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利益相关者对心血管疾病延迟和误诊的原因及其对数字健康技术的影响的看法:基于英国的一项定性研究。

Stakeholder perspectives on contributors to delayed and inaccurate diagnosis of cardiovascular disease and their implications for digital health technologies: a UK-based qualitative study.

机构信息

School of Psychology, University of Sussex, Falmer, UK

School of Psychology, University of Sussex, Falmer, UK.

出版信息

BMJ Open. 2024 May 20;14(5):e080445. doi: 10.1136/bmjopen-2023-080445.

Abstract

OBJECTIVE

The aim of this study is to understand stakeholder experiences of diagnosis of cardiovascular disease (CVD) to support the development of technological solutions that meet current needs. Specifically, we aimed to identify challenges in the process of diagnosing CVD, to identify discrepancies between patient and clinician experiences of CVD diagnosis, and to identify the requirements of future health technology solutions intended to improve CVD diagnosis.

DESIGN

Semistructured focus groups and one-to-one interviews to generate qualitative data that were subjected to thematic analysis.

PARTICIPANTS

UK-based individuals (N=32) with lived experience of diagnosis of CVD (n=23) and clinicians with experience in diagnosing CVD (n=9).

RESULTS

We identified four key themes related to delayed or inaccurate diagnosis of CVD: symptom interpretation, patient characteristics, patient-clinician interactions and systemic challenges. Subthemes from each are discussed in depth. Challenges related to time and communication were greatest for both stakeholder groups; however, there were differences in other areas, for example, patient experiences highlighted difficulties with the psychological aspects of diagnosis and interpreting ambiguous symptoms, while clinicians emphasised the role of individual patient differences and the lack of rapport in contributing to delays or inaccurate diagnosis.

CONCLUSIONS

Our findings highlight key considerations when developing digital technologies that seek to improve the efficiency and accuracy of diagnosis of CVD.

摘要

目的

本研究旨在了解利益相关者在心血管疾病(CVD)诊断方面的体验,以支持开发满足当前需求的技术解决方案。具体而言,我们旨在确定 CVD 诊断过程中的挑战,识别患者和临床医生在 CVD 诊断方面的体验差异,并确定旨在改善 CVD 诊断的未来健康技术解决方案的要求。

设计

半结构化焦点小组和一对一访谈,以生成定性数据,并进行主题分析。

参与者

英国有 CVD 诊断经验的个人(n=23)和有 CVD 诊断经验的临床医生(n=9)。

结果

我们确定了与 CVD 延迟或不准确诊断相关的四个关键主题:症状解释、患者特征、患者-临床医生互动和系统挑战。每个主题的子主题都进行了深入讨论。对于两个利益相关者群体来说,与时间和沟通相关的挑战最大;然而,在其他方面也存在差异,例如,患者体验强调了诊断的心理方面和解释模棱两可症状的困难,而临床医生则强调了个体患者差异和缺乏融洽关系在导致延迟或不准确诊断方面的作用。

结论

我们的研究结果强调了在开发旨在提高 CVD 诊断效率和准确性的数字技术时需要考虑的关键因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bec1/11110589/475002174faa/bmjopen-2023-080445f01.jpg

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