Patients' perceptions of joint teleconsultations: a qualitative evaluation
Patients' perceptions of joint teleconsultations: a qualitative evaluation
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DOI：
10.1111/j.1369-7625.2006.00368.x
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发表时间：
2006-03-01
影响因子：
3.2
通讯作者：
Wallace, P
中科院分区：
文献类型：
--
作者：
Harrison, R;MacFarlane, A;Wallace, P
确定患者对联合远程会诊(JTC)的看法，特别是参考患者对这种医疗服务模式满意和不满意的潜在原因和因素。远程医疗作为改善医疗服务的一种方式受到欢迎，因为它改善了患者获得二级护理和专家服务的机会，从而扩大了患者的选择，特别是对主要城市以外的患者。然而，最近的一项系统回顾发现，目前可获得的关于患者对远程医疗的满意度的数据在方法上存在缺陷。定性评估提供了阐明患者对这种医疗保健提供方式的满意度的机会。半结构化访谈的定性研究。JTC在英国一个城市和一个农村地区进行的一项大型随机对照试验(虚拟外联研究)的目的样本28名参与者。与患者、患者的全科医生(GP)和医院专家举行的联合电话会议会诊。患者和全科医生在当地执业，而医院专科医生在医院门诊部，双方通过ISDN2链路和视频会议软件连接。JTC的既往经历，特别是涉及总体满意或不满意的原因和因素。确定了两个主要主题：客户关怀和医患互动。患者欣赏JTC的客户关怀方面，特别是与JTC相关的增强便利性、降低成本和改善准点率。然而，对于医生与患者之间的互动存在不同的看法，这些患者表达了由于使用技术而产生的疏离感，以及医生与患者沟通的问题。这些数据通过阐明总体满意度得分的因素，显著增加了现有关于患者对远程医疗的满意度的文献，从而对未来的服务提供和远程医疗的实施产生了影响。
To determine patient perceptions of joint teleconsultations (JTC), with particular reference to reasons underlying, and factors contributing to, patient satisfaction and dissatisfaction with this mode of health delivery.Telemedicine has been welcomed as one way of improving health-care delivery, by improving patient access to secondary care and specialist services hence widening patient choice, particularly for patients outside major conurbations. However, a recent systematic review found currently available data on patient satisfaction with telemedicine to be methodologically flawed. Qualitative evaluations offer the opportunity to elucidate the details of patient satisfaction with this mode of health-care delivery.Qualitative study using semi-structured interviews.Purposive sample of 28 participants of a major randomized controlled trial (Virtual Outreach study) of JTC conducted in one urban and one rural area in Britain.Joint teleconferenced consultations with the patient, patient's general practitioner (GP), and a hospital specialist. The patient and GP were sited in the local practice, while the hospital specialist was in the hospital outpatient department, and the two parties were connected by an ISDN2 link and video-conferencing software.Patient experiences of JTC, with particular reference to reasons underlying, and factors contributing to, overall satisfaction or dissatisfaction.Two major themes were identified: customer care and doctor-patient interaction. Patients appreciated the customer care aspects of JTC, particularly the enhanced convenience, reduced costs and improved punctuality associated with JTC. However, there were divergent views about the doctor-patient interactions with some patients expressing a sense of alienation arising from the use of technology, and problems with doctor-patient communication.These data add significantly to the existing literature on patient satisfaction with telemedicine, by elucidating the factors underlying overall satisfaction scores and hence have implications for future service delivery and implementation of telemedicine.