"It was like he was in the room with us': patients' and carers' perspectives of telemedicine in acute stroke

被引:17
作者
Gibson, Josephine [1 ]
Lightbody, Elizabeth [1 ]
McLoughlin, Alison [2 ]
McAdam, Joanna [1 ]
Gibson, Alison [1 ]
Day, Elaine [3 ]
Fitzgerald, Jane [1 ]
May, Carl [4 ]
Price, Chris [5 ]
Emsley, Hedley [2 ]
Ford, Gary A. [6 ]
Watkins, Caroline [1 ]
机构
[1] Univ Cent Lancashire, Clin Practice Res Unit, Brook Bldg 425, Preston PR1 2HE, Lancs, England
[2] Lancashire Teaching Hosp NHS Fdn Trust, Preston, Lancs, England
[3] Cardiac & Stroke Networks Lancashire & Cumbria, Preston, Lancs, England
[4] Univ Southampton, Southampton, NY USA
[5] Northumbria Healthcare NHS Fdn Trust, Preston, Lancs, England
[6] Newcastle Univ, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England
基金
美国国家卫生研究院;
关键词
acute stroke; telemedicine; remote consultation; thrombolysis; patient satisfaction; carer satisfaction; THROMBOLYSIS;
D O I
10.1111/hex.12333
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
BackgroundTelemedicine can facilitate delivery of thrombolysis in acute stroke. The aim of this qualitative study was to explore patients' and carers' views of their experiences of using a stroke telemedicine system in order to contribute to the development of reliable and acceptable telemedicine systems and training for health-care staff. MethodWe recruited patients who had, and carers who were present at, recent telemedicine consultations for acute stroke in three hospitals in NW England. Semi-structured interviews were conducted using an interview guide based on normalization process theory (NPT). Thematic analysis was undertaken. ResultsWe conducted 24 interviews with 29 participants (16 patients; 13 carers). Eleven interviews pertained to live' telemedicine assessments (at the time of admission); nine had mock-up telemedicine assessments (within 48h of admission); four had both assessments. Using the NPT domains as a framework for analysis, factors relating to coherence (sense making) included people's knowledge and understanding of telemedicine. Cognitive participation (relational work) included interaction between staff and with patients and carers. Issues relating to collective action (operational work) included information exchange and support, and technical matters. Findings relating to reflexive monitoring (appraisal) included positive and negative impressions of the telemedicine process, and emotional reactions. ConclusionAlthough telemedicine was well accepted by many participants, its use added an additional layer of complexity to the acute stroke consultation. The remote' nature of the consultationposed challenges for some patients. These issues may be ameliorated by clear information for patients and carers, staff interpersonal skills, and teamworking.
引用
收藏
页码:98 / 111
页数:14
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