Osman Abdelhady, Lee Seung Heyck, Noori Mateen, Al-Jaishi Melissa, Gallo Kerri, Harwood Lori, Moist Louise
Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Faculty of Medicine, University of Ottawa, ON, Canada.
Can J Kidney Health Dis. 2024 Oct 28;11:20543581241293192. doi: 10.1177/20543581241293192. eCollection 2024.
The COVID-19 pandemic notably disrupted care for patients with chronic kidney disease (CKD) care, necessitating a rapid shift to telemedicine. Despite the growing use of telemedicine, the impact of this transition on patients' experiences, particularly in Canada and considering sociocultural factors, remains underexplored. This study aims to investigate patients with CKD perspectives on telemedicine versus in-person care and to offer recommendations for enhancing telemedicine services.
The objective was to understand patients with CKD views on telemedicine clinics during the pandemic compared to traditional in-person clinics.
This was a qualitative descriptive study employing semi-structured interviews.
This study was conducted in general nephrology and multidisciplinary kidney care clinics in London, Canada.
The study population was English-speaking patients with CKD with at least one in-person nephrology visit before March 15, 2020, and one telemedicine appointment after March 30, 2020.
Interviews were conducted using a structured guide, with transcripts analyzed line-by-line by 3 independent reviewers through directed content analysis. Themes were identified and agreed upon through group consensus.
Interviews with 12 participants revealed 5 key themes: (1) convenience; (2) building connection and trust; (3) necessity of in-person care; (4) role of family or caregivers; and (5) preferences for clinic types. Most participants (11/12) valued the convenience of telemedicine, noting similar levels of care compared to in-person visits. However, they found it easier to establish personal connections in face-to-face appointments. Most (8/12) preferred in-person visits if their condition worsened. Overall, a combination of in-person and telemedicine was favored, with a preference for video over telephone.
The study's focus on one academic nephrology center in Ontario and predominantly white participants limits broader applicability. Additionally, recall bias may affect the findings due to the interview-based design.
Telemedicine will remain integral to CKD care, with a hybrid model combining in-person and telemedicine preferred. Integrating patient feedback into future telemedicine practices is essential to enhance flexibility, access, and patient satisfaction.
2019年冠状病毒病（COVID-19）大流行显著扰乱了慢性肾脏病（CKD）患者的护理，使得迅速转向远程医疗成为必要。尽管远程医疗的使用日益增加，但这种转变对患者体验的影响，尤其是在加拿大并考虑到社会文化因素，仍未得到充分探索。本研究旨在调查CKD患者对远程医疗与面对面护理的看法，并为改善远程医疗服务提供建议。
目的是了解大流行期间CKD患者对远程医疗诊所与传统面对面诊所的看法。
这是一项采用半结构化访谈的定性描述性研究。
本研究在加拿大伦敦的普通肾脏病学和多学科肾脏护理诊所进行。
研究对象为2020年3月15日前至少有一次面对面肾脏病学就诊且2020年3月30日后有一次远程医疗预约的讲英语的CKD患者。
使用结构化指南进行访谈，3名独立评审员通过定向内容分析逐行分析访谈记录。通过小组共识确定并认可主题。
对12名参与者的访谈揭示了5个关键主题：（1）便利性；（2）建立联系和信任；（3）面对面护理的必要性；（4）家庭或护理人员的作用；（5）对诊所类型的偏好。大多数参与者（11/12）重视远程医疗的便利性，指出与面对面就诊相比护理水平相似。然而，他们发现面对面预约更容易建立个人联系。如果病情恶化，大多数人（8/12）更喜欢面对面就诊。总体而言，倾向于将面对面和远程医疗相结合，更喜欢视频而非电话。
该研究对安大略省一个学术肾脏病学中心的关注以及主要为白人参与者限制了其更广泛的适用性。此外，由于基于访谈的设计，回忆偏差可能会影响研究结果。
远程医疗仍将是CKD护理不可或缺的一部分，更喜欢将面对面和远程医疗相结合的混合模式。将患者反馈纳入未来的远程医疗实践对于提高灵活性、可及性和患者满意度至关重要。
