Sota Takashi, Jackson Tim, Yang Eleanor, Lau Annie Y S
Centre for Health Informatics, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Science, Macquarie University, Sydney, Australia.
School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
Appl Clin Inform. 2025 Jan;16(1):56-66. doi: 10.1055/a-2425-8626. Epub 2024 Sep 30.
As teleconsultations continue to rise in popularity due to their convenience and accessibility, it is crucial to identify and address the challenges they present in order to improve the patient experience, enhance outcomes, and ensure the quality of care. To identify communication challenges that clinicians and patients experience during teleconsultation, a scoping review was conducted.
This study aimed to identify communication challenges that clinicians and patients experience during teleconsultation.
Studies were obtained from four databases (Ovid [MEDLINE], Ovid [Embase], CINAHL, and Scopus). Gray literatures were not included. Studies focused on communication challenges between clinicians and their patients during teleconsultation in the context of coronavirus disease 2019 (COVID-19) and published from January 2000 to December 2022, were collected. The screening process was conducted by two independent reviewers. Data extraction was performed using a standardized form to capture study characteristics and communication challenges. Extracted data were analyzed to identify the communication challenges during teleconsultation, adherent to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR).
A total of 893 studies were collected from four databases and 26 studies were selected based on inclusion/exclusion criteria. Of these 26 eligible studies, 12 (46%) were from the United States, 3 studies (12%) were from Australia, and 2 (8%) were from the United Kingdom and Canada. These studies included 12 (46%) qualitative studies, 6 (23%) quantitative studies, 6 (23%) review articles, and 2 (8%) case reports. Eight factors contributing to communication challenges between clinicians and patients during teleconsultations were identified: technical issues, difficulties in developing rapport, lack of non-verbal communication, lack of physical examination, language barrier, spatial issues, clinician preparation, and difficulties in assessing patients' health literacy.
Eight factors were identified as contributing to communication challenges during teleconsultation in the context of COVID-19. These findings highlight the need to address communication challenges to ensure effective teleconsultations. With the rise of teleconsultation in routine health care delivery, further research is warranted to confirm these findings and to explore ways to overcome communication challenges during teleconsultation.
由于远程会诊便捷且易于使用，其受欢迎程度持续上升，识别并应对其带来的挑战对于改善患者体验、提高治疗效果以及确保医疗质量至关重要。为了识别临床医生和患者在远程会诊过程中遇到的沟通挑战，开展了一项范围综述。
本研究旨在识别临床医生和患者在远程会诊过程中遇到的沟通挑战。
从四个数据库（Ovid [医学索引数据库（MEDLINE）]、Ovid [荷兰医学文摘数据库（Embase）]、护理学与健康领域数据库（CINAHL）和Scopus）获取研究。未纳入灰色文献。收集2000年1月至2022年12月发表的、聚焦于2019冠状病毒病（COVID-19）背景下临床医生与患者在远程会诊期间沟通挑战的研究。筛选过程由两名独立评审员进行。使用标准化表格进行数据提取，以获取研究特征和沟通挑战。对提取的数据进行分析，以识别远程会诊期间的沟通挑战，遵循系统评价与Meta分析的首选报告项目：范围综述（PRISMA-ScR）。
从四个数据库共收集到893项研究，根据纳入/排除标准选择了26项研究。在这26项符合条件的研究中，12项（46%）来自美国，3项（12%）来自澳大利亚，2项（8%）来自英国和加拿大。这些研究包括12项（46%）定性研究、6项（23%）定量研究、6项（23%）综述文章和2项（8%）病例报告。确定了导致临床医生与患者在远程会诊期间沟通挑战的八个因素：技术问题、难以建立融洽关系、缺乏非语言沟通、缺乏体格检查、语言障碍、空间问题、临床医生准备情况以及难以评估患者的健康素养。
确定了八个因素导致COVID-19背景下远程会诊期间的沟通挑战。这些发现凸显了应对沟通挑战以确保有效远程会诊的必要性。随着远程会诊在常规医疗服务中的兴起，有必要进行进一步研究以证实这些发现，并探索克服远程会诊期间沟通挑战的方法。
