A scoping review of patient engagement activities during COVID-19: More consultation, less partnership.
A scoping review of patient engagement activities during COVID-19: More consultation, less partnership.
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DOI：
10.1371/journal.pone.0257880
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Kuluski K
中科院分区：
文献类型：
--
作者：
Cadel L;Marcinow M;Sandercock J;Dowedoff P;Guilcher SJT;Maybee A;Law S;Kuluski K
COVID-19 大流行对医疗保健系统和护理服务产生了毁灭性影响，改变了患者和家庭参与活动的环境。鉴于此类活动对实现卫生系统质量目标的关键贡献，我们致力于解决以下问题：对大流行期间患者参与活动所做的工作了解多少？研究同行评审和灰色文献，以确定在 COVID-19 大流行的前六个月内国际卫生系统内发生的广泛定义的患者参与活动（包括支持临床护理的参与和决策伙伴关系），以及在大流行期间维持患者参与活动的主要障碍和促进因素。检索了以下数据库：Medline、Embase 和 LitCOVID；对灰色文献的搜索主要集中在专业组织的网站上。文章必须针对 COVID-19，描述患者参与活动，涉及医疗保健组织，并在 2020 年 3 月至 2020 年 9 月期间发表。使用 Microsoft Excel 提取和管理数据。对调查结果进行了内容分析。收录了二十九篇文章。很少有与患者建立更真诚合作关系的例子（例如共同设计和组织层面的决策）；大多数活动与临床层面的互动有关（例如虚拟咨询、远程预约、使用技术的家人探访和社区外展）。几乎所有报告的研究都利用技术来与患者和家人互动或联系。确定了五个主要描述类别：(1) 通过虚拟护理参与； (2) 通过其他技术参与； (3) 参与服务改进/建议； (4) 影响患者参与的因素； (5) 通过患者参与吸取的经验教训。确定了医疗保健系统和组织在大流行期间如何与患者和家庭保持联系的证据；大多数活动涉及通过技术进行直接护理咨询。由于本次审查是在大流行的前六个月进行的，因此需要做更多的工作来揭示患者参与活动的范围，包括它们如何随着时间的推移而演变，并探索在大流行等重大破坏期间维持活动的障碍和促进因素。
The COVID-19 pandemic has had a devastating impact on healthcare systems and care delivery, changing the context for patient and family engagement activities. Given the critical contribution of such activities in achieving health system quality goals, we undertook to address the question: What is known about work that has been done on patient engagement activities during the pandemic? To examine peer-reviewed and grey literature to identify the range of patient engagement activities, broadly defined (inclusive of engagement to support clinical care to partnerships in decision-making), occurring within health systems internationally during the first six months of the COVID-19 pandemic, as well as key barriers and facilitators for sustaining patient engagement activities during the pandemic. The following databases were searched: Medline, Embase and LitCOVID; a search for grey literature focused on the websites of professional organizations. Articles were required to be specific to COVID-19, describe patient engagement activities, involve a healthcare organization and be published from March 2020 to September 2020. Data were extracted and managed using Microsoft Excel. A content analysis of findings was conducted. Twenty-nine articles were included. Few examples of more genuine partnership with patients were identified (such as co-design and organizational level decision making); most activities related to clinical level interactions (e.g. virtual consultations, remote appointments, family visits using technology and community outreach). Technology was leveraged in almost all reported studies to interact or connect with patients and families. Five main descriptive categories were identified: (1) Engagement through Virtual Care; (2) Engagement through Other Technology; (3) Engagement for Service Improvements/ Recommendations; (4) Factors Impacting Patient Engagement; and (5) Lessons Learned though Patient Engagement. Evidence of how healthcare systems and organizations stayed connected to patients and families during the pandemic was identified; the majority of activities involved direct care consultations via technology. Since this review was conducted over the first six months of the pandemic, more work is needed to unpack the spectrum of patient engagement activities, including how they may evolve over time and to explore the barriers and facilitators for sustaining activities during major disruptions like pandemics.
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