OBJECTIVE: This study aims to identify the benefits and challenges geriatric care professionals face when using telemedicine technologies with frail older patients, their caregivers, and their families and how to maximize the benefits of this method of providing care.
METHODS: This was a mixed methods study that recruited geriatric care professionals to complete an online survey regarding their personal demographics and experiences with using telemedicine technologies and participate in a semistructured interview. Interview responses were analyzed using the Consolidated Framework for Implementation Research (CFIR).
RESULTS: Quantitative and qualitative data were obtained from 30 practicing geriatric care professionals (22, 73%, geriatricians, 5, 17%, geriatric psychiatrists, and 3, 10%, geriatric nurse practitioners) recruited from across the Greater Toronto Area. Analysis of interview data identified 5 CFIR contextual barriers (complexity, design quality and packaging, patient needs and resources, readiness for implementation, and culture) and 13 CFIR contextual facilitators (relative advantage, adaptability, tension for change, available resources, access to knowledge, networks and communications, compatibility, knowledge and beliefs, self-efficacy, champions, external agents, executing, and reflecting and evaluating). The CFIR concept of external policy and incentives was found to be a neutral construct.
CONCLUSIONS: This is the first known study to use the CFIR to develop a comprehensive narrative to characterize the experiences of Ontario geriatric care professionals using telemedicine technologies in providing care. Overall, telemedicine can significantly enable most of the geriatric care that is traditionally provided in person but is less useful in providing specific aspects of geriatric care to frail older patients, their caregivers, and their families.
目的:本研究旨在确定老年护理专业人员在对体弱的老年患者使用远程医疗技术时所面临的益处和挑战。他们的照顾者,以及他们的家人,以及如何最大限度地利用这种提供护理的方法。
方法:这是一项混合方法研究,招募了老年护理专业人员,以完成有关其个人人口统计和使用远程医疗技术经验的在线调查,并参与半结构化访谈。使用实施研究综合框架(CFIR)分析了面试答复。
结果:从30名执业老年护理专业人员获得了定量和定性数据(22,73%,老年病学家,5,17%,老年精神病医生,和3,10%,老年护士从业人员)从大多伦多地区招募。访谈数据分析确定了5个CFIR背景障碍(复杂性,设计质量和包装,患者的需求和资源,准备实施,和文化)和13个CFIR上下文促进者(相对优势,适应性,改变的张力,可用资源,获取知识,网络和通信,兼容性,知识和信仰,自我效能感,冠军,外部代理人,执行,以及反思和评估)。外部政策和激励措施的CFIR概念被认为是中立的。
结论:这是第一个使用CFIR开发综合叙述的已知研究,以描述安大略省老年护理专业人员使用远程医疗技术提供护理的经验。总的来说,远程医疗可以显着实现传统上亲自提供的大多数老年护理,但在为虚弱的老年患者提供老年护理的特定方面不太有用,他们的照顾者,和他们的家人。