Lindblad Katrine Vammen, Bødtcher Hanne, Sørensen Dina Melanie, Rosted Elizabeth, Kjeldsted Eva, Christensen Helle Gert, Svendsen Mads Nordahl, Thomsen Linda Aagaard, Dalton Susanne Oksbjerg
Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark.
Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde and Naestved, Denmark.
Digit Health. 2024 Dec 19;10:20552076241304870. doi: 10.1177/20552076241304870. eCollection 2024 Jan-Dec.
During the COVID-19 pandemic, changes were made in cancer care including increased use of teleconsultations (TCs) and restrictions for relatives to attend in-person appointments at the outpatient clinics. This study aimed to provide in-depth information on healthcare professionals' experiences of TC and the limited access for relatives during the COVID-19 pandemic in 2020.
This qualitative study was conducted at an oncological department responsible for oncological care of all patients with cancer in one of five health regions in Denmark. Fourteen healthcare professionals participated in three semi-structured focus group interviews with either secretaries and nurses or physicians, and one semi-structured individual interview with a secretary. Data were analyzed by thematic analysis.
Four overall themes emerged in the thematic analysis: "Possibilities and limitations in relation to TC," "Information load and timing," "Insecurity" and "Lessons learned for the future." Healthcare professionals missed face-to-face interactions, feared to overlook patients' symptoms and relapse during TC, agreed that TC were not suitable for all types of consultations, and experienced improved work environment due to fewer patients and relatives at the department. Furthermore, patients should be involved in the decision of changing to TC, relatives must be recommended to participate in TC, physicians must meet the patient in-person before TC, and video consultations should be considered.
TC may be a valuable supplement to in-person consultations for patients with cancer in the future, and guidelines must be implemented to ensure suitable consultation types for TC, include patients' preferences, and involve relatives.
在新冠疫情期间，癌症护理发生了变化，包括增加了远程会诊（TC）的使用，并限制亲属前往门诊进行面对面预约。本研究旨在深入了解医疗保健专业人员在2020年新冠疫情期间进行远程会诊的经验以及亲属就诊受限的情况。
本定性研究在丹麦五个健康区域之一负责所有癌症患者肿瘤护理的肿瘤科进行。14名医疗保健专业人员参与了三次半结构化焦点小组访谈，分别与秘书和护士或医生进行，以及一次与一名秘书的半结构化个人访谈。数据通过主题分析进行分析。
主题分析中出现了四个总体主题：“与远程会诊相关的可能性和局限性”、“信息负荷和时机”、“不安全感”以及“对未来的经验教训”。医疗保健专业人员怀念面对面交流方式，担心在远程会诊期间忽略患者症状和复发情况，一致认为远程会诊并非适用于所有类型咨询，且由于科室患者和亲属减少，工作环境得到改善。此外，患者应参与转向远程会诊的决策，必须建议亲属参与远程会诊，医生在进行远程会诊前必须亲自会见患者，并且应考虑视频会诊。
未来远程会诊可能是癌症患者面对面会诊的宝贵补充，必须实施相关指南，以确保远程会诊有合适的会诊类型，纳入患者偏好，并让亲属参与其中。
