Remote primary care consultations for people living with dementia during the COVID-19 pandemic: experiences of people living with dementia and their carers.
Remote primary care consultations for people living with dementia during the COVID-19 pandemic: experiences of people living with dementia and their carers.
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DOI：
10.3399/bjgp.2020.1094
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发表时间：
2021-08
期刊：
影响因子：
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通讯作者：
Walters K
中科院分区：
文献类型：
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作者：
Tuijt R;Rait G;Frost R;Wilcock J;Manthorpe J;Walters K
COVID-19 加速了初级保健领域的远程医疗保健服务的提供，而且这种变化可能是永久性的。实施远程医疗服务需要弱势群体（例如痴呆症患者）的知情同意。了解 COVID-19 大流行期间痴呆症患者及其家庭护理人员的远程医疗体验。 Qualitative interviews with community-based patients living with dementia and their carers were carried out between May–August 2020, while the COVID-19 pandemic was ongoing in England.通过电话或视频电话对 30 名痴呆症患者和 31 名护理人员进行了远程半结构化访谈。使用主题分析对数据进行分析。得出的三个主题涉及：COVID-19 限制开始时的主动护理；避免医疗保健场所和服务；以及远程医疗保健遇到的困难。痴呆症患者及其护理人员认为检查电话令人安心，但范围和内容有限。有些人回避医疗保健服务，希望最大限度地降低 COVID-19 风险或减轻 NHS 负担，或者遇到技术障碍。远程会诊的困难包括缺乏记住问题的提示、处理新出现的困难、重新安排/未接电话以及纳入痴呆症患者的声音。虽然远程咨询可能很有效，但主动致电可以根据需求更加结构化。应考虑取代描述问题的非语言提示，特别是对于新的健康问题。在持续的远程咨询中，重要的是促进痴呆症患者及其护理人员的参与，以确保良好的实践。
COVID-19 has accelerated remote healthcare provision in primary care, with changes potentially permanent. The implementation of remote provision of health care needs to be informed by vulnerable populations, such as people living with dementia. To understand the remote healthcare experiences of patients living with dementia and their family carers during the COVID-19 pandemic. Qualitative interviews with community-based patients living with dementia and their carers were carried out between May–August 2020, while the COVID-19 pandemic was ongoing in England. Semi-structured interviews were conducted remotely by telephone or video call with 30 patients living with dementia and 31 carers. Data were analysed using thematic analysis. Three main themes were derived relating to: proactive care at the onset of COVID-19 restrictions; avoidance of healthcare settings and services; and difficulties with remote healthcare encounters. People living with dementia and their carers felt check-up calls were reassuring but limited in scope and content. Some avoided healthcare services, wishing to minimise COVID-19 risk or reduce NHS burden, or encountering technological barriers. Difficulties in remote consultations included lack of prompts to remember problems, dealing with new emerging difficulties, rescheduling/missed calls, and inclusion of the voice of the person with dementia. While remote consultations could be effective, proactive calls could be more structured around needs. Consideration should be given to replace non-verbal prompts to describe problems, particularly for new health concerns. In continuing remote consultations, it is important to facilitate engagement with patients living with dementia and their carers to ensure good practice.