A mixed-method study on the provision of remote consultations for non-communicable disease patients during the first wave of the COVID-19 pandemic in Latvia: lessons for the future.
A mixed-method study on the provision of remote consultations for non-communicable disease patients during the first wave of the COVID-19 pandemic in Latvia: lessons for the future.
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DOI：
10.1186/s12913-022-07634-x
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发表时间：
2022-02-26
影响因子：
2.8
通讯作者：
Villeruša A
中科院分区：
文献类型：
--
作者：
Kursīte M;Stars I;Strēle I;Gobiņa I;Ķīvīte-Urtāne A;Behmane D;Dūdele A;Villeruša A
2019冠状病毒病大流行对医疗系统确保非传染性疾病患者医疗服务连续性的能力提出了挑战。出现了远程咨询的问题。在2019冠状病毒病大流行之前，拉脱维亚的公共卫生资金并没有定期提供远程咨询或覆盖远程咨询。本研究旨在描述咨询的动态和为特定非传染性疾病患者提供的远程咨询量，并探索临床医生在拉脱维亚第一波COVID-19大流行期间提供远程咨询的经验。针对2020年春季拉脱维亚的第一波COVID-19疫情进行了混合方法研究。对国家卫生服务局提供的定量数据进行了分析，以评估为某些非传染性疾病患者提供咨询的动态。通过34个半结构化的采访全科医生（GP）和专家收集定性数据，并进行了分析，使用归纳专题分析。目的性最大变异抽样用于参与者选择。在计划的现场会诊受到最严格限制的时期，各种非传染性疾病的会诊总数有所减少。在此期间，很大一部分咨询是远程提供的。全科医生提供了大约三分之一的癌症相关咨询，近一半的其他选定条件远程咨询。在专科医生中，内分泌科医生远程会诊比例最高（高达72.0%），泌尿科医生最低（16.4%）。半结构化访谈的主题分析揭示了五个主题：1）在混乱和恐惧的时期进行调整，2）远程咨询：安全与可用性，3）牺牲和隐私的丧失，4）通信技术的优点和缺点，以及5）不同形式的通信和健康素养的挑战。在拉脱维亚第一波COVID-19大流行期间，医疗服务中断导致全科医生和专科医生为非传染性疾病患者提供的咨询总数减少。在此期间，远程会诊被证明是确保非传染性疾病患者保健连续性的重要手段，并强调了在拉脱维亚建立一个设计良好的远程医疗系统的必要性。
The COVID-19 pandemic has challenged the ability of healthcare systems to ensure the continuity of health services for patients with non-communicable diseases (NCDs). The issue of remote consultations has emerged. Before the COVID-19 pandemic, remote consultations were not routinely provided or covered by public health funding in Latvia. This study aimed to describe the dynamics of consultations and the volume of remote consultations provided for patients with particular NCD and explore clinicians’ experiences of providing remote consultations during the first wave of the COVID-19 pandemic in Latvia. A mixed-method study focusing on the first wave of the COVID-19 pandemic in Latvia in Spring 2020 was conducted. Quantitative data from the National Health Services were analysed to assess the dynamics of consultations for patients with selected NCDs. Qualitative data were collected through 34 semi-structured interviews with general practitioners (GPs) and specialists and were analysed using an inductive thematic analysis. Purposive maximum variation sampling was used for participant selection. During the period with the strongest restrictions of scheduled on-site consultations, a decrease in the total number of consultations was observed for a variety of NCDs. A significant proportion of consultations in this period were provided remotely. GPs provided approximately one-third of cancer-related consultations and almost half of consultations for the other selected conditions remotely. Among specialists, endocrinologists had the highest proportion of remote consultations (up to 72.0%), while urologists had the lowest (16.4%). Thematic analysis of the semi-structured interviews revealed five themes: 1) Adjusting in a time of confusion and fear, 2) Remote consultations: safety versus availability, 3) Sacrifice and loss of privacy, 4) Advantages and disadvantages of communication technologies, and 5) Different form of communication and a health literacy challenge. During the first wave of the COVID-19 pandemic in Latvia, disruptions to health care services decreased the total number of consultations for patients with NCDs provided by both GPs and specialists. In this period, remote consultations proved to be an important instrument for ensuring the continuity of health care for patients with NCDs, and the necessity to develop a well-designed system for telemedicine in Latvia was highlighted.
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影响因子：
2.8
作者：
Bagot KL;Cadilhac DA;Bladin CF;Watkins CL;Vu M;Donnan GA;Dewey HM;Emsley HCA;Davies DP;Day E;Ford GA;Price CI;May CR;McLoughlin ASR;Gibson JME;Lightbody CE;VST and ASTUTE investigators
通讯作者：
VST and ASTUTE investigators
影响因子：
4.7
作者：
Cottrell M;Burns CL;Jones A;Rahmann A;Young A;Sam S;Cruickshank M;Pateman K
通讯作者：
Pateman K
影响因子：
2.9
作者：
Edwards HB;Marques E;Hollingworth W;Horwood J;Farr M;Bernard E;Salisbury C;Northstone K
通讯作者：
Northstone K
影响因子：
5.9
作者：
Banks, Jon;Farr, Michelle;Horwood, Jeremy
通讯作者：
Horwood, Jeremy
影响因子：
1.7
作者：
Guest, Greg;Bunce, Arwen;Johnson, Laura
通讯作者：
Johnson, Laura