Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
PLoS One. 2024 Jun 4;19(6):e0304618. doi: 10.1371/journal.pone.0304618. eCollection 2024.
Patients from equity-deserving populations, such as those who are from racialized communities, the 2SLGBTQI+ community, who are refugees or immigrants, and/or who have a disability, may experience a unique set of challenges accessing virtual models of care. The objective of this qualitative study was to describe the experiences of patients from equity-deserving communities and their family members who received care from a Virtual Emergency Department (ED) in Toronto, Canada. Forty-three participants (36 patients and 7 family caregivers) with different and intersecting identities who used the Virtual ED participated in the study. Semi-structured interviews were conducted to explore reasons for accessing the Virtual ED, barriers to access, and how the Virtual ED met their care needs and expectations, including ways their experience could have been improved. Thematic analysis was used to identify themes from the data. Patients from equity-deserving populations described negative past experiences with ED in-person care, which included recounts of discrimination or culturally insensitive care while waiting to see the ED physician or nurse. Conversely, participants found the Virtual ED to be a socially and culturally safe space since they could now by-pass the waiting room experience. However, virtual care could not replace in-person care for certain issues (e.g., physical exam), and there was a need for greater promotion of the service to specific communities that might benefit from having access to the Virtual ED. Targeted outreach to help raise awareness of the service to equity-deserving communities is an important future direction.
从公平权益群体(例如,来自种族化社区、2SLGBTQI+ 社区、难民或移民以及/或者有残疾的人群)来的患者可能会在使用虚拟护理模式时遇到独特的挑战。本定性研究的目的是描述在加拿大多伦多使用虚拟急诊部(ED)接受护理的公平权益群体患者及其家属的经历。43 名参与者(36 名患者和 7 名家属照顾者)具有不同和交叉的身份,他们使用了虚拟 ED。进行了半结构化访谈,以探讨他们使用虚拟 ED 的原因、访问障碍以及虚拟 ED 如何满足他们的护理需求和期望,包括如何改进他们的体验。使用主题分析从数据中确定主题。来自公平权益群体的患者描述了他们在 ED 面对面护理方面的负面过往经历,包括在等待看 ED 医生或护士时遭受歧视或文化不敏感的护理。相比之下,参与者认为虚拟 ED 是一个社会和文化安全的空间,因为他们现在可以绕过等候室的体验。然而,虚拟护理不能替代某些问题的面对面护理(例如,体检),并且需要向可能受益于访问虚拟 ED 的特定社区更广泛地推广该服务。针对特定社区的定向外展活动,以提高对该服务的认识,是未来的一个重要方向。