PDF(Pubmed)
Abstract：
OBJECTIVE: Patients referred to rheumatologists are currently facing months of inefficient waiting time due to the increasing demand and rising workforce shortage. We piloted a pre-assessment of patients with suspected axial spondyloarthritis (axSpA) combining student-led clinics and telemedicine (symptom assessment, symptom monitoring and at-home capillary self-sampling) to improve access to rheumatology care. The aim of this study was to explore (1) current challenges accessing axSpA care and (2) patients\' first-hand experiences.
METHODS: Embedded within a clinical trial, this study was based on qualitative interviews with patients with suspected axSpA (n = 20). Data was analysed via qualitative content analysis.
RESULTS: Student-led clinics were perceived as high-quality care, comparable to conventional rheumatologist-led visits. Patients expressed that their interactions with the students instilled a sense of trust. History-taking and examinations were perceived as comprehensive and meticulous. Telehealth tools were seen as empowering, offering immediate and continuous access to symptom assessment at home. Patients reported a lack of specificity of the electronic questionnaires, impeding accurate responses. Patients requested a comments area to supplement questionnaire responses. Some patients reported receiving help to complete the blood collection.
CONCLUSIONS: Patients\' access to rheumatology care is becoming increasingly burdensome. Pre-assessment including student-led clinics and telemedicine was highly accepted by patients. Patient interviews provided valuable in-depth feedback to improve the piloted patient pathway.
METHODS: Embedded within a clinical trial, this study was based on qualitative interviews with patients with suspected axSpA (n = 20). Data was analysed via qualitative content analysis.
RESULTS: Student-led clinics were perceived as high-quality care, comparable to conventional rheumatologist-led visits. Patients expressed that their interactions with the students instilled a sense of trust. History-taking and examinations were perceived as comprehensive and meticulous. Telehealth tools were seen as empowering, offering immediate and continuous access to symptom assessment at home. Patients reported a lack of specificity of the electronic questionnaires, impeding accurate responses. Patients requested a comments area to supplement questionnaire responses. Some patients reported receiving help to complete the blood collection.
CONCLUSIONS: Patients\' access to rheumatology care is becoming increasingly burdensome. Pre-assessment including student-led clinics and telemedicine was highly accepted by patients. Patient interviews provided valuable in-depth feedback to improve the piloted patient pathway.
摘要：
目的：由于需求的增加和劳动力短缺的增加，目前被风湿病学家转诊的患者面临数月的低效等待时间。我们试行了对疑似轴性脊柱关节炎（axSpA）患者的预评估，结合学生主导的诊所和远程医疗（症状评估，症状监测和家庭毛细血管自我采样），以改善获得风湿病护理的机会。这项研究的目的是探索（1）当前获得axSpA护理的挑战和（2）患者的第一手经验。
方法：嵌入临床试验中，本研究基于对疑似axSpA患者(n=20)的定性访谈.通过定性内容分析对数据进行分析。
结果：学生主导的诊所被认为是高质量的护理，与传统的风湿病学家主导的访问相当。患者表示，他们与学生的互动灌输了一种信任感。历史学习和考试被认为是全面而细致的。远程医疗工具被视为赋权，在家中提供即时和持续的症状评估。患者报告电子问卷缺乏特异性，阻碍准确的反应。患者要求提供评论区以补充问卷答复。一些患者报告接受帮助以完成采血。
结论：患者获得风湿病治疗的负担越来越沉重。包括学生主导的诊所和远程医疗在内的预评估被患者高度接受。患者访谈提供了有价值的深入反馈，以改善试点的患者路径。
方法：嵌入临床试验中，本研究基于对疑似axSpA患者(n=20)的定性访谈.通过定性内容分析对数据进行分析。
结果：学生主导的诊所被认为是高质量的护理，与传统的风湿病学家主导的访问相当。患者表示，他们与学生的互动灌输了一种信任感。历史学习和考试被认为是全面而细致的。远程医疗工具被视为赋权，在家中提供即时和持续的症状评估。患者报告电子问卷缺乏特异性，阻碍准确的反应。患者要求提供评论区以补充问卷答复。一些患者报告接受帮助以完成采血。
结论：患者获得风湿病治疗的负担越来越沉重。包括学生主导的诊所和远程医疗在内的预评估被患者高度接受。患者访谈提供了有价值的深入反馈，以改善试点的患者路径。
