在产妇护理中优化数字临床咨询:一个现实的审查和实施原则
Catrin Evans1, Georgia Clancy2, Kerry Evans2
1School of Health Sciences, University of Nottingham, Nottingham, UK catrin.evans@nottingham.ac.uk.
BMJ open
|November 1, 2024
概括
在英国产妇服务中进行数字临床咨询可以是有效和可接受的. 实施需要适当的基础设施,个性化和以人际关系为中心的护理,需要更多关于安全和公平的研究.
科学领域:
- 孕产妇健康 孕产妇健康
- 数字健康数字健康
- 医疗保健服务研究 医疗保健服务研究
背景情况:
- 随着COVID-19大流行,英国产妇服务部门加速采用数字临床咨询 (电话/视频通话).
- 需要了解这些咨询的最佳使用方法,以确保安全,个性化和公平的产妇护理.
研究的目的:
- 审查有关产妇系统数字临床咨询的现有证据.
- 确定这些咨询如何,为谁,以及在什么情况下最能支持护理.
主要方法:
- 采用了现实主义的综合方法,分析了经合组织国家2010年至今的证据.
- 从知识用户群体 (包括医疗保健提供者和服务用户) 收集了见解.
- 分析的三个代阶段 (诱导,绑架,回归) 用于开发和完善程序理论.
主要成果:
- 93个证据来源为合成提供了信息,导致了15个程序理论.
- 数字咨询涉及跨组织,提供者,关系和患者背景的机制.
- 有效性和可接受性取决于基础设施,个性化,知情选择,专业自主性和关系质量;关于安全性和公平性的证据较少.
结论:
- 由于系统的复杂性,一个"适合所有人"的方法不适合数字产妇咨询.
- 提出了四个"核心"实施原则:创建环境/基础设施,优化响应/个性化,承认访问/包容,并使质量/安全.
- 进一步的服务创新和研究对于实施和评估这些原则至关重要,特别是在安全和公平方面.
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