■在2019年冠状病毒病(COVID-19)大流行之后,美国联邦政府扩大了原始远程医疗站点,包括门诊透析单位。第一次,对于接受中心血液透析的患者,美国的肾脏科医生可以用远程医疗代替面对面就诊.这项研究描述了患者在中心血液透析期间使用远程医疗的观点。
■定性研究。
■来自服务不足人群的32名患者(年龄较大,受教育程度较低,失业,有色人种)接受中心血液透析的人,在COVID-19大流行期间与肾病医生一起使用远程医疗。
■电话半结构化面试以英语或西班牙语进行。对成绩单进行了主题分析。
■我们确定了6个具有子主题的主题:适应远程医疗(获得熟悉和信心,克服和解决技术困难,并依靠员工进行沟通);确保医生的可用性(能够立即应对紧急医疗需求,提供内心的平静,充分满足患者需求,以及加强医生的关注和联系);防止感染(限制COVID-19暴露并减少使用);紧张的交流和身体互动(失去个性化接触,有限的体检,并且无法就被遗忘的问题重新联系医生);维护隐私(增强隐私和投射声音使其他人能够听到);并支持对远程医疗的信心(需要与医生建立融洽的关系,健康的临床稳定性,以及必要时亲自访问的能力)。
■采访是在大流行的后期进行的,当时一些肾病护理提供者很少使用远程医疗。
■在COVID-19大流行的背景下,接受中心血液透析的患者适应了肾病学家的远程医疗访问,并观察了其益处。然而,关于沟通的进一步考虑,隐私,和物理评估是必要的。使用混合方法将远程医疗整合到未来的中心血液透析护理中可能会建立信任,优化沟通,和增强护理。
这项研究描述了患者在2019年冠状病毒病(COVID-19)大流行期间接受中心血液透析时使用远程医疗的观点。数据来自对服务不足人群的32名患者的半结构化访谈(年龄较大,受教育程度较低,失业,有色人种)。我们确定了6个主要主题,包括适应远程医疗,确保医生的可用性,防止感染,紧张的交流和身体互动,维护隐私,并支持对远程医疗的信心。这些发现表明,在COVID-19大流行的背景下,接受中心血液透析的患者适应了肾病学家的远程医疗访问,并观察到了其益处。然而,关于沟通的进一步考虑,隐私,和物理评估是必要的。使用混合方法将远程医疗整合到未来的中心血液透析护理中可能会建立信任,优化沟通,和增强护理。
UNASSIGNED: In the wake of the coronavirus disease 2019 (COVID-19) pandemic, the United States federal government expanded originating telemedicine sites to include outpatient dialysis units. For the first time, nephrology practitioners across the United States could replace face-to-face visits with telemedicine for patients receiving in-center
hemodialysis. This study describes patients\' perspectives on the use of telemedicine during in-center
hemodialysis.
UNASSIGNED: A qualitative study.
UNASSIGNED: Thirty-two patients from underserved populations (older, less educated, unemployed, persons of color) receiving in-center hemodialysis who used telemedicine with their nephrologist during the COVID-19 pandemic.
UNASSIGNED: Telephone semistructured interviews were conducted in English or Spanish. Transcripts were thematically analyzed.
UNASSIGNED: We identified 6 themes with subthemes: adapting to telemedicine (gaining familiarity and confidence, overcoming and resolving technical difficulties, and relying on staff for communication); ensuring availability of the physician (enabling an immediate response to urgent medical needs, providing peace of mind, addressing patient needs adequately, and enhanced attention and contact from physicians); safeguarding against infection (limiting COVID-19 exposures and decreasing use); straining communication and physical interactions (loss of personalized touch, limited physical examination, and unable to reapproach physicians about forgotten issues); maintaining privacy (enhancing privacy and projecting voice enables others to hear); and supporting confidence in telemedicine (requiring established rapport with physicians, clinical stabilty of health, and ability to have in-person visits when necessary).
UNASSIGNED: Interviews were conducted later in the pandemic when some nephrology care providers were using telemedicine infrequently.
UNASSIGNED: Patients receiving in-center
hemodialysis adapted to telemedicine visits by their nephrologists in the context of the COVID-19 pandemic and observed its benefits. However, further considerations regarding communication, privacy, and physical assessments are necessary. Integrating telemedicine into future in-center
hemodialysis care using a hybrid approach could potentially build trust, optimize communication, and augment care.
This study describes patients’ perspectives on the use of telemedicine while receiving in-center hemodialysis during the coronavirus disease 2019 (COVID-19) pandemic. Data are derived from semistructured interviews with thirty-two patients from underserved populations (older, less educated, unemployed, persons of color). We identified 6 major themes including adapting to telemedicine, ensuring availability of the physicians, safeguarding against infection, straining communication and physical interactions, maintaining privacy, and supporting confidence in telemedicine. These findings suggest that patients receiving in-center
hemodialysis adapted to telemedicine visits by their nephrologists in the context of the COVID-19 pandemic and observed its benefits. However, further considerations regarding communication, privacy, and physical assessments are necessary. Integrating telemedicine into future in-center
hemodialysis care using a hybrid approach could potentially build trust, optimize communication, and augment care.