自新冠疫情以来欧洲全科医疗中远程医疗的应用:患者和从业者观点的范围综述
Use of telemedicine in general practice in Europe since the COVID-19 pandemic: A scoping review of patient and practitioner perspectives.
作者信息
Walley David, McCombe Geoff, Broughan John, O'Shea Conor, Crowley Des, Quinlan Diarmuid, Wann Catherine, Crowley Tadhg, Cullen Walter
机构信息
UCD School of Medicine, University College Dublin, Dublin 4, Ireland.
Irish College of General Practitioners, Dublin, Ireland.
出版信息
PLOS Digit Health. 2024 Feb 14;3(2):e0000427. doi: 10.1371/journal.pdig.0000427. eCollection 2024 Feb.
General practice is generally the first point of contact for patients presenting with COVID-19. Since the start of the COVID-19 pandemic general practitioners (GPs) across Europe have had to adopt to using telemedicine consultations in order to minimise the number of social contacts made. GPs had to balance two needs: preventing the spread of COVID-19, while providing their patients with regular care for other health issues. The aim of this study was to conduct a scoping review of the literature examining the use of telemedicine for delivering routine general practice care since the start of the pandemic from the perspectives of patients and practitioners. The six-stage framework developed by Arksey and O'Malley, with recommendations by Levac et al was used to review the existing literature. The study selection process was conducted according to the PRISMA Extension for Scoping Reviews guidelines. Braun and Clarke's' Thematic Analysis' approach was used to interpret data. A total of eighteen studies across nine countries were included in the review. Thirteen studies explored the practitioner perspective of the use of telemedicine in general practice since the COVID-19 pandemic, while five studies looked at the patient perspective. The types of studies included were: qualitative studies, literature reviews, a systematic review, observational studies, quantitative studies, Critical incident technique study, and surveys employing both closed and open styled questions. Key themes identified related to the patient/ practitioner experience and knowledge of using telemedicine, patient/ practitioner levels of satisfaction, GP collaboration, nature of workload, and suitability of consultations for telemedicine. The nature of general practice was radically changed during the COVID-19 pandemic. Certain patient groups and areas of clinical and administrative work were identified as having performed well, if not better, by using telemedicine. Our findings suggest a level of acceptability and satisfaction of telemedicine by GPs and patients during the pandemic; however, further research is warranted in this area.
全科医疗通常是新冠病毒病患者的首个接触点。自新冠病毒病大流行开始以来,欧洲各地的全科医生不得不采用远程医疗咨询,以尽量减少社交接触的次数。全科医生必须平衡两项需求:防止新冠病毒病传播,同时为患者提供其他健康问题的常规护理。本研究的目的是从患者和从业者的角度,对自疫情开始以来使用远程医疗提供常规全科医疗服务的文献进行范围综述。采用了由阿克西和奥马利开发并经莱瓦克等人推荐的六阶段框架来回顾现有文献。研究选择过程是根据《系统综述与Meta分析扩展版范围综述指南》进行的。采用了布劳恩和克拉克的“主题分析”方法来解释数据。该综述共纳入了九个国家的18项研究。13项研究探讨了自新冠病毒病大流行以来从业者对远程医疗在全科医疗中应用的看法,而5项研究着眼于患者的看法。纳入的研究类型包括:定性研究、文献综述、系统综述、观察性研究、定量研究、关键事件技术研究以及采用封闭式和开放式问题的调查。确定的关键主题涉及患者/从业者使用远程医疗的体验和知识、患者/从业者的满意度水平、全科医生的协作、工作量的性质以及远程医疗咨询的适用性。在新冠病毒病大流行期间,全科医疗的性质发生了根本性变化。某些患者群体以及临床和行政工作领域被确定为通过使用远程医疗表现良好,甚至更好。我们的研究结果表明,在大流行期间,全科医生和患者对远程医疗有一定程度的接受度和满意度;然而,该领域仍需进一步研究。