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新加坡社区医护人员对老年人使用远程牙科的看法:一项定性研究。

Perceptions of community healthcare workers on the use of teledentistry for seniors in Singapore: A qualitative study.

作者信息

Nurjono Milawaty, Ho Ezra, Lee Jing Yi, Petcu Roland, Sim Christina Pc

机构信息

Health Services Research, Changi General Hospital, Singapore, Singapore.

Centre for Population Health and Implementation Research, Singapore, Singapore.

出版信息

Digit Health. 2025 Jan 15;11:20552076241312562. doi: 10.1177/20552076241312562. eCollection 2025 Jan-Dec.

Abstract

OBJECTIVE

This study aimed to identify barriers and facilitators surrounding the implementation of TDOCS from Community Health Workers (CHW)'s perspective before TDOCS implementation.

METHODS

A descriptive qualitative study was conducted through semistructured interviews with a purposive sampling of CHWs from partner nursing homes and home care teams. A French framework outlining barriers to asynchronous oral teleconsultation adoption was used to develop the topic guide for this study. Then, the Consolidated Framework for Implementation research (CFIR 1.0) was used to guide coding and analysis.

RESULTS

A total of 43 CHWs from participating institutions were interviewed prior to receiving teledentistry training. Perceived barriers included low awareness about the importance of dental care, limiting conditions to T-DOCS participation among beneficiaries, limited understanding of T-DOCS, perceived low self-efficacy among CHWs, manpower shortages, perceived low priority of dental care, competition with other nursing duties and restricted access due to COVID-19. Facilitators included existing relationships between CHWs and beneficiaries, receptivity towards participation, CHWs' motivation to upskill and improve dental care for seniors, prior experience with other telemedicine technology, perceived need for change, supportive management, colleagues and existing impediments to access dental care.

CONCLUSION

This study identified barriers and facilitators to implementing T-DOCS from the CHWs' perspectives. We recommend for targeted CHW training, programme champions, workflow integration and incentivisation schemes. Addressing challenges like manpower strain and resource limitations through efficient scheduling and capacity building is vital for sustainability. Policy-level support, including legal frameworks, funding and regulatory structures, is essential for integrating teledentistry into mainstream healthcare.

摘要

目的

本研究旨在从社区卫生工作者(CHW)的角度,在远程口腔综合护理服务(TDOCS)实施之前,确定围绕其实施的障碍和促进因素。

方法

通过对来自合作疗养院和家庭护理团队的CHW进行有目的抽样的半结构化访谈,开展了一项描述性定性研究。一个概述异步口腔远程会诊采用障碍的法国框架被用于制定本研究的主题指南。然后,实施研究综合框架(CFIR 1.0)被用于指导编码和分析。

结果

在接受远程牙科培训之前,共对来自参与机构的43名CHW进行了访谈。感知到的障碍包括对牙齿护理重要性的认识不足、限制受益人参与TDOCS的条件、对TDOCS的理解有限、CHW中自我效能感较低、人力短缺、认为牙齿护理的优先级较低、与其他护理职责的竞争以及由于COVID-19导致的获取受限。促进因素包括CHW与受益人之间现有的关系、对参与的接受度、CHW提升技能和改善老年人牙齿护理的积极性、先前使用其他远程医疗技术的经验、感知到的变革需求、支持性的管理、同事以及现有的获取牙齿护理的障碍。

结论

本研究从CHW的角度确定了实施TDOCS的障碍和促进因素。我们建议进行有针对性的CHW培训、设立项目倡导者、整合工作流程和激励计划。通过高效的排班和能力建设来应对人力紧张和资源限制等挑战对于可持续性至关重要。包括法律框架、资金和监管结构在内的政策层面支持对于将远程牙科纳入主流医疗保健至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c3a/11736726/8424bfe4e869/10.1177_20552076241312562-fig1.jpg

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