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探索慢性病患者远程医疗利用与治疗负担之间的关系:加拿大安大略省的一项横断面研究。

Exploring the relationship between telehealth utilization and treatment burden among patients with chronic conditions: A cross-sectional study in Ontario, Canada.

作者信息

Tahsin Farah, Steele Gray Carolyn, Shaw Jay, Shachak Aviv

机构信息

Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario Canada.

出版信息

PLOS Digit Health. 2024 Oct 15;3(10):e0000610. doi: 10.1371/journal.pdig.0000610. eCollection 2024 Oct.

Abstract

One in five Canadians lives with one or more chronic conditions. Patients with chronic conditions often experience a high treatment burden because of the work associated with managing care. Telehealth is considered a useful solution to reduce the treatment burden among patients with chronic conditions. However, telehealth can also increase the treatment burden by offloading responsibilities on patients. This cross-sectional study conducted in Ontario, Canada examines the association between telehealth utilization and treatment burden among patients with chronic conditions. This study aimed to explore whether and to what extent, telehealth use is associated with treatment burden among patients with chronic conditions. The secondary objective was to explore which sociodemographic variables are associated with patients' treatment burden. An online survey was administered to community-dwelling patients with one or more chronic conditions. The Treatment Burden Questionnaire (TBQ-15) was used to measure the patient's level of treatment burden, and a modified telehealth usage scale was developed and used to measure the frequency of telehealth use. Data was analyzed using descriptive statistics, correlations, analyses of variance, and hierarchical linear regression analysis. A total of 75 patients completed the survey. The participants' mean age was 64 (SD = 18.93) and 79% were female. The average reported treatment burden was 72.15 out of 150 (a higher score indicating a higher level of burden). When adjusted for demographic variables, a higher frequency of telehealth use was associated with experiencing a higher treatment burden, but the association was not statistically significant. Additionally, when adjusted for demographic variables, younger age, and the presence of an unpaid caregiver were positively related to a high treatment burden score. This finding demonstrates that some patient populations are more at risk of experiencing high treatment burden in the context of telehealth use; and hence, may require extra support to utilize telehealth technologies. The study highlights the need for further research to explore how to minimize the treatment burden among individuals with higher healthcare needs.

摘要

五分之一的加拿大人患有一种或多种慢性病。慢性病患者由于管理护理工作往往承受着较高的治疗负担。远程医疗被认为是减轻慢性病患者治疗负担的有效解决方案。然而,远程医疗也可能通过将责任转嫁给患者而增加治疗负担。这项在加拿大安大略省进行的横断面研究,考察了慢性病患者远程医疗使用与治疗负担之间的关联。本研究旨在探讨远程医疗的使用是否以及在多大程度上与慢性病患者的治疗负担相关。次要目标是探讨哪些社会人口统计学变量与患者的治疗负担相关。对患有一种或多种慢性病的社区居民患者进行了在线调查。使用治疗负担问卷(TBQ - 15)来衡量患者的治疗负担水平,并开发了一个改良的远程医疗使用量表来衡量远程医疗的使用频率。使用描述性统计、相关性分析、方差分析和分层线性回归分析对数据进行了分析。共有75名患者完成了调查。参与者的平均年龄为64岁(标准差 = 18.93),79%为女性。报告的平均治疗负担在150分中为72.15分(分数越高表明负担水平越高)。在对人口统计学变量进行调整后,更高频率的远程医疗使用与更高的治疗负担相关,但这种关联在统计学上并不显著。此外,在对人口统计学变量进行调整后,年龄较小以及有无偿护理人员与较高的治疗负担得分呈正相关。这一发现表明,在使用远程医疗的情况下,一些患者群体承受高治疗负担的风险更高;因此,可能需要额外的支持来使用远程医疗技术。该研究强调需要进一步研究,以探索如何将医疗需求较高者的治疗负担降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d839/11478863/c6047b44db6a/pdig.0000610.g001.jpg

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