PDF(Pubmed)
Abstract：
While virtual care services existed prior to the emergence of COVID-19, the pandemic catalyzed a rapid transition from in-person to virtual care service delivery across the Canadian health care system. Virtual care includes synchronous or asynchronous delivery of health care services through video visits, telephone visits, or secure messaging. Patient advisors are people with patient and caregiving experiences who collaborate within the health care system to share insights and experiences in order to improve health care.
This study aimed to understand patient advisors\' perceptions related to virtual care and potential impacts on health care quality.
We adopted a phenomenological approach, whereby we interviewed 20 participants who were patient advisors across Canada using a semistructured interview protocol. The protocol was developed by content experts and medical education researchers. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Data collection stopped once thematic saturation was reached. The study was conducted at Queen\'s University, Kingston, Ontario. We recruited 20 participants from 5 Canadian provinces (17 female participants and 3 male participants).
Six themes were identified: (1) characteristics of effective health care, (2) experiences with virtual care, (3) modality preferences, (4) involvement of others, (5) risks associated with virtual care encounters, and (6) vulnerable populations. Participants reported that high-quality health care included building relationships and treating patients holistically. In general, participants described positive experiences with virtual care during the pandemic, including greater efficiency, increased accessibility, and that virtual care was less stressful and more patient centered. Participants comparing virtual care with in-person care reported that time, scheduling, and content of interactions were similar across modalities. However, participants also shared the perception that certain modalities were more appropriate for specific clinical encounters (eg, prescription renewals and follow-up appointments). Perspectives related to the involvement of family members and medical trainees were positive. Potential risks included miscommunication, privacy concerns, and inaccurate patient assessments. All participants agreed that stakeholders should be proactive in applying strategies to support vulnerable patients. Participants also recommended education for patients and providers to improve virtual care delivery.
Participant-reported experiences of virtual care encounters were relatively positive. Future work could focus on delivering training and resources for providers and patients. While initial experiences are positive, there is a need for ongoing stakeholder engagement and evaluation to improve patient and caregiver experiences with virtual care.
This study aimed to understand patient advisors\' perceptions related to virtual care and potential impacts on health care quality.
We adopted a phenomenological approach, whereby we interviewed 20 participants who were patient advisors across Canada using a semistructured interview protocol. The protocol was developed by content experts and medical education researchers. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Data collection stopped once thematic saturation was reached. The study was conducted at Queen\'s University, Kingston, Ontario. We recruited 20 participants from 5 Canadian provinces (17 female participants and 3 male participants).
Six themes were identified: (1) characteristics of effective health care, (2) experiences with virtual care, (3) modality preferences, (4) involvement of others, (5) risks associated with virtual care encounters, and (6) vulnerable populations. Participants reported that high-quality health care included building relationships and treating patients holistically. In general, participants described positive experiences with virtual care during the pandemic, including greater efficiency, increased accessibility, and that virtual care was less stressful and more patient centered. Participants comparing virtual care with in-person care reported that time, scheduling, and content of interactions were similar across modalities. However, participants also shared the perception that certain modalities were more appropriate for specific clinical encounters (eg, prescription renewals and follow-up appointments). Perspectives related to the involvement of family members and medical trainees were positive. Potential risks included miscommunication, privacy concerns, and inaccurate patient assessments. All participants agreed that stakeholders should be proactive in applying strategies to support vulnerable patients. Participants also recommended education for patients and providers to improve virtual care delivery.
Participant-reported experiences of virtual care encounters were relatively positive. Future work could focus on delivering training and resources for providers and patients. While initial experiences are positive, there is a need for ongoing stakeholder engagement and evaluation to improve patient and caregiver experiences with virtual care.
摘要：
背景：虽然在COVID-19出现之前就存在虚拟护理服务，但大流行促进了整个加拿大医疗保健系统从当面向虚拟护理服务提供的快速过渡。虚拟护理包括通过视频访问同步或异步提供医疗保健服务，电话访问,或安全消息。患者顾问是具有患者和护理经验的人，他们在医疗保健系统内协作以分享见解和经验，以改善医疗保健。
目的：本研究旨在了解患者顾问对虚拟护理的看法以及对医疗质量的潜在影响。
方法：我们采用了现象学方法，因此，我们使用半结构化访谈协议采访了加拿大各地的20名患者顾问。该协议是由内容专家和医学教育研究人员开发的。采访是录音的，逐字转录，并按主题进行分析。一旦达到主题饱和，就停止数据收集。这项研究是在女王大学进行的，金斯顿,安大略省。我们招募了来自加拿大5个省的20名参与者（17名女性参与者和3名男性参与者）。
结果：确定了六个主题：（1）有效医疗保健的特征，(2)虚拟护理的经验，(3)模态偏好，（4）他人的参与；(5)与虚拟护理遭遇相关的风险，（6）弱势群体。参与者报告说，高质量的医疗保健包括建立关系和全面治疗患者。总的来说,参与者描述了大流行期间虚拟护理的积极经历，包括更高的效率，增加可达性，虚拟护理压力较小，以患者为中心。参与者将虚拟护理与亲自护理进行比较，调度,不同模式的互动内容相似。然而,参与者还认为某些模式更适合特定的临床接触(例如，续开处方和随访预约)。与家庭成员和医学受训者的参与有关的观点是积极的。潜在风险包括沟通不畅,隐私问题,和不准确的患者评估。所有参与者都同意，利益相关者应积极主动地应用策略来支持弱势患者。参与者还建议对患者和提供者进行教育，以改善虚拟护理的提供。
结论：参与者报告的虚拟护理体验相对积极。未来的工作可以集中在为提供者和患者提供培训和资源。虽然最初的经历是积极的，需要持续的利益相关者参与和评估,以改善患者和护理人员的虚拟护理体验.
目的：本研究旨在了解患者顾问对虚拟护理的看法以及对医疗质量的潜在影响。
方法：我们采用了现象学方法，因此，我们使用半结构化访谈协议采访了加拿大各地的20名患者顾问。该协议是由内容专家和医学教育研究人员开发的。采访是录音的，逐字转录，并按主题进行分析。一旦达到主题饱和，就停止数据收集。这项研究是在女王大学进行的，金斯顿,安大略省。我们招募了来自加拿大5个省的20名参与者（17名女性参与者和3名男性参与者）。
结果：确定了六个主题：（1）有效医疗保健的特征，(2)虚拟护理的经验，(3)模态偏好，（4）他人的参与；(5)与虚拟护理遭遇相关的风险，（6）弱势群体。参与者报告说，高质量的医疗保健包括建立关系和全面治疗患者。总的来说,参与者描述了大流行期间虚拟护理的积极经历，包括更高的效率，增加可达性，虚拟护理压力较小，以患者为中心。参与者将虚拟护理与亲自护理进行比较，调度,不同模式的互动内容相似。然而,参与者还认为某些模式更适合特定的临床接触(例如，续开处方和随访预约)。与家庭成员和医学受训者的参与有关的观点是积极的。潜在风险包括沟通不畅,隐私问题,和不准确的患者评估。所有参与者都同意，利益相关者应积极主动地应用策略来支持弱势患者。参与者还建议对患者和提供者进行教育，以改善虚拟护理的提供。
结论：参与者报告的虚拟护理体验相对积极。未来的工作可以集中在为提供者和患者提供培训和资源。虽然最初的经历是积极的，需要持续的利益相关者参与和评估,以改善患者和护理人员的虚拟护理体验.
