School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith 2751 NSW Australia.
Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Level 11, East Tower, 410 Ann Street, Brisbane, Qld 4000, Australia.
Women Birth. 2024 Mar;37(2):419-427. doi: 10.1016/j.wombi.2023.12.008. Epub 2024 Jan 12.
To reduce transmission risk during the COVID-19 pandemic, 'telehealth' (health care delivered via telephone/video-conferencing) was implemented into Australian maternity services. Whilst some reports on telehealth implementation ensued, there was scant evidence on women and midwives' perspectives regarding telehealth use.
A qualitative study was conducted in Australia during 2020-2021 using two data sources from the Birth in the Time of COVID-19 (BITTOC) study: i) interviews and ii) surveys (open-text responses). Content analysis was utilised to analyse the data and explore telehealth from the perspective of midwives and women accessing maternity care services. In-depth interviews were conducted with 20 women and 16 midwives. Survey responses were provided from 687 midwives and 2525 women who were pregnant or gave birth in 2021, generating 212 and 812 comments respectively.
Telehealth delivery was variable nationally and undertaken primarily by telephone/videoconferencing. Perceived benefits included: reduced COVID-19 transmission risk, increased flexibility, convenience and cost efficiency. However, women described inadequate assessment, and negative impacts on communication and rapport development. Midwives had similar concerns and also reported technological challenges.
During the COVID-19 pandemic, telehealth offered flexibility, convenience and cost efficiency whilst reducing COVID-19 transmission, yet benefits came at a cost. Telehealth may particularly suit women in rural and remote areas, however, it also has the potential to further reduce equitable, and appropriate care delivery for those at greatest risk of poor outcomes. Telehealth may play an adjunct role in post-pandemic maternity services, but is not a suitable replacement to traditional face-to-face maternity care.
为降低 COVID-19 大流行期间的传播风险，澳大利亚的产妇保健服务中引入了“远程医疗”（通过电话/视频会议提供的医疗保健）。虽然随后有一些关于远程医疗实施情况的报告，但关于妇女和助产士对远程医疗使用的看法的证据很少。
本研究于 2020-2021 年在澳大利亚开展，利用来自 COVID-19 时期分娩研究（Birth in the Time of COVID-19，BITTOC）的两个数据源：i）访谈和 ii）调查（开放式文本回复）。采用内容分析法分析数据，并从接受产妇保健服务的助产士和妇女的角度探讨远程医疗。对 20 名妇女和 16 名助产士进行了深入访谈。对 2021 年怀孕或分娩的 687 名助产士和 2525 名妇女进行了调查回复，分别产生 212 条和 812 条评论。
远程医疗的实施情况在全国范围内各不相同，主要通过电话/视频会议进行。认为的好处包括降低 COVID-19 传播风险、增加灵活性、便利性和成本效益。然而，妇女描述了评估不足，以及对沟通和关系建立的负面影响。助产士也有类似的担忧，并报告了技术挑战。
在 COVID-19 大流行期间，远程医疗提供了灵活性、便利性和成本效益，同时降低了 COVID-19 的传播风险，但好处是有代价的。远程医疗可能特别适合农村和偏远地区的妇女，但也有可能进一步减少对那些最有可能出现不良结局的人公平和适当的护理服务。远程医疗可能在大流行后产妇保健服务中发挥辅助作用，但不能替代传统的面对面产妇保健。
