TY - JOUR AU - Craighead, Caitlin G AU - Collart, Christina AU - Frankel, Richard AU - Rose, Susannah AU - Misra-Hebert, Anita D AU - Tucker Edmonds, Brownsyne AU - Michie, Marsha AU - Chien, Edward AU - Coleridge, Marissa AU - Goje, Oluwatosin AU - Ranzini, Angela C AU - Farrell, Ruth M PY - 2022 DA - 2022/12/5 TI - COVID-19大流行期间远程医疗对产前护理的影响:妊娠和产前基因检测讨论中改善卫生保健沟通的障碍和机会的混合方法研究KW - JMIR Form Res SP - e38821 VL - 6 IS - 12 KW -产前卫生保健提供KW -卫生保健沟通KW -远程卫生保健KW -获得卫生保健KW - COVID-19 KW -妊娠AB -背景:COVID-19大流行给卫生保健带来了重大变化，特别是加速了远程卫生保健的使用。鉴于产前护理的独特方面，了解远程保健对保健沟通和质量以及患者满意度的影响非常重要。这项混合方法研究审查了在大流行期间迅速和广泛实施远程保健提供产前护理所面临的挑战。目的:在本研究中，我们调查了COVID-19大流行期间患者的观点、偏好和经验，旨在支持开发成功的模式，以满足怀孕患者、产科提供者和卫生保健系统在此期间的需求。方法:对2021年1 - 12月在俄亥俄州克利夫兰接受门诊产前护理的孕妇进行深度访谈，并完成冠状病毒围产期经历-影响调查(COPE-IS)。转录本使用NVivo 12编码，并使用定性分析，这是一种与扎根理论一致的方法。在分析过程中对定量数据进行汇总和整合。结果:60个访谈达到主题饱和。我们了解到，58%(35/60)的妇女在怀孕前有过远程医疗的经历。 However, only 8% (5/60) of women had used both in-person and virtual visits during this pregnancy, while the majority (54/60, 90%) of women participated in only in-person visits. Among 59 women who responded to the COPE-IS, 59 (100%) felt very well supported by their provider, 31 (53%) were moderately to highly concerned about their child’s health, and 17 (29%) reported that the single greatest stress of COVID-19 was its impact on their child. Lead themes focused on establishing patient-provider relationships that supported shared decision-making, accessing the information needed for shared decision-making, and using technology effectively to foster discussions during the COVID-19 pandemic. Key findings indicated that participants felt in-person visits were more personal, established greater rapport, and built better trust in the patient-provider relationship as compared to telehealth visits. Further, participants felt they could achieve a greater dialogue and ask more questions regarding time-sensitive information, including prenatal genetic testing information, through an in-person visit. Finally, privacy concerns arose if prenatal genetic testing or general pregnancy conversations were to take place outside of the health care facility. Conclusions: While telehealth was recognized as an option to ensure timely access to prenatal care during the COVID-19 pandemic, it also came with multiple challenges for the patient-provider relationship. These findings highlighted the barriers and opportunities to achieve effective and patient-centered communication with the continued integration of telehealth in prenatal care delivery. It is important to address the unique needs of this population during the pandemic and as health care increasingly adopts a telehealth model. SN - 2561-326X UR - https://formative.www.mybigtv.com/2022/12/e38821 UR - https://doi.org/10.2196/38821 UR - http://www.ncbi.nlm.nih.gov/pubmed/36383634 DO - 10.2196/38821 ID - info:doi/10.2196/38821 ER -