Dale Craig M, Ambreen Munazzah, Kang Sohee, Buchanan Francine, Pizzuti Regina, Gershon Andrea S, Rose Louise, Amin Reshma
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Tory Trauma Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Digit Health. 2024 Jan 27;10:20552076241228417. doi: 10.1177/20552076241228417. eCollection 2024 Jan-Dec.
Clinical management of ventilator-assisted individuals (VAIs) was challenged by social distancing rules during the COVID-19 pandemic. In May 2020, the Long-Term In-Home Ventilator Engagement (LIVE) Program was launched in Ontario, Canada to provide intensive digital care case management to VAIs. The purpose of this qualitative study was to explore the acceptability of the LIVE Program hosted via a digital platform during the COVID-19 pandemic from diverse perspectives.
We conducted a qualitative descriptive study (May 2020-April 2021) comprising semi-structured interviews with participants from eight home ventilation specialty centers in Ontario, Canada. We purposively recruited patients, family caregivers, and providers enrolled in LIVE. Content analysis and the theoretical concepts of acceptability, feasibility, and appropriateness were used to interpret findings.
A total of 40 individuals (2 VAIs, 18 family caregivers, 20 healthcare providers) participated. Participants described LIVE as acceptable as it addressed a longstanding imperative to improve care access, ease of use, and training provided; feasible for triaging problems and sharing information; and appropriate for timeliness of provider responses, workflows, and perceived value. Negative perceptions of acceptability among healthcare providers concerned digital workload and fit with existing clinical workflows. Perceived benefits accorded to LIVE included enhanced physical and psychological safety in the home, patient-provider relations, and VAI engagement in their own care.
Study findings identify factors influencing the LIVE Program's acceptability by patients, family caregivers, and healthcare providers during pandemic conditions including enhanced access to care, ease of case management triage, and VAI safety. Findings may inform the implementation of digital health services to VAIs in non-pandemic circumstances.
在新冠疫情期间，社交距离规定给呼吸机辅助患者（VAIs）的临床管理带来了挑战。2020年5月，加拿大安大略省启动了长期居家呼吸机参与（LIVE）项目，为VAIs提供强化数字护理病例管理。这项定性研究的目的是从不同角度探讨在新冠疫情期间通过数字平台开展的LIVE项目的可接受性。
我们进行了一项定性描述性研究（2020年5月至2021年4月），包括对加拿大安大略省八个家庭通气专科中心的参与者进行半结构化访谈。我们有目的地招募了参与LIVE项目的患者、家庭护理人员和提供者。采用内容分析以及可接受性、可行性和适宜性的理论概念来解释研究结果。
共有40人参与（2名VAIs患者、18名家庭护理人员、20名医疗保健提供者）。参与者认为LIVE项目是可接受的，因为它解决了长期以来改善护理可及性、易用性和所提供培训的迫切需求；在对问题进行分类和共享信息方面是可行的；在提供者响应的及时性、工作流程和感知价值方面是适宜的。医疗保健提供者对可接受性的负面看法涉及数字工作量以及与现有临床工作流程的契合度。LIVE项目的感知益处包括增强家庭中的身体和心理安全、患者与提供者的关系以及VAIs患者对自身护理的参与度。
研究结果确定了在疫情期间影响患者、家庭护理人员和医疗保健提供者对LIVE项目可接受性的因素，包括改善护理可及性、病例管理分类的便利性和VAIs患者的安全。研究结果可能为在非疫情情况下向VAIs患者提供数字健康服务提供参考。
