Perceptions and Attitudes of Patients and Health Care Stakeholders on Implementing a Telehealth Service for Preoperative Evaluation: A Qualitative Analysis.

Autor:	Lew E; Women's Anaesthesia, KK Women's and Children's Hospital, Singapore, Singapore.; Anaesthesiology and Perioperative Sciences Academic Clinical Program, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore., Tan SFJ; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore., Teo A; Women's Anaesthesia, KK Women's and Children's Hospital, Singapore, Singapore., Sng BL; Women's Anaesthesia, KK Women's and Children's Hospital, Singapore, Singapore.; Anaesthesiology and Perioperative Sciences Academic Clinical Program, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore., Lum EPM; Health Services and Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
Jazyk:	angličtina
Zdroj:	Telemedicine reports [Telemed Rep] 2023 Jun 26; Vol. 4 (1), pp. 156-165. Date of Electronic Publication: 2023 Jun 26 (Print Publication: 2023).
DOI:	10.1089/tmr.2023.0023
Abstrakt:	Background: Studies suggest that preoperative evaluation can be effectively conducted through telehealth. As the COVID-19 pandemic has accelerated digital transformation, we hypothesize that a new telehealth model of care may be feasibly implemented for preoperative evaluation at our institution. This qualitative study seeks to evaluate the attitudes and perception of elective surgery patients and health care providers toward telehealth conducted for preanesthesia evaluation. Methods: At a tertiary women's hospital in Asia, health care providers and elective surgery patients were recruited by convenience and snowball sampling to undergo one-on-one semistructured interviews regarding a new telehealth model of care for preanesthesia evaluation, under-pinned by the Normalization Process Theory. Data were analyzed, coded, and consolidated into themes using the framework analysis method by a team of four researchers from diverse backgrounds. Results: Twenty-five interviews were conducted among 10 patients and 15 health care participants. Ninety-five codes were identified, consolidated into four themes that connect to guide the implementation of a new telehealth pathway for preoperative care, mapped to the Normalization Process Theory. The themes pertain to advantages of telehealth workflow (coherence), requisites for new telehealth workflow (coherence, collective action), barriers to implementation (cognitive participation, collective action), and enablers of implementation (cognitive participation, collective action). All participants were receptive to telehealth, but health care participants expressed concern about the impact of additional tasks on current clinical workload. Training in videoconferencing was deemed essential by both patients and health care providers. Conclusions: The study has provided insights into levels of coherence and cognitive participation among patients and health care providers. The telehealth workflow should be redesigned, considering systems' constraints and stakeholders' needs. Greater buy-in is needed to gain health care providers' commitment for collective action. Clinicaltrials.gov identifier: NCT05781789. Competing Interests: No competing financial interests exist. (© Eileen Lew et al., 2023; Published by Mary Ann Liebert, Inc.)
Databáze:	MEDLINE
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