门诊姑息关怀团队对姑息关怀中数字关怀会议的看法和需求:混合方法在线调查

A. S. Ebneter, Maud Maessen, Thomas C. Sauter, Georgette Jenelten, Steffen Eychmueller
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摘要

背景:远程医疗在姑息治疗(PC)中的应用越来越广泛,尤其是在地理距离较远的门诊环境中。其经证实的优点包括改善沟通、提高协调质量和节省时间。然而,对症状控制的效果却不太明显。这些优势是否适用于瑞士的医疗环境以及医疗保健专业人员(HCPs)的需求尚不清楚:目的:确定医疗保健专业人员(护士和医生)对瑞士门诊姑息关怀网络中远程医疗(一般和特别是关怀会议)的看法和需求。方法:我们对门诊姑息关怀团队的医护专业人员进行了横断面混合方法在线调查,作为质量改进项目(数字关怀会议)规划阶段的基线数据。结果:在接触的 251 名医护专业人员中,有 66 人做出了回应,包括护士(n = 37)和医生(n = 29),总体回应率为 26.6%。他们被分为两组:普通姑息关怀保健人员(n = 48,回复率为 21.3%)和专业姑息关怀保健人员(n = 18,回复率为 69.2%)。总体而言,远程医疗被认为是有用的。他们认为,远程医疗的优势在于可以方便地与其他医疗保健人员联系,从而改善沟通和协调。障碍包括缺乏接受度和实际接触、尚未解决的潜在数据泄露问题以及技术障碍。关于数字护理会议,人们认为其接受度和可行性都很好;首选参与者是专业的姑息关怀保健医生(护士和医生)、主治医生和家庭护理护士,以及一名护士的领导。医疗保健人员的需求如下(结论:在瑞士当地的姑息关怀网络中,医护人员认为数字关怀会议是一种可行且有用的工具。下一步将在试点阶段将这种远程医疗模式系统地整合到门诊姑息治疗中。
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Perceptions and needs of an outpatient palliative care team regarding digital care conferences in palliative care: a mixed-method online survey
BACKGROUND: Telemedicine in palliative care (PC) is increasingly being used, especially in outpatient settings with large geographic distances. Its proven benefits include improved communication, coordination quality and time savings. However, the effect on symptom control is less evident. Whether these benefits apply to the Swiss setting and the needs of healthcare professionals (HCPs) is unknown. OBJECTIVES: To identify the perceptions and needs of healthcare professionals (nurses and physicians) regarding telemedicine (generally and specifically for care conferences) in a Swiss outpatient palliative care network. METHODS: We conducted a cross-sectional, mixed-method online survey with purposefully sampled healthcare professionals from an outpatient palliative care team as baseline data during the planning phase of a quality improvement project (digital care conferences). FINDINGS/RESULTS: Of the 251 HCPs approached, 66 responded, including nurses (n = 37) and physicians (n = 29), with an overall response rate of 26.6%. These were distributed into two groups: general palliative care HCPs (n = 48, return rate 21.3%) and specialised palliative care HCPs (n = 18, return rate 69.2%). Generally, telemedicine was perceived as useful. Potential easy access to other HCPs and hence improved communication and coordination were perceived as advantages. Barriers included a lack of acceptance and physical contact, unsolved questions about potential data breaches and technical obstacles. Regarding digital care conferences, the perceived acceptance and feasibility were good; preferred participants were the specialised palliative care HCPs (nurses and physicians), primary physicians and home care nurses, as well as the leadership of a nurse. The needs of the HCPs were as follows: (a) clear and efficient planning, (b) usability and security and (c) visual contact with the patient. CONCLUSION: Digital care conferences are perceived as a feasible and useful tool by healthcare professionals in a local palliative care network in Switzerland. A pilot phase will be the next step towards systematic integration of this telemedicine modality into outpatient palliative care.
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