van Schalkwijk Dinah, Lodder Paul, Everaert Jonas, Widdershoven Jos, Habibović Mirela
Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands.
Cardiovasc Digit Health J. 2023 Dec 14;5(2):85-95. doi: 10.1016/j.cvdhj.2023.11.022. eCollection 2024 Apr.
During the COVID-19 pandemic, telemedicine was advocated and rapidly scaled up worldwide. However, little is known about for whom this type of care is acceptable.
To examine which patient characteristics (demographic, medical, psychosocial) are associated with telehealth care satisfaction, attitude toward telehealth, and preference regarding telehealth over time in a cardiac patient population.
In total, 317 patients were recruited at the Elisabeth-TweeSteden Hospital in The Netherlands. All patients who had received telehealth care (telephone and video) in the previous 2 months were approached for participation. Baseline, 3-month, and 6-month questionnaires were administered online. A 3-step latent class analysis was conducted to identify trajectories of telehealth use over time and the possible association of the found trajectories with external variables.
Five trajectories (classes) were identified for satisfaction with telehealth and 4 for attitude toward telehealth. Patients with higher distress, lower physical and mental health, higher scores on pessimism, and negative affectivity were more likely to be less satisfied. Patients with no partner, more comorbidities, higher distress, lower physical and mental health, and higher scores on pessimism were more likely to hold a negative attitude toward telehealth. For the future application of telehealth, marital status, comorbidities, digital health literacy, and pessimism were significantly related.
Results show that patients' profiles should be considered when offering telehealth care and that the "one size fits all" approach does not apply. Results can inform clinical practice on how to better implement remote health care in the future while considering a personalized approach.
在新冠疫情期间，远程医疗在全球范围内得到倡导并迅速推广。然而，对于哪些人接受这种医疗方式知之甚少。
研究在心脏病患者群体中，哪些患者特征（人口统计学、医学、心理社会特征）与远程医疗满意度、对远程医疗的态度以及随时间推移对远程医疗的偏好相关。
在荷兰的伊丽莎白 - 特维斯特登医院共招募了317名患者。邀请前两个月接受过远程医疗（电话和视频）的所有患者参与。通过在线方式发放基线、3个月和6个月的调查问卷。进行了三步潜在类别分析，以确定随时间推移远程医疗使用的轨迹以及所发现轨迹与外部变量的可能关联。
确定了5种远程医疗满意度轨迹（类别）和4种对远程医疗态度的轨迹。痛苦程度较高、身心健康状况较差、悲观得分较高以及消极情感性较强的患者更有可能不太满意。没有伴侣、合并症较多、痛苦程度较高、身心健康状况较差以及悲观得分较高的患者更有可能对远程医疗持消极态度。对于远程医疗的未来应用，婚姻状况、合并症、数字健康素养和悲观情绪显著相关。
结果表明，提供远程医疗时应考虑患者的特征，“一刀切”的方法并不适用。这些结果可为未来如何在考虑个性化方法的同时更好地实施远程医疗的临床实践提供参考。
