Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto ON, Canada.
Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
Age Ageing. 2024 Jan 2;53(1). doi: 10.1093/ageing/afad231.
BACKGROUND: During the COVID-19 pandemic, telemedicine was widely implemented to minimise viral spread. However, its use in the older adult patient population was not well understood. OBJECTIVE: To understand the perspectives of geriatric care providers on using telemedicine with older adults through telephone, videoconferencing and eConsults. DESIGN: Qualitative online survey study. SETTING AND PARTICIPANTS: We recruited geriatric care physicians, defined as those certified in Geriatric Medicine, Care of the Elderly (family physicians with enhanced skills training) or who were the most responsible physician in a long-term care home, in Ontario, Canada between 22 December 2020 and 30 April 2021. METHODS: We collected participants' perspectives on using telemedicine with older adults in their practice using an online survey. Two researchers jointly analysed free-text responses using the 6-phase reflexive thematic analysis. RESULTS: We recruited 29 participants. Participants identified difficulty using technology, patient sensory impairment, lack of hospital support and pre-existing high patient volumes as barriers against using telemedicine, whereas the presence of a caregiver and administrative support were facilitators. Perceived benefits of telemedicine included improved time efficiency, reduced travel, and provision of visual information through videoconferencing. Ultimately, participants felt telemedicine served various purposes in geriatric care, including improving accessibility of care, providing follow-up and obtaining collateral history. Main limitations are the absence of, or incomplete physical exams and cognitive testing. CONCLUSIONS: Geriatric care physicians identify a role for virtual care in their practice but acknowledge its limitations. Further work is required to ensure equitable access to virtual care for older adults.
背景:在 COVID-19 大流行期间,远程医疗被广泛应用以最大程度地减少病毒传播。然而,其在老年患者群体中的应用尚不清楚。
目的:通过电话、视频会议和电子咨询了解老年护理提供者对使用远程医疗为老年人提供服务的看法。
设计:定性在线调查研究。
设置和参与者:我们于 2020 年 12 月 22 日至 2021 年 4 月 30 日期间在加拿大安大略省招募了老年护理医生,定义为通过老年医学、老年护理(家庭医生,具有增强的技能培训)认证的医生,或在长期护理院担任最主要负责医生的医生。
方法:我们使用在线调查收集参与者对在其实践中使用远程医疗为老年人提供服务的看法。两名研究人员使用 6 阶段反思性主题分析联合分析了自由文本回复。
结果:我们招募了 29 名参与者。参与者认为使用远程医疗存在技术困难、患者感官障碍、缺乏医院支持以及患者数量高企等障碍,而有护理人员和行政支持则是促进因素。远程医疗的好处包括提高时间效率、减少旅行和通过视频会议提供视觉信息。最终,参与者认为远程医疗在老年护理中具有多种用途,包括改善护理的可及性、提供随访和获取间接病史。主要限制是缺乏或不完整的体检和认知测试。
结论:老年护理医生认为虚拟护理在他们的实践中有一定作用,但也承认其存在局限性。需要进一步努力确保老年患者能够公平地获得虚拟护理。
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