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转向远程会诊有何影响?一项针对初级和二级医疗保健的定性访谈研究。

What is the impact of a shift to remote consultations? A qualitative interview study in primary and secondary healthcare.

作者信息

Chaloner Chris, Stevenson Fiona A, Rehill Nirandeep, Halvorsrud Kristoffer, Raine Rosalind, Barratt Helen

机构信息

Research Department of Primary Care and Population Health, Institute of Epidemiology & Health Care, UCL, London, UK.

Research Department of Primary Care and Population Health, Institute of Epidemiology & Health Care, UCL, London, UK

出版信息

BMJ Open. 2025 Jun 13;15(6):e097633. doi: 10.1136/bmjopen-2024-097633.

Abstract

OBJECTIVE

The COVID-19 pandemic prompted a significant increase in the use of remote consultations-by telephone or video-in both primary and secondary healthcare. The reported advantages of remote consulting for both patients and clinicians include greater efficiency, flexibility and convenience. However, disadvantages, such as the uncertainty created by a loss of face-to-face contact, have also been highlighted. The aim of this study was to explore, explain and interpret patients' and clinicians' perceptions and experiences of remote consultations and assist decision-making about their future use.

DESIGN

A qualitative study based on semistructured online interviews.

SETTING

Primary mental healthcare or secondary care cardiology services, London, UK, February-March 2022.

PARTICIPANTS

Primary care mental health patients (n=5), primary care clinicians (general practitioners) (n=15), secondary care cardiology patients (n=9) and secondary care cardiology clinicians (n=5).

RESULTS

The results demonstrate that a range of factors have influenced the experiences of both clinicians and patients and indicate shifts in the norms of professional practice and clinician-patient relationships.

CONCLUSIONS

Patients and clinicians demonstrated pragmatic acceptance of remote consultations and, looking forward, a preference for a balanced 'hybrid model' of remote and face-to-face appointments. The study also highlights a need to consolidate and build on the informal learning and adaptation to remote consulting that has already taken place.

摘要

目的

新冠疫情促使初级和二级医疗保健机构中通过电话或视频进行的远程会诊使用量大幅增加。据报道,远程会诊对患者和临床医生的优势包括更高的效率、灵活性和便利性。然而,诸如面对面接触缺失所带来的不确定性等劣势也已被凸显。本研究的目的是探索、解释和解读患者及临床医生对远程会诊的看法和体验,并协助对其未来使用进行决策。

设计

基于半结构化在线访谈的定性研究。

背景

英国伦敦的初级精神卫生保健或二级心脏病学服务,2022年2月至3月。

参与者

初级保健精神卫生患者(n = 5)、初级保健临床医生(全科医生)(n = 15)、二级保健心脏病学患者(n = 9)和二级保健心脏病学临床医生(n = 5)。

结果

结果表明,一系列因素影响了临床医生和患者的体验,并表明专业实践规范和医患关系发生了变化。

结论

患者和临床医生对远程会诊表现出务实的接受态度,展望未来,他们更倾向于远程和面对面预约相结合的“混合模式”。该研究还强调了巩固和基于已经发生的非正式学习及对远程会诊的适应的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a16/12164634/677086d27d0b/bmjopen-15-6-g001.jpg

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