‘It was like he was in the room with us’: patients’ and carers’ perspectives of telemedicine in acute
stroke
‘It was like he was in the room with us’: patients’ and carers’ perspectives of telemedicine in acute
stroke
Background
Telemedicine can facilitate delivery of thrombolysis in acute stroke. The aim of this qualitative study was to explore patients’ and carers’ views of their experiences of using a stroke telemedicine system in order to contribute to the development of reliable and acceptable telemedicine systems and training for health-care staff.
Method
We recruited patients who had, and carers who were present at, recent telemedicine consultations for acute stroke in three hospitals in NW England. Semi-structured interviews were conducted using an interview guide based on normalization process theory (NPT). Thematic analysis was undertaken.
Results
We conducted 24 interviews with 29 participants (16 patients; 13 carers). Eleven interviews pertained to ‘live’ telemedicine assessments (at the time of admission); nine had mock-up telemedicine assessments (within 48 h of admission); four had both assessments. Using the NPT domains as a framework for analysis, factors relating to coherence (sense making) included people's knowledge and understanding of telemedicine. Cognitive participation (relational work) included interaction between staff and with patients and carers. Issues relating to collective action (operational work) included information exchange and support, and technical matters. Findings relating to reflexive monitoring (appraisal) included positive and negative impressions of the telemedicine process, and emotional reactions.
Conclusion
Although telemedicine was well accepted by many participants, its use added an additional layer of complexity to the acute stroke consultation. The ‘remote’ nature of the consultation posed challenges for some patients. These issues may be ameliorated by clear information for patients and carers, staff interpersonal skills, and teamworking.
acute stroke, telemedicine, remote consultation, thrombolysis, patient satisfaction, carer satisfaction
1-14
Gibson, Josephine
ceb63331-237e-4528-b4fe-2460587e95a0
Lightbody, Elizabeth
ca78cd98-e5fe-47f9-b701-a74c6486e726
McLoughlin, Alison
0791774d-24dc-43c8-88cd-7a39191bde27
MacAdam, Joanna
6d612543-7588-4dfe-a93a-9a84529e297c
Gibson, Alison
33df43ec-8313-404d-9b37-23406e8b14c6
Day, Elaine
24fa652d-43e4-426f-a4e1-5dc4976b6cbb
Fitzgerald, Jane
0e75b082-1949-441b-b178-0e2575e3a3ea
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Gibson, Josephine
ceb63331-237e-4528-b4fe-2460587e95a0
Lightbody, Elizabeth
ca78cd98-e5fe-47f9-b701-a74c6486e726
McLoughlin, Alison
0791774d-24dc-43c8-88cd-7a39191bde27
MacAdam, Joanna
6d612543-7588-4dfe-a93a-9a84529e297c
Gibson, Alison
33df43ec-8313-404d-9b37-23406e8b14c6
Day, Elaine
24fa652d-43e4-426f-a4e1-5dc4976b6cbb
Fitzgerald, Jane
0e75b082-1949-441b-b178-0e2575e3a3ea
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Gibson, Josephine, Lightbody, Elizabeth, McLoughlin, Alison, MacAdam, Joanna, Gibson, Alison, Day, Elaine, Fitzgerald, Jane and May, Carl
(2015)
‘It was like he was in the room with us’: patients’ and carers’ perspectives of telemedicine in acute
stroke.
Health Expectations, .
(doi:10.1111/hex.12333).
(PMID:25581591)
Abstract
Background
Telemedicine can facilitate delivery of thrombolysis in acute stroke. The aim of this qualitative study was to explore patients’ and carers’ views of their experiences of using a stroke telemedicine system in order to contribute to the development of reliable and acceptable telemedicine systems and training for health-care staff.
Method
We recruited patients who had, and carers who were present at, recent telemedicine consultations for acute stroke in three hospitals in NW England. Semi-structured interviews were conducted using an interview guide based on normalization process theory (NPT). Thematic analysis was undertaken.
Results
We conducted 24 interviews with 29 participants (16 patients; 13 carers). Eleven interviews pertained to ‘live’ telemedicine assessments (at the time of admission); nine had mock-up telemedicine assessments (within 48 h of admission); four had both assessments. Using the NPT domains as a framework for analysis, factors relating to coherence (sense making) included people's knowledge and understanding of telemedicine. Cognitive participation (relational work) included interaction between staff and with patients and carers. Issues relating to collective action (operational work) included information exchange and support, and technical matters. Findings relating to reflexive monitoring (appraisal) included positive and negative impressions of the telemedicine process, and emotional reactions.
Conclusion
Although telemedicine was well accepted by many participants, its use added an additional layer of complexity to the acute stroke consultation. The ‘remote’ nature of the consultation posed challenges for some patients. These issues may be ameliorated by clear information for patients and carers, staff interpersonal skills, and teamworking.
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Uclan telestroke paper.docx
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More information
Accepted/In Press date: 5 December 2014
e-pub ahead of print date: 8 January 2015
Keywords:
acute stroke, telemedicine, remote consultation, thrombolysis, patient satisfaction, carer satisfaction
Organisations:
Faculty of Health Sciences
Identifiers
Local EPrints ID: 375016
URI: http://eprints.soton.ac.uk/id/eprint/375016
ISSN: 1369-6513
PURE UUID: e8877640-5be8-4165-af25-baf0883aee4c
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Date deposited: 08 Jul 2015 13:28
Last modified: 14 Mar 2024 19:17
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Contributors
Author:
Josephine Gibson
Author:
Elizabeth Lightbody
Author:
Alison McLoughlin
Author:
Joanna MacAdam
Author:
Alison Gibson
Author:
Elaine Day
Author:
Jane Fitzgerald
Author:
Carl May
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