为 VC 在 CPC 咨询中有一席之地。使用患者设备使患者获得了自由,提高了临床评估的及时性,并补充了面对面咨询,同时最大限度地降低了感染风险。还揭示了意想不到但有价值的好处。可行的技术至关重要。

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