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通过视频会诊进行急诊护理:对瑞典北部农村社区医院患者体验的访谈

Emergency care via video consultation: interviews on patient experiences from rural community hospitals in northern Sweden.

作者信息

Ärlebrant Lina, Dubois Hanna, Creutzfeldt Johan, Edin-Liljegren Anette

机构信息

Department of Epidemiology and Global Health, Umeå University, Centre for Rural Health, Region Västerbotten, Storuman, Sweden.

Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.

出版信息

Int J Emerg Med. 2024 Sep 3;17(1):109. doi: 10.1186/s12245-024-00703-4.

Abstract

BACKGROUND

Delivering emergency care in rural areas can be challenging, but video consultation (VC) offers opportunities to make healthcare more accessible. The communication and relationship between professionals and patients have a significant impact on the patient's experience of safety and inclusion. Understanding the patient perspective is crucial to developing good quality healthcare, but little is known about patient experiences of emergency care via VC in a rural context. The aim of this study was to explore patient experiences of emergency care via VC in northern rural Sweden.

METHODS

Using a qualitative approach, semi- structured interviews (n = 12) were conducted with individuals aged 18-89 who had received emergency care with a registered nurse (RN) on site and VC with a general practitioner (GP). The interviews were conducted between October 2021 and March 2023 at community hospitals (n = 7) in Västerbotten County, Sweden. Interviews were analysed with content analysis.

RESULTS

The analysis resulted in main categories (n = 2), categories (n = 5) and subcategories (n = 20). In the main category, "We were a team of three", patients described a sense of inclusion and ability to contribute. The patients perceived the interaction between the GP and RN to function well despite being geographically dispersed. Patients highly valued the opportunity to speak directly to the GP. In the main category, "VC was a two-sided coin", some experienced the emergency care through VC to be effective and smooth, while some felt that they received a lower quality of care and preferred face-to-face consultation with the GP. The quality of the VC was highly dependent on the RN's ability to function as the hub in the emergency room.

CONCLUSION

Patients in rural areas perceived being included in 'the team' during VC, however they experienced disadvantages with the system on individual basis. The nursing profession plays an important role, and a proper educational background is crucial to support RNs in their role as the hub of the visit. The GP's presence via VC was seen as important, but to fully enable them to fulfil their commitments as medical professionals, VC needs to be further improved with education and support from technical devices.

摘要

背景

在农村地区提供紧急护理可能具有挑战性,但视频会诊(VC)为提高医疗服务的可及性提供了机会。专业人员与患者之间的沟通和关系对患者的安全和融入体验有重大影响。了解患者的观点对于提供高质量的医疗服务至关重要,但在农村背景下,关于患者通过视频会诊接受紧急护理的体验知之甚少。本研究的目的是探讨瑞典北部农村地区患者通过视频会诊接受紧急护理的体验。

方法

采用定性研究方法,对18至89岁的个人进行了半结构化访谈(n = 12),这些人在现场接受了注册护士(RN)的紧急护理,并与全科医生(GP)进行了视频会诊。访谈于2021年10月至2023年3月在瑞典韦斯特博滕县的社区医院(n = 7)进行。采用内容分析法对访谈进行分析。

结果

分析得出主要类别(n = 2)、类别(n = 5)和子类别(n = 20)。在主要类别“我们是一个三人团队”中,患者描述了一种融入感和贡献能力。尽管地理位置分散,患者认为全科医生和注册护士之间的互动运作良好。患者高度重视直接与全科医生交谈的机会。在主要类别“视频会诊是一把双刃剑”中,一些人体验到通过视频会诊进行的紧急护理有效且顺利,而另一些人则觉得他们得到的护理质量较低,更喜欢与全科医生进行面对面会诊。视频会诊的质量高度依赖于注册护士在急诊室作为核心的能力。

结论

农村地区的患者在视频会诊期间感觉自己被纳入了“团队”,然而他们在个人层面上体验到了该系统存在的劣势。护理专业起着重要作用,适当的教育背景对于支持注册护士作为会诊核心的角色至关重要。通过视频会诊让全科医生在场被视为很重要,但为了使他们能够充分履行作为医疗专业人员的职责,需要通过教育和技术设备的支持进一步改进视频会诊。

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Exploring patient participation during video consultations: A qualitative study.探索视频会诊期间的患者参与度:一项定性研究。
Digit Health. 2023 Jun 5;9:20552076231180682. doi: 10.1177/20552076231180682. eCollection 2023 Jan-Dec.

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