Emergency physician perspectives on using telehealth with older adults during COVID-19: A qualitative study.
Emergency physician perspectives on using telehealth with older adults during COVID-19: A qualitative study.
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DOI：
10.1002/emp2.12577
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发表时间：
2021-10
影响因子：
2.3
通讯作者：
Goldberg EM
中科院分区：
文献类型：
--
作者：
Davoodi NM;Chen K;Zou M;Li M;Jiménez F;Wetle TF;Goldberg EM
急诊科医生通过亲自和远程管理和治疗，在整个冠状病毒病19（COVID-19）大流行期间发挥了关键作用。我们的主要目标是了解急诊医生在整个流行病期间使用远程医疗的经验，成功使用的任何促进因素/障碍，实施过程中吸取的经验教训，以及用于与老年人互动的成功/放弃的策略。使用半结构化面试指南，我们进行了30分钟的面试。我们采用有目的的抽样方法，从美国所有地区、城乡环境以及学术和社区实践中招募急诊医生，他们报告在大流行期间亲自或虚拟地照顾65岁或以上的患者。访谈被录音，转录，双重编码，并使用框架分析分析紧急主题。于2020年9月至11月期间，共完成15次深入访谈。医生的中位年龄为37岁，其中7人为女性，9人在大流行病之前有远程保健经验。我们确定了几个主题：（1）使用远程医疗的动机多种多样;（2）远程医疗主要用于补充而不是取代亲自护理;（3）大多数平台易于使用;（4）患者和护理人员对远程医疗的接受程度很高;（5）有感官和认知障碍的老年人通常依赖护理人员。急诊医生在第一波初级保健办公室关闭期间发挥了关键作用-消除有关COVID-19的错误信息，将患者分流到检测和治疗，并提供否则会被推迟的护理。我们的数据表明，远程医疗获得了急诊医生的接受，并提供了选择，否则可能会推迟护理的患者。这些发现可以为未来的医疗服务提供信息，以满足急性护理需求或应对大流行病。
Emergency medicine physicians have played a pivotal role throughout the coronavirus disease 19 (COVID‐19) pandemic through in‐person and remote management and treatment. Our primary objectives were to understand emergency medicine physicians’ experiences using telehealth throughout the pandemic, any facilitators/barriers to successful usage, lessons learned during implementation, and successful/abandoned strategies used to engage with older adults. Using a semi‐structured interview guide, we conducted 30‐min interviews. We used purposeful sampling to recruit emergency medicine physicians from all United States regions, rural–urban settings, and academic and community practices, who reported caring for patients 65 years or older in‐person or virtually during the pandemic. Interviews were audio‐recorded, transcribed, double‐coded, and analyzed for emergent themes using framework analysis. A total of 15 in‐depth interviews were completed from September to November 2020. Physicians had a median age of 37 years, 7 were women, and 9 had experience with telehealth before the pandemic. We identified several themes: (1) there were various motivations for telehealth use; (2) telehealth was used primarily to supplement, not replace in‐person care; (3) most platforms were easy to use; (4) patients and caregivers had high acceptability of telemedicine; and (5) older adults with sensory and cognitive impairments often relied on caregivers. Emergency medicine physicians played a critical role during primary care office closures during the first wave—dispelling misinformation about COVID‐19, triaging patients to testing and treatment, and providing care that would otherwise have been deferred. Our data show that telemedicine gained acceptability among emergency medicine physicians and provided options to patients who may have otherwise deferred care. These findings can inform future healthcare delivery for acute care needs or pandemic responses.
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作者：
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通讯作者：
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DOI：
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发表时间：
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