Izkušnje kronično obolelih pacientov s telemedicinsko obravnavo v ambulantah družinske medicine
analiza fokusnih skupin
DOI:
https://doi.org/10.14528/snr.2022.56.4.3150Ključne besede:
primarno zdravstveno varstvo, diabetes, kvalitativna raziskava, hipertenzija, telemedicina, uporabniška izkušnjaPovzetek
Uvod: Telemedicinska obravnava stopa v ospredje kot strategija za obvladovanje kroničnih nenalezljivih bolezni, ki v Sloveniji povzročijo visok delež smrti. Namen raziskave je bil preučiti, kakšne izkušnje imajo pacienti z diagnozo kronične bolezni tako z uporabo telemedicinske opreme kot s telemedicinsko obravnavo v ambulanti družinske medicine.
Metode: Julija 2020 so bile v enem od slovenskih zdravstvenih domov izvedene štiri fokusne skupine z 19 pacienti s sladkorno boleznijo tipa 2 in/ali visokim krvnim tlakom. Prepisi skupinskih pogovorov so bili analizirani po načelih induktivne tematske analize.
Rezultati: S pomočjo induktivne tematske analize je bilo oblikovanih sedem tem: prednosti in slabosti telemedicinske obravnave, enostavnost uporabe telemedicinske opreme, dvosmerna komunikacija z zdravstvenim osebjem, učinki telemedicinske obravnave na zdravstveno stanje pacientov, želja po uporabi in dostopnosti telemedicinske obravnave, vpliv in opora okolja ter skrb za lastno zdravje. Teme vsebujejo 10 podtem in 29 dejavnikov.
Diskusija in zaključek: Na izvajanje telemedicinskih meritev najbolj vplivajo zaznana potreba pacientov in navodila zdravstvenega osebja. Kljub pozitivni izkušnji pacientov z uporabo telemedicinske opreme je potrebna strokovna presoja primernosti tovrstne obravnave na individualni ravni, ki ne vključuje le zdravstvenega stanja pacientov, marveč tudi oceno njihovega odnosa do zdravja in digitalnih veščin.
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Literatura
Aberer, F., Hochfellner, D. A., & Mader, J. K. (2021). Application of telemedicine in diabetes care: The time is now. Diabetes Therapy, 12(3), 629–639. https://doi.org/10.1007/s13300-020-00996-7 PMid:33474646; PMCid:PMC7816834
Asua, J., Orruño, E., Reviriego, E., & Gagnon, M. P. (2012). Healthcare professional acceptance of telemonitoring for chronic care patients in primary care. BMC Medical Informatics and Decision Making, 12(1), 139. https://doi.org/10.1186/1472-6947-12-139 PMid:23194420; PMCid:PMC3520721
Beštek, M., & Brodnik, A. (2015). Preconditions for successful eCare. Informatica Medica Slovenica, 20(1/2), 17–29.
Božič, N., Knez, J., Dolenc, P., Salobir, B., Erhartič, A., Čegovnik, B. … Brguljan Hitij, J. (2020). May measurement month 2018: An analysis of blood pressure screening results from Slovenia. European Heart Journal Supplements, 22(Suppl. H), H112–H114. https://doi.org/10.1093/eurheartjsupp/suaa042
Braun, V., & Clarke, V. (2012). Thematic analysis. In H. Cooper, P. M. Camic, D. L. Long, A. T. Panter, D. Rindskopf, & K. J. Sher (Eds.), APA handbook of research methods in psychology, Vol. 2. Research designs: Quantitative, qualitative, neuropsychological, and biological (pp. 57–71). American Psychological Association. https://doi.org/10.1037/13620-004 PMid:22108560
Cimperman, M., Brenčič, M. M., Trkman, P., & Stanonik, M. D. L. (2013). Older adults' perceptions of home telehealth services. Telemedicine and E-Health, 19(10), 786–790. https://doi.org/10.1089/tmj.2012.0272 PMid:23931702; PMCid:PMC3787386
Cimperman, M., Brenčič, M. M., & Trkman, P. (2016). Analyzing older users' home telehealth services acceptance behavior: Applying an Extended UTAUT model. International Journal of Medical Informatics, 90, 22–31. https://doi.org/10.1016/j.ijmedinf.2016.03.002 PMid:27103194
de Graaf, M. M. A., Ben Allouch, S., & van Dijk, J. A. G. M. (2018). A phased framework for long-term user acceptance of interactive technology in domestic environments. New Media & Society, 20(7), 2582–2603. https://doi.org/10.1177/1461444817727264 PMid:30581364; PMCid:PMC6256720
Donelan, K., Barreto, E. A., Sossong, S., Michael, C., Estrada, J. J., Cohen, A. B. ... Schwamm, L. H. (2019). Patient and clinician experiences with telehealth for patient follow-up care. The American Journal of Managed Care, 25(1), 40–44.
Eržen, I., Zaletel, J., & Nadrag, P. (2020). Obvladovanje sladkorne bolezni: Ključni podatki za leto 2019. Retrieved February 12, 2022 from https://www.nijz.si/sites/www.nijz.si/files/uploaded/podatki/sladkorna_bolezen_slikovno_gradivo_2019_f.pdf
European Commission. (2018). Market study on telemedicine. Retrieved January 30, 2022 from https://ec.europa.eu/health/sites/health/files/ehealth/docs/2018_provision_marketstudy_telemedicine_en.pdf
Gellis, Z. D., Kenaley, B., McGinty, J., Bardelli, E., Davitt, J., & Ten Have, T. (2012). Outcomes of a telehealth intervention for homebound older adults with heart or chronic respiratory failure: A randomized controlled trial. The Gerontologist, 52(4), 541–552. https://doi.org/10.1093/geront/gnr134 PMid:22241810
Goodwin, N. (2010). The state of telehealth and telecare in the UK: Prospects for integrated care. Journal of Integrated Care, 18(6), 3–10. https://doi.org/10.5042/jic.2010.0646
Govc Eržen, J., Vračko, P., Čuš, B., & Medved, N. (2017). Timska obravnava v referenčnih ambulantah družinske medicine: Dokument pripravljen za OE NIJZ. Retrieved December 12, 2021 from https://www.nijz.si/sites/www.nijz.si/files/datoteke/clanek_oe_nijz_timska_obravnava_v_radm_04052017.pdf
Guest, G., Namey, E., Taylor, J., Eley, N., & McKenna, K. (2017). Comparing focus groups and individual interviews: Findings from a randomized study. International Journal of Social Research Methodology, 20(6), 693–708. https://doi.org/10.1080/13645579.2017.1281601
Harris, E., Alfonso, S. A., Stewart, B., & Moore, M. A. (2021). Patients are unaware of clinical recommendations and resources. Primary Care Diabetes, 15, 693–698. https://doi.org/10.1016/j.pcd.2021.03.004 PMid:33858784
Hibbard, J. H., & Greene, J. (2013). What the evidence shows about patient activation: Better health outcomes and care experiences; fewer data on costs. Health Affairs, 32(2), 207–214. https://doi.org/10.1377/hlthaff.2012.1061 PMid:23381511
Hvalič-Touzery, S., Dolničar, V., Prevodnik, K., Škafar, M., & Petrovčič, A. (2019). The importance of patients' user experience with a telehealth system for their evaluation of its psychosocial impacts. Proceedings of Smart Living Forum 2019, Villach, 14. November 2019 (pp. 19–25).
Iljaz, R., Meglič, M., Petek, D., Kolšek, M., & Susič, T. P. (2014). Adherence factors to paperless primary healthcare: A focus group study. Zdravstveno varstvo, 53(1), 42–54. https://doi.org/10.2478/sjph-2014-0006
Janković, M., Zili, D., Bizjak Bajec, N., Leskovšek, J., Baje, M., & Ilijaz, R. (2020). Telemedicina v referenčnih ambulantah: Pilotna študija. In T. Marčun & E. Dornik (Eds.), Digitalni mostovi v zdravstvu: e-Kongres MI'2020: zbornik prispevkov in povzetkov (pp. 1–6). Ljubljana: SDMI.
Joo, J. Y., & Liu, M. F. (2021). A scoping review of telehealthassisted case management for chronic illnesses. Western Journal of Nursing Research, 44(6), 598–611. https://doi.org/10.1177/01939459211008917 PMid:33890848
Kaufman, A., Rudel, D., & Rudel, L. (2020). Telemedicinsko spremljanje bolnikov s sladkorno boleznijo v diabetoloških ambulantah. In T. Marčun & E. Dornik (Eds.), Digitalni mostovi v zdravstvu: e-Kongres MI'2020: Zbornik prispevkov in povzetkov (p. 19). Ljubljana: SDMI.
Lehoux, P., Poland, B., & Daudelin, G. (2006). Focus group research and "the patient's view". Social Science & Medicine, 63(8), 2091–2104. https://doi.org/10.1016/j.socscimed.2006.05.016 PMid:16797811
Michaud, T. L., Hill, J. L., Estabrooks, P. A., & Su, D. (2021). Cost analysis of a remote patient monitoring programme for postdischarge patients with type 2 diabetes. Journal of Telemedicine and Telecare. https://doi.org/10.1177/1357633X20985393 PMid:33497310
Nyumba, O. T., Wilson, K., Derrick, C. J., & Mukherjee, N. (2018). The Use of Focus Group Discussion Methodology: Insights from Two Decades of Application in Conservation. Methods in Ecology and Evolution, 9(1), 20–32. https://doi.org/10.1111/2041-210X.12860
OECD. (2019). State of health in the EU: Slovenia country health profile. Retrieved November 12, 2022 from https://www.oecd.org/slovenia/slovenia-country-health-profile-2019-79ba70a2-en.htm
Oliveira Hashiguchi, T. (2020). Bringing health care to the patient: An overview of the use of telemedicine in OECD countries. OECD Health Working Papers, 116. https://doi.org/10.1787/8e56ede7-en.
Pečelin, S., & Sočan, M. (2016). Referenčne ambulante: Izkušnje diplomiranih medicinskih sester. Obzornik zdravstvene nege, 50(2). https://doi.org/10.14528/snr.2016.50.2.82
Petek, D., & Mlakar, M. (2016). Quality of care for patients with diabetes mellitus type 2 in »model practices« in Slovenia: First results. Zdravstveno varstvo, 55(3), 179–184. https://doi.org/10.1515/sjph-2016-0023 PMid:27703537; PMCid:PMC5031067
Petrovčič, A., Peek, S., & Dolničar, V. (2019). Predictors of seniors' interest in assistive applications on smartphones: Evidence from a population-based survey in Slovenia. International Journal of Environmental Research and Public Health, 16(9), 1623. https://doi.org/10.3390/ijerph16091623 PMid:31075879; PMCid:PMC6539287
Polit, D. F., & Tatano Beck, C. (2014). Nursing research: Generating and assessing evidence for nursing practice (8th ed.). London: Lippincott Williams & Wilkins.
Rant, Ž., & Rudel, D. (2021). Telemedicinske storitve v Sloveniji. In P. Šprajc (Ed.), 40. mednarodna konferenca o razvoju organizacijskih znanosti: vrednote, kompetence in spremembe v organizacijah (pp. 849–863). Maribor: Univerza v Mariboru, University Press.
Rudel, D., Slemenik-Pušnik, C., Epšek-Lenart, M., Balorda, Z., & Lavre, J. (2016). Telemedicine support to patients with chronic diseases for better long-term control at home. Slovenian Medical Journal, 85(11/12), 676–685. https://doi.org/10.6016/zdravvestn.1553
Simblett, S., Greer, B., Matcham, F., Curtis, H., Polhemus, A., Ferrão, J. ... Wykes, T. (2018). Barriers to and facilitators of engagement with remote measurement technology for managing health: Systematic review and content analysis of findings. Journal of Medical Internet Research, 20(7), Article e10480. https://www.jmir.org/2018/7/e10480/ PMid:30001997; PMCid:PMC6062692
Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., & Caffery, L. J. (2020). Determining if telehealth can reduce health system costs: Scoping review. Journal of Medical Internet Research, 22(10), Article e17298. https://doi.org/10.2196/17298 PMid:33074157; PMCid:PMC7605980
Steigenberger, C., Flatscher-Thoeni, M., Siebert, U., & Leiter, A. M. (2022). Determinants of willingness to pay for health services: A systematic review of contingent valuation studies. The European Journal of Health Economics, 23,1455–1482. https://doi.org/10.1007/s10198-022-01437-x PMid:35166973; PMCid:PMC8853086
Su, D., Michaud, T. L., Estabrooks, P., Schwab, R. J., Eiland, L. A., Hansen, G. … Siahpush, M. (2019). Diabetes management through remote patient monitoring: The importance of patient activation and engagement with the technology. Telemedicine and E-Health, 25(10), 952–959. https://doi.org/10.1089/tmj.2018.0205 PMid:30372366
van den Berg, N., Schumann, M., Kraft, K., & Hoffmann, W. (2012). Telemedicine and telecare for older patients: A systematic review. Maturitas, 73(2), 94–114. https://doi.org/10.1016/j.maturitas.2012.06.010 PMid:22809497
Vermeulen, J., Neyens, J. C. L., Spreeuwenberg, M. D., van Rossum, E., Sipers, W., Habets, H. … de Witte, L. P. (2013). User-centered development and testing of a monitoring system that provides feedback regarding physical functioning to elderly people. Patient Preference and Adherence, 7, 843–854. https://doi.org/10.2147/PPA.S45897 PMid:24039407; PMCid:PMC3770345
Zaletel, J. (2020). Akcijski načrt za obvladovanje sladkorne bolezni 2020-2021 (ANOSB), poročilo za leto 2020. Retrieved November 22, 2021 from https://www.obvladajmosladkorno.si/wp-content/uploads/2020/11/Porocilo-2020-k-ANOSB-20-21.pdf
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