Safeguarding patients from technology-facilitated abuse in clinical settings: A narrative review.
Safeguarding patients from technology-facilitated abuse in clinical settings: A narrative review.
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DOI：
10.1371/journal.pdig.0000089
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发表时间：
2023-01
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保护弱势患者是医疗保健专业人员的主要责任。然而，现有的临床和患者管理协议已经过时，因为它们没有解决技术促进的滥用的新威胁。后者描述了滥用智能手机或其他互联网连接设备等数字系统来监视、控制和恐吓个人。缺乏对技术协助的滥用如何影响患者生活的关注，可能导致临床医生无法保护弱势患者，并可能以几种意想不到的方式影响他们的护理。我们试图通过评估与受数字化伤害影响的患者一起工作的医疗保健从业者可用的文献来解决这一差距。在2021年9月至2022年1月期间进行了文献检索，其中使用相关检索词字符串对三个学术数据库进行了检索，共检索到59篇文章进行全文综述。根据三个标准对文章进行评价：（a）关注技术促进的滥用;（B）与临床环境的相关性;（c）医疗保健从业人员在保护中的作用。在59篇文章中，17篇文章至少满足一项标准，只有一篇文章满足所有三项标准。我们从灰色文献中提取了额外的信息，以确定医疗环境和高危患者群体的改进领域。从咨询点到出院点，技术促进的滥用涉及医疗保健专业人员，因此临床医生需要配备工具，以在患者旅程的任何阶段识别和解决这些伤害。在这篇文章中，我们为不同医学亚专业的进一步研究提供了建议，并强调了临床环境中需要制定政策的领域。技术协助的滥用描述了滥用智能手机或其他互联网连接设备等数字系统来伤害个人。这些设备在我们环境中的扩散，由于COVID 19大流行而加剧，增加了社会弱势成员滥用技术的风险。这些形式的虐待正在上升，犯罪者使用数字技术，如GPS标签和设备间谍软件工具来监视和控制个人。易受伤害的个人经常认为医疗环境是一个安全的地方，因此医疗保健专业人员在提供医疗和心理社会护理方面发挥作用，以确保他们的福祉。目前，现有的临床和患者管理协议已经过时，无法解决新出现的技术滥用威胁。在我们对现有文献的研究中，我们探讨了为照顾受影响人群的医疗保健从业人员提供的指导，并提出了迫切需要有效保护弱势患者群体的具体建议。
Safeguarding vulnerable patients is a key responsibility of healthcare professionals. Yet, existing clinical and patient management protocols are outdated as they do not address the emerging threats of technology-facilitated abuse. The latter describes the misuse of digital systems such as smartphones or other Internet-connected devices to monitor, control and intimidate individuals. The lack of attention given to how technology-facilitated abuse may affect patients in their lives, can result in clinicians failing to protect vulnerable patients and may affect their care in several unexpected ways. We attempt to address this gap by evaluating the literature that is available to healthcare practitioners working with patients impacted by digitally enabled forms of harm. A literature search was carried out between September 2021 and January 2022, in which three academic databases were probed using strings of relevant search terms, returning a total of 59 articles for full text review. The articles were appraised according to three criteria: (a) the focus on technology-facilitated abuse; (b) the relevance to clinical settings; and (c) the role of healthcare practitioners in safeguarding. Of the 59 articles, 17 articles met at least one criterion and only one article met all three criteria. We drew additional information from the grey literature to identify areas for improvement in medical settings and at-risk patient groups. Technology-facilitated abuse concerns healthcare professionals from the point of consultation to the point of discharge, as a result clinicians need to be equipped with the tools to identify and address these harms at any stage of the patient’s journey. In this article, we offer recommendations for further research within different medical subspecialities and highlight areas requiring policy development in clinical environments. Technology-facilitated abuse describes the misuse of digital systems such as smartphones or other Internet-connected devices to harm individuals. The proliferation of these devices within our environment, exacerbated by the COVID19 pandemic, has increased the risks of technology-facilitated-abuse for vulnerable members of society. These forms of abuse are on the rise, with perpetrators using digital technologies such as GPS Tags, and device spyware tools to monitor and control individuals. Vulnerable individuals frequently perceive medical settings as a place of safety and thus healthcare professionals have a role in providing both medical and psychosocial care to ensure their wellbeing. At present, existing clinical and patient management protocols are outdated and do not address the emerging threats of technology-facilitated abuse. Throughout our examination of the existing literature we explore the guidance that is available to healthcare practitioners who are caring for affected populations and make concrete recommendations that are urgently needed to effectively safeguard vulnerable patient groups.