O'Connor Úna, Crilly Geraldine
Respiratory Department, University Limerick Hospitals Group, Mid West Community Healthcare, HSE Mid West, Ireland.
Nurse Practice Development Unit, University Hospital Limerick, Limerick, Ireland.
J Adv Nurs. 2025 Apr;81(4):1700-1716. doi: 10.1111/jan.16493. Epub 2024 Oct 18.
To systematically identify, appraise and synthesise qualitative research evidence which examined the impact of telehealth on the experiences and perceptions of patients living with advanced chronic obstructive pulmonary disease, to inform the development of patient-centred telehealth.
Qualitative evidence synthesis.
CINAHL, Cochrane, Embase, PUBMED, MEDLINE, EThOS, Web of Science, PsycINFO, Lenus, DART, RIAN and ProQuest were searched for primary qualitative studies undertaken between 2008 and 2023.
A thematic synthesis of studies was undertaken to identify descriptive themes relating to patient views. Methodological quality was assessed using the Critical Appraisal Skills Programme framework, and confidence in review findings was assessed using the GRADE-CERQual approach.
Nine studies met the inclusion criteria and were included in the final synthesis. Four analytical themes were generated (1) telehealth as a facilitator of independence, (2) the influence of patient and healthcare provider relationship on successful engagement with telehealth, (3) usability of telehealth to patients living with advanced chronic obstructive pulmonary disease and (4) trusting virtual health services and facilitating confidence in the patient/service user. Five descriptive themes emerged: (i) individualised telehealth chronic obstructive pulmonary disease care (ownership and control), (ii) managing chronic obstructive pulmonary disease exacerbations, (iii) being heard and feeling understood, (iv) telehealth as an education aid and (v) aging and virtual technology.
Understanding the experiences of patients with chronic obstructive pulmonary disease and their engagement with telehealth is a necessary determinant of how best to utilise telehealth in this population and may serve to inform policymakers to further develop and implement telehealth into practice. Future research on patients and healthcare professionals' views on telehealth use in the palliative stage of this illness may also be valuable.
Findings add value by providing healthcare providers with additional evidence to improve understanding of both telehealth complexity and human experiences and perceptions. It is anticipated that a deeper understanding of chronic obstructive pulmonary disease patients' experiences and perceptions will inform the development of strategies to maximise and enhance the application of patient-centred telehealth within the context of coping and living with a debilitating condition.
No patient or public contribution was utilised in this study.
系统识别、评估和综合定性研究证据，这些证据探讨了远程医疗对晚期慢性阻塞性肺疾病患者体验和认知的影响，以为以患者为中心的远程医疗发展提供信息。
定性证据综合。
检索了CINAHL、Cochrane、Embase、PUBMED、MEDLINE、EThOS、科学网、PsycINFO、Lenus、DART、RIAN和ProQuest，以查找2008年至2023年期间开展的主要定性研究。
对研究进行主题综合，以识别与患者观点相关的描述性主题。使用批判性评估技能计划框架评估方法学质量，并使用GRADE-CERQual方法评估对综述结果的信心。
九项研究符合纳入标准并被纳入最终综合分析。产生了四个分析主题：（1）远程医疗作为独立的促进因素；（2）患者与医疗服务提供者关系对成功参与远程医疗的影响；（3）远程医疗对晚期慢性阻塞性肺疾病患者的可用性；（4）信任虚拟健康服务并增强患者/服务使用者的信心。出现了五个描述性主题：（i）个性化远程医疗慢性阻塞性肺疾病护理（自主权和控制权）；（ii）管理慢性阻塞性肺疾病急性加重；（iii）被倾听和被理解的感受；（iv）远程医疗作为教育辅助工具；（v）衰老与虚拟技术。
了解慢性阻塞性肺疾病患者的体验及其与远程医疗的互动，是确定如何在该人群中最佳利用远程医疗的必要决定因素，可能有助于为政策制定者提供信息，以进一步发展和实施远程医疗实践。未来关于患者和医疗专业人员对该疾病姑息阶段远程医疗使用看法的研究也可能具有价值。
研究结果通过为医疗服务提供者提供额外证据，以增进对远程医疗复杂性以及人类体验和认知的理解，从而增加了价值。预计对慢性阻塞性肺疾病患者体验和认知的更深入理解，将为制定策略提供信息，以在应对和生活于衰弱状况的背景下最大化和加强以患者为中心的远程医疗应用。
本研究未利用患者或公众参与。
