探索远程保健气功共享医疗预约的可行性和可接受性:扩大就医机会的新方法。

Global advances in integrative medicine and health Pub Date : 2024-09-11 eCollection Date: 2024-01-01 DOI:10.1177/27536130241283789
Michelle H Loy, Tim Fatato
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引用次数: 0

摘要

背景:有关气功(QG)的研究表明,气功对健康大有裨益。在过去十年中,美国成年人对气功的兴趣和使用率都有所增加。共享医疗预约(SMA)是一种新颖、经济、省时的医疗保健服务方式,患者和临床医生都很满意:在一家学术医学中心的综合医学实践中,对远程医疗提供的 QG SMA 在不同人群中进行了试点测试,以评估其可行性和可接受性:这是一项可行性/可接受性试点研究,于 2023 年 1 月至 7 月在纽约市一家大型学术医疗中心的中西医结合保健中心进行。一名QG指导员--针灸师和一名综合医学医生--针灸师通过远程医疗共同指导了3个独立系列(五行QG、八段锦和关节动员/新力量练习)的QG SMA课程,每周一次,每次30-45分钟,时间为工作日的下午。第一次课程包括 QG 和传统中医药研究概述,后续课程包括签到、QG 练习后的教学演示以及回答问题的汇报。课程还提供了视频链接,供学员在家练习。在系列活动前/后进行了满意度调查:在 6 个月的时间里,共开展了 18 次 QG SMA 课程。共有 40 名来自不同人口统计(性别、种族/民族、主要居住地)的独特参与者参加,虚拟访问总计 197 次。共有 20 人参加了系列 1(8 周),23 人参加了系列 2(7 周),16 人参加了系列 3(3 周)。每次小组活动的参加人数为 8-16 人,平均 11 人。参加者的出席率很高,平均出席率为 72%。在第一个为期 8 周的系列课程中,参与者参加了 88%的课程;在第二个为期 7 周的系列课程中,参与者参加了 54%的课程;在第三个系列课程中,参与者参加了 60%的课程。参与者的兴趣随着时间的推移而持续,40 名参与者中有 35% 参加了一个以上的系列课程,12.5% 参加了全部 3 个系列课程。参与者的诊断和健康症状包括疼痛(62.5%)、癌症(45%)、焦虑/抑郁(40%)、心血管疾病或代谢疾病(32.5%)、胃肠道症状/诊断(27.5%)、压力(22.5%)、骨质疏松症/骨质疏松症(17.5%)和失眠(17.5%)。系列活动前[n = 27]的参与者认可的症状包括睡眠障碍、疲劳、疼痛、压力、虚弱、消化道症状、心理症状、潮热和脑雾。课程结束后的调查结果[n = 11]表明,QG 课程解决了疲劳、失眠、焦虑、压力、疼痛、虚弱和胃肠道症状等常见症状。参与者表示,他们已将 QG、呼吸技巧和冥想融入了日常生活。所有参与者都表示他们的目标已经实现,并会向其他人推荐该计划。关于授课方式的偏好,73% 的人偏好远程医疗,27% 的人偏好混合式授课,没有人偏好面对面授课。参与者对课程形式、新技能、社区和讲师表示赞赏:虚拟 QG SMA 系列课程面向具有混合诊断的不同人口群体,是可行的、可接受的,并在此次试点中显示出积极的影响,但由于课程后调查的回复率较低,因此在解释数据时应谨慎。建议进行更长时间的随访研究。
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Exploring the Feasibility and Acceptability of Telehealth Qi Gong Shared Medical Appointments: A Novel Approach to Expand Access.

Background: Research on Qi Gong (QG) supports promising health benefits. Both interest and use of QG in U.S. adults has increased over the past decade. Shared Medical Appointments (SMAs) are a novel, cost-effective, and time efficient health care delivery approach associated with patient and clinician satisfaction.

Objectives: A telehealth delivered QG SMA was pilot tested among a diverse demographic population within an integrative medicine practice at an academic medical center to assess feasibility and acceptability.

Methods: This was a feasibility/acceptability pilot study conducted at a large New York City academic medical center's Integrative Health and Wellness center from January to July 2023. A QG instructor-acupuncturist and an integrative medicine physician-acupuncturist co-led 3 separate series (5 Element QG, Eight-Section Brocade, and Joint-Mobilizing/Sinew Strengthening exercises) of weekly 30-45-minute sessions of QG SMA on a weekday afternoon via telemedicine. The first session included an overview of QG and Traditional Chinese Medicine (TCM) research while follow-up sessions included a check-in, didactic demonstration followed by QG practice, and a debrief to answer questions. Video links were provided for home practice. Surveys assessing satisfaction were sent pre/post series.

Results: 18 sessions of QG SMA were offered over a 6-month period. A total of 40 unique participants from diverse demographics (gender, race/ethnicity, primary residence) attended, for a total of 197 virtual visits. A total of 20 participants enrolled in Series 1 (8 weeks), 23 enrolled in Series 2 (7 weeks), and 16 enrolled in Series 3 (3cweeks). For each session, group attendance ranged from 8-16 with an average of 11 participants. Attendance was high with participants attending an average of 72% of the sessions. Participants attended 88% of the first 8-week series, 54% of the second 7-week series, and 60% of the third series. Participant interest persisted over time with 35% of the 40 participants attending more than 1 series, and 12.5% attending all 3 series. Participants' diagnoses and health symptoms included pain (62.5%), cancer (45%) anxiety/depression (40%), cardiovascular disease (CVD) or metabolic conditions (32.5%), gastrointestinal (GI) symptoms/diagnoses (27.5%), stress (22.5%), osteopenia/osteoporosis (17.5%), and insomnia (17.5%). Pre-series [n = 27] participants endorsed symptoms including sleep disturbances, fatigue, pain, stress, weakness, GI symptoms, psychological symptoms, hot flashes, and brain fog. Post-program survey results [n = 11] suggested QG program addressed common symptoms including fatigue, insomnia, anxiety, stress, pain, weakness, and gastrointestinal symptoms. Participants reported incorporating QG, breathing techniques, and meditation into their daily routine. All participants reported their goals were met and that they would recommend the program to others. Regarding delivery preferences, 73% preferred telehealth, 27% hybrid, and none preferred in-person. Participants appreciated the format, new skills, community, and instructors.

Conclusion: While the Virtual QG SMA series provided to diverse demographic population with mixed diagnoses is feasible, acceptable, and shows promising positive impact in this pilot, caution in interpreting the data is advised due to the low response rate of the post-program survey. Robust studies with longer follow-ups are recommended.

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