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远程医疗在加强老年人姑息治疗中的作用:机遇与挑战。

The role of telemedicine in enhancing palliative care for older adults: opportunities and challenges.

作者信息

Mukamal Roni Chaim, Dias Laiane Moraes, Sarti Thiago Dias, Nunes Rui, Rego Guilhermina

机构信息

Faculty of Medicine/Federal Council of Medicine, University of Porto, Porto, Portugal.

Faculty of Medicine, Federal University of Espírito Santo, Vitória, Brazil.

出版信息

BMC Geriatr. 2025 Jul 2;25(1):474. doi: 10.1186/s12877-025-06041-1.


DOI:10.1186/s12877-025-06041-1
PMID:40604531
Abstract

BACKGROUND AND OBJECTIVE: Telemedicine holds promise for older adults with chronic and complex conditions, particularly those in need of palliative care. However, more information is needed about the perceptions of patients and their caregivers regarding this technology for providing care. Therefore, this study aims to explore the experience of non-oncologic older adult patients in palliative care with telemedicine. METHODS: We followed Arksey and O'Malley's five-stage scoping review approach and conducted searches in Medline, Scopus, and Web of Science databases. Key concepts included: "telemedicine" or "telehealth"; "elderly" or "old age" or "geriatric"; "palliative care" and NO "cancer" and were included articles written in English or Portuguese from the last five years. RESULTS: Eighteen articles were included out of 137 abstracts selected. Most studies focused on elderly individuals in homebound settings, nursing homes, or long-term care facilities. The experiences reported in many articles were positive, with patients and caregivers expressing a willingness to use telemedicine. It was particularly convenient for patients in rural areas. However, several barriers were identified, such as difficulties in using and accessing technology and concerns about privacy, influencing the willingness to use telemedicine. CONCLUSIONS: Telemedicine can be beneficial in the care of older adults with non-oncologic chronic disease, multimorbidity, and life-threatening conditions. Nevertheless, understanding this barrier and searching for solutions from the patients' perspectives is essential for integrating telemedicine into their care. More studies involving older adults palliative care patients are needed to explore this area further.

摘要

背景与目的:远程医疗有望为患有慢性和复杂疾病的老年人,尤其是那些需要姑息治疗的老年人提供帮助。然而,对于患者及其护理人员对这种护理技术的看法,还需要更多信息。因此,本研究旨在探讨非肿瘤老年姑息治疗患者使用远程医疗的体验。 方法:我们遵循阿克西和奥马利的五阶段范围综述方法,在Medline、Scopus和科学网数据库中进行检索。关键概念包括:“远程医疗”或“远程健康”;“老年人”或“老年”或“老年医学”;“姑息治疗”且不包括“癌症”,纳入过去五年用英文或葡萄牙文撰写的文章。 结果:在筛选出的137篇摘要中,有18篇文章被纳入。大多数研究关注居家、养老院或长期护理机构中的老年人。许多文章报道的体验是积极的,患者和护理人员表示愿意使用远程医疗。这对农村地区的患者尤其方便。然而,也发现了一些障碍,如使用和获取技术困难以及对隐私的担忧,这些影响了使用远程医疗的意愿。 结论:远程医疗在护理患有非肿瘤慢性疾病、多种疾病和危及生命疾病的老年人方面可能有益。然而,从患者角度理解这些障碍并寻找解决方案对于将远程医疗纳入他们的护理至关重要。需要更多涉及老年姑息治疗患者的研究来进一步探索这一领域。

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本文引用的文献

[1]
Unresolved Palliative Care Needs of Elderly Non-Cancer Patients at Home: A Multicenter Prospective Study.

J Prim Care Community Health. 2023

[2]
Advantages and Challenges of Using Telehealth for Home-Based Palliative Care: Systematic Mixed Studies Review.

J Med Internet Res. 2023-3-13

[3]
Assessing Technical Feasibility and Acceptability of Telehealth Palliative Care in Nursing Homes.

Palliat Med Rep. 2022-8-22

[4]
Perceived benefits of geriatric specialty telemedicine among rural patients and caregivers.

Health Serv Res. 2023-2

[5]
Gap in Willingness and Access to Video Visit Use Among Older High-risk Veterans: Cross-sectional Study.

J Med Internet Res. 2022-4-8

[6]
Editorial: Covid-19 and Virtual Geriatric Care.

J Nutr Health Aging. 2022

[7]
Data privacy concerns and use of telehealth in the aged care context: An integrative review and research agenda.

Int J Med Inform. 2022-4

[8]
Telehealth was beneficial during COVID-19 for older Americans: A qualitative study with physicians.

J Am Geriatr Soc. 2021-11

[9]
Virtual models of care for people with palliative care needs living in their own home: A systematic meta-review and narrative synthesis.

Palliat Med. 2021-9

[10]
Disparities in access to palliative care facilities for patients with and without cancer: A retrospective review.

Palliat Med. 2021-6

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