Lewis Heledd, Taubert Mark, Nelson Annmarie
Velindre University NHS Trust, Cardiff, CF14 2TL, UK.
School of Medicine, Marie Curie Palliative Care Research Centre, Cardiff, UK.
BMC Palliat Care. 2024 May 2;23(1):114. doi: 10.1186/s12904-024-01400-y.
To maintain continuity of care during the Covid-19 pandemic, virtual consultations (VC) became the mainstay of patient-healthcare practitioner interactions. The aim of this study was to explore the views of oncology and palliative care healthcare professionals (HCPs) regarding the medium of VC.
A cross sectional mixed methodology observational study of oncology and palliative care HCPs, analysed via an inductive thematic approach. This was undertaken in accordance with relevant guidelines and regulations.
87 surveys were completed. Three master themes were identified. Personal, professional, and familial factors including patient age, illness and VC skillset all influenced practitioner's experience of VC. Relationships and connection were highlighted by survey respondents as important influences, with a perception that VC could reduce usual relationships with patients, compared to previous face-to-face consults. There was a perceived loss in these domains with VC. Sharing bad news and having challenging conversations was seen as particularly difficult via VC. Many survey respondents emphasized that they preferred to have first time consultations face-to-face, and not virtually. Within the domain of logistical and practical implications reduced travel and increased accessibility were seen as a significant benefit of VC. The inability to examine patients and concerns regarding missing clinical signs was emphasised as a significant worry, alongside the challenges faced with occasionally failing technology.
VC were felt to have a role for those patients who are already known to professionals, where there was an established relationship. VC for difficult discussions and for unstable patients were felt to be inadequate. Triaging patient suitability prior to offering VC, with emphasis on the importance of patient choice, was seen as a priority in this new era of VC.
在新冠疫情期间为保持医疗服务的连续性,虚拟会诊(VC)成为了患者与医护人员互动的主要方式。本研究旨在探讨肿瘤学和姑息治疗医护人员(HCPs)对虚拟会诊方式的看法。
对肿瘤学和姑息治疗医护人员进行横断面混合方法观察性研究,采用归纳主题分析法进行分析。该研究是按照相关指南和规定进行的。
共完成87份调查问卷。确定了三个主要主题。个人、专业和家庭因素,包括患者年龄、疾病和虚拟会诊技能,均会影响医护人员的虚拟会诊体验。调查对象强调关系和联系是重要影响因素,他们认为与之前的面对面会诊相比,虚拟会诊可能会减少与患者的日常关系。虚拟会诊在这些方面存在明显缺失。通过虚拟会诊分享坏消息和进行具有挑战性的对话被认为特别困难。许多调查对象强调他们更倾向于首次会诊采用面对面方式,而非虚拟方式。在后勤和实际影响方面,减少出行和增加可及性被视为虚拟会诊的显著益处。无法对患者进行检查以及对遗漏临床体征的担忧被视为重大问题,同时技术偶尔出现故障也带来了挑战。
对于那些医护人员已经认识且存在既定关系的患者,虚拟会诊被认为有一定作用。但对于进行困难讨论和不稳定患者的虚拟会诊则被认为存在不足。在提供虚拟会诊之前对患者适用性进行分类,并强调患者选择的重要性,在这个虚拟会诊的新时代被视为优先事项。