一种基于家庭的病人评估的有意远程医疗观看指南的发展。

Telemedicine reports Pub Date : 2021-01-22 eCollection Date: 2021-01-01 DOI:10.1089/tmr.2020.0017
Kimberly D Shea, Victoria Towers, Melissa Koon, Graciela Silva
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引用次数: 1

摘要

背景:越来越多地使用远程医疗在患者家中进行访问,使他们更容易获得护理,也增加了进行全人评估的机会,从而改善个性化护理。视频会议摄像机是家访提供者眼睛的代表。然而,摄像头限制了视野,从而减少了环境线索。从新手到专家的技能习得理论支持使用有意识的观看指南,以确保在家中使用远程医疗(CPATH)进行全面的患者评估。本研究推动了CPATH框架的发展,以指导提供者在使用电视技术时有意识。方法:采用定量内容效度方法来确定原始协议框架中域内先验项目的效度。内容有效性确定需要5-10名专家对域内项目的一致性(范围1-5)进行评级。我们的样本由7位家庭保健专家组成。结果:在方案的15个项目中,只有8个项目在样本量上有显著的一致性。这些项目包括呼吸、非语言手势、体位、氧气、安全性以及药物的种类、剂量和使用指导。在现有的患者特征、治疗和设备功能、药物和环境质量领域中添加了其他项目,但护理人员除外。结论:这些领域引发了对需要评估的现有项目或其他项目的考虑,从而制定了允许个性化远程保健家庭访问的有意指导框架。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Development of an Intentional Telehealth Viewing Guide for Home-Based Patient Assessment.

Development of an Intentional Telehealth Viewing Guide for Home-Based Patient Assessment.

Development of an Intentional Telehealth Viewing Guide for Home-Based Patient Assessment.

Background: The increased use of telehealth to visit patients in their home permits greater access to care, and also increases the opportunity for whole-person assessments that improve individualized care. The videoconferencing camera is a proxy for home visit provider's eyes. However, cameras limit views, thereby reducing environmental cues. The Novice to Expert Theory of skill acquisition supports the use of an intentional viewing guide to assure a comprehensive patient assessment using telehealth in the home (CPATH). This study advances the development of a CPATH framework to guide providers to be intentional when using televideo technology.

Methods: A quantitative content validity approach was used to determine the validity of a priori items within domains that were in the original protocol framework. A content validity determination requires 5-10 experts to rate agreement (range 1-5) on items within domains. Our sample was composed of seven expert home health providers. More than five experts had to agree to achieve statistical significance (p < 0.05) for validity.

Results: Of the 15 items in the protocol, only 8 items had significant agreement for the sample size. These items were breathing, nonverbal gesturing, positioning, oxygen, safety, and types, dosages, and administration guidance of medication. Other items were added within the existing domains of Patient Characteristics, Treatment and Equipment Functioning, Medications and Environmental Quality, with the exception of Caregivers.

Conclusion: The domains triggered considerations for existing or additional items that require assessment, thereby developing the intentional guide framework that permits individualization of a telehealth home-based visit.

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