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[新冠疫情期间远程会诊的范围与局限性:来自布宜诺斯艾利斯自治市基层医疗专业人员的描述]

[Scope and limitations of teleconsultation during the covid-19 pandemic: accounts from primary healthcare professionals in the Autonomous City of Buenos Aires].

作者信息

Ganiele María de Las Nieves, Weisbrot Mariela Alejandra, Sian Andrea Melissa, Carosella Reboredo Julieta Milagros, Weisbrot María Victoria, Grande Ratti María Florencia

机构信息

Médica, investigadora, docente, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.

Magíster en Epidemiología, Gestión y Políticas de Salud. Investigadora, docente, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Salud Colect. 2024 Feb 16;20:e4579. doi: 10.18294/sc.2024.4579.

Abstract

The aim was to explore the scope and limitations of teleconsultation during the pandemic from the perspective of primary care physicians at the Hospital Italiano de Buenos Aires, a private institution located in the Autonomous City of Buenos Aires. A qualitative study was conducted with ten individual semi-structured interviews between January and April 2022. The three major emerging topics were the transition to virtuality, accessibility, and the new care model. Obstacles were related to the massive, forced, and unplanned implementation of teleconsultations. The main benefits included providing care during isolation-distancing and addressing epidemiological doubts. Changes were highlighted in care strategies, consultation frameworks, exchange among colleagues, referral criteria, requests for complementary studies, and in the profiles of those seeking consultations. A misuse of the system by individuals and a trivialization of the consultation moment emerged. The rise of communication and information technologies undoubtedly allowed the continuity of healthcare processes, but it does not replace in-person care, and normative guidelines are needed for its continuity.

摘要

目的是从位于布宜诺斯艾利斯自治市的一家私立机构——布宜诺斯艾利斯意大利医院的初级保健医生的角度,探讨疫情期间远程会诊的范围和局限性。2022年1月至4月期间,对10名医生进行了个人半结构化访谈,开展了一项定性研究。出现的三个主要话题是向虚拟模式的转变、可及性和新的护理模式。障碍与远程会诊的大规模、强制性和无计划实施有关。主要益处包括在隔离-社交距离期间提供护理以及解决流行病学疑问。护理策略、会诊框架、同事间交流、转诊标准、补充检查请求以及寻求会诊者的特征等方面都出现了变化。出现了个人对系统的滥用以及会诊时刻的 trivialization(此处原文该词含义不明,暂保留英文)。通信和信息技术的发展无疑使医疗保健过程得以持续,但它并不能取代面对面护理,其持续开展需要规范性指导方针。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b80e/11822899/601e3f009557/1851-8265-scol-20-e4579-gf1.jpg

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