"The Patient Should Have a Choice": Adults with Sickle Cell Disease Advise Integration of Telemedicine into the Comprehensive Sickle Cell Disease Care Model.

IF 3.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Lydia H Pecker, Elizabeth Ruvalcaba, Sophie Lanzkron, Michelle N Eakin
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引用次数: 0

Abstract

Background: Adults with sickle cell disease (SCD) constitute a unique and vulnerable patient population with complex healthcare needs including routine follow-up visits and acute care evaluations. The COVID-19 pandemic accelerated healthcare systems' transition to providing telemedicine care. The purpose of this qualitative study was to elicit the perspectives of adults with SCD about their experience with telemedicine during the COVID-19 pandemic and to understand their preferences with respect to future telemedicine care.

Methods: Adults with SCD who had a telemedicine visit between March August 2020 and were cared for at our SCD center were eligible to participate in a one-time interview. Interviews were audio taped, transcribed, and analyzed using NVIVO software.

Results: Among 30 interviewed subjects, 28 transcripts were available for analysis. Analysis identified that participants compared telemedicine to in-person care across several domains including (a) how time is used, (b) personal safety, (c) pain management, and (d) maintaining caring relationships. Participants agreed that telemedicine care was most appropriate for follow-up care and less useful for painful crises or urgent needs. They expressed concerns about the need to expand telemedicine to other specialities and to ensure that privacy and technical support are provided.

Conclusions: Telemedicine appeals to adults with SCD for maintenance SCD care. Decisions about in-person or telemedicine care need to be made in discussion with the patient with particular attention to pain management preferences. Ultimately, telemedicine is an option that adults with SCD would like to see continue and that has the potential to expand access to care to more geographically distant regions.

"患者应有选择权":成人镰状细胞病患者建议将远程医疗纳入镰状细胞病综合治疗模式。
背景:成人镰状细胞病 (SCD) 患者是一个独特而脆弱的群体,他们有着复杂的医疗保健需求,包括常规随访和急性护理评估。COVID-19 大流行加速了医疗系统向提供远程医疗服务的过渡。本定性研究的目的是了解成年 SCD 患者对 COVID-19 大流行期间远程医疗体验的看法,并了解他们对未来远程医疗护理的偏好:在 2020 年 3 月至 8 月期间接受过远程医疗访问并在我们的 SCD 中心接受护理的成年 SCD 患者有资格参加一次性访谈。使用 NVIVO 软件对访谈进行录音、转录和分析:在 30 名受访者中,有 28 份记录誊本可供分析。分析发现,受访者对远程医疗与面对面护理在多个领域进行了比较,包括(a)时间的使用方式,(b)人身安全,(c)疼痛管理,以及(d)保持关爱关系。与会者一致认为,远程医疗最适合用于后续护理,而对于疼痛危机或紧急需求则作用不大。他们对将远程医疗扩展到其他专科以及确保提供隐私和技术支持的必要性表示担忧:结论:远程医疗对患有 SCD 的成人进行维持性 SCD 护理很有吸引力。需要与患者进行讨论,并特别关注患者对疼痛管理的偏好,从而决定是采用现场护理还是远程医疗护理。归根结底,远程医疗是成年 SCD 患者希望看到的一种选择,它有可能将医疗服务扩展到地理位置更遥远的地区。
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来源期刊
Journal of Racial and Ethnic Health Disparities
Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.30
自引率
5.10%
发文量
263
期刊介绍: Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.
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