在农村环境中,远程心脏监测的促进因素和障碍:一项定性分析。

IF 5.3 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Journal of the American Heart Association Pub Date : 2025-10-07 Epub Date: 2025-09-30 DOI:10.1161/JAHA.125.042303
Emily P Zeitler, Jennifer Wenner, Laura Bernstein, Mark A Creager, Karen E Schifferdecker
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引用次数: 0

摘要

背景:作为全面的心脏植入式电子设备护理计划的一部分,远程监测(RM)是最大化临床和患者满意度结果的有效策略。然而,在农村环境中,多重影响可能同时使RM护理更难实现。我们试图确定有效的RM作为农村地区心脏植入式电子设备护理项目的一部分的促进因素和障碍。方法:采用定性研究设计,对新英格兰农村地区使用心脏植入式电子设备的患者和治疗这些患者的医生进行了半结构化访谈,包括初级保健医生、心脏病专家和心脏电生理学家。使用混合演绎和归纳方法分析数据,以确定与RM障碍和促进因素相关的主题。结果:最终的患者访谈组(n=23)包括参加和不参加RM的患者(分别为n=14和n=9)。受访医师共15人。分析得出5个患者主题和4个医生主题。总体而言,人们对RM总体满意。促进因素包括易于整合、充分的初始教育和清晰的沟通。障碍包括资源限制、不完整的沟通和不充分的持续教育。结论:这项针对新英格兰农村地区患者和医生的定性研究确定了有效RM的促进因素和障碍。在地方和国家层面优化RM教育、基础设施和人员配置(包括通过政策变化),可能会在心脏植入式电子设备护理(包括数字健康的其他新兴领域)之外具有重要和相关的应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Facilitators and Barriers to Uptake of Remote Cardiac Monitoring in a Rural Setting: A Qualitative Analysis.

Background: When part of a comprehensive cardiac implantable electronic device care program, remote monitoring (RM) is an effective strategy for maximizing clinical and patient satisfaction outcomes. In rural settings, however, there are multilevel influences that could simultaneously make RM care less attainable. We sought to identify facilitators and barriers to effective RM as part of a cardiac implantable electronic device care program in rural areas.

Methods: Using a qualitative study design, semistructured interviews were conducted of patients with a cardiac implantable electronic device and physicians who treat these patients in rural New England inclusive of primary care doctors, cardiologists, and cardiac electrophysiologists. Data were analyzed using a mixed deductive and inductive approach to identify themes related to barriers and facilitators to RM.

Results: The final group of patient interviewees (n=23) included a combination of those who do and do not participate in RM (n=14 and n=9, respectively). There was a total of 15 physician interviewees. Analysis resulted in 5 patient themes and 4 physician themes. Overall, there was general satisfaction with RM. Facilitators included ease of integration, adequate initial education, and clear communication. Barriers included resource constraints, incomplete communication, and inadequate ongoing education.

Conclusions: This qualitative study of patients and physicians in rural New England identified facilitators and barriers to effective RM. Optimizing RM education, infrastructure, and staffing at local and national levels, including through policy changes, may have important and relevant applications beyond cardiac implantable electronic device care, including other emerging areas of digital health.

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来源期刊
Journal of the American Heart Association
Journal of the American Heart Association CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
9.40
自引率
1.90%
发文量
1749
审稿时长
12 weeks
期刊介绍: As an Open Access journal, JAHA - Journal of the American Heart Association is rapidly and freely available, accelerating the translation of strong science into effective practice. JAHA is an authoritative, peer-reviewed Open Access journal focusing on cardiovascular and cerebrovascular disease. JAHA provides a global forum for basic and clinical research and timely reviews on cardiovascular disease and stroke. As an Open Access journal, its content is free on publication to read, download, and share, accelerating the translation of strong science into effective practice.
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