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首页> 外文期刊>BMC Medical Informatics and Decision Making >What do emergency medicine and burns specialists from resource constrained settings expect from mHealth-based diagnostic support? A qualitative study examining the case of acute burn care
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What do emergency medicine and burns specialists from resource constrained settings expect from mHealth-based diagnostic support? A qualitative study examining the case of acute burn care

机译：资源受限的紧急医疗和烧伤专家对基于mHealth的诊断支持有何期待？对急性烧伤护理病例进行定性研究

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Traumatic injury is a serious global health burden, particularly in low- and middle-income countries where medical care often lacks resources and expertise. In these contexts, diagnostic telemedicine could prove a cost effective tool, yet it remains largely underused here, and knowledge on its potential impact is limited. Particularly scarce is the view of the expert user physicians, and how they themselves relate to this technology. This qualitative study investigated tele-experts’ (n?=?15) views on the potential for image based teleconsultation to be integrated in trauma and emergency care services. A semi-structured interview guide was used to gather data concerning an mHealth app for burns diagnostics in the acute care setting, in the Western Cape, South Africa. Questions examined challenges and opportunities in user acceptance and outcomes, in specific case management and in the wider healthcare system. Resulting data were subject to qualitative content analysis. Experts perceived remote diagnostic support through mHealth as linking directly to several key ideas in medicine, including barriers to care, medical culture and hierarchy, and medical ethics within a society. Ideas running through the data pertained to the widening and narrowing of inherent gaps in the healthcare system, and the formalisation of processes, practices and relationships, effected by the introduction of an app. Wide consensus was stated on positive outcomes such as increased education opportunities, improved professional relationships and a better ability to advise and diagnose, all further facilitated through greater ease of access. The belief was that these could achieve a narrowing of systemic divides within healthcare, although it was acknowledged that the possibility to induce the opposite effect also arose. Differing opinions were voiced relating to the involvement of allied health professionals and feedback. Experts see several aspects to an mHealth app for remote diagnostic support which could enhance provision of trauma and emergency care in a resource poor setting, relating to reduced delays, streamlined care and improved outcomes. Attention is also drawn, however, to specifics of the environment which would demand further and careful consideration for success – time pressure, intensity and the wide range of subspecialties to be considered.
机译：创伤伤害是严重的全球健康负担，尤其是在医疗服务通常缺乏资源和专业知识的中低收入国家中。在这些情况下，诊断远程医疗可以证明是一种具有成本效益的工具，但在这里仍未得到充分利用，并且对其潜在影响的了解也很有限。专家用户医师的观点以及他们自身与这项技术的关系尤其缺乏。这项定性研究调查了远程专家（n？=？15）关于将基于图像的远程咨询整合到创伤和急救服务中的潜力的观点。使用半结构化访谈指南收集了有关mHealth应用程序的数据，该应用程序用于在南非西开普的急性护理环境中进行烧伤诊断。问题探讨了用户接受度和结果，特定案例管理以及更广泛的医疗保健系统中的挑战和机遇。结果数据经过定性内容分析。专家认为，通过mHealth提供的远程诊断支持直接与医学中的几个关键思想联系在一起，包括护理障碍，医学文化和等级制度以及社会中的医学伦理。通过应用程序的引入，贯穿数据的想法涉及到医疗系统中固有差距的扩大和缩小，以及流程，实践和关系的形式化。人们对积极成果达成了广泛共识，例如增加了受教育的机会，改善了职业关系并提高了建议和诊断的能力，所有这些都通过更容易获得而得到了进一步的促进。人们认为，尽管人们认识到也有可能引起相反的效果，但它们可以缩小医疗保健领域的系统性鸿沟。有人就联盟卫生专业人员的参与和反馈发表了不同意见。专家看到了mHealth应用程序提供远程诊断支持的几个方面，这些方面可以在资源匮乏的情况下增强创伤和急诊护理的提供，与减少延迟，简化护理和改善结果有关。但是，也请注意需要进一步仔细考虑成功的环境细节-时间压力，强度和要考虑的广泛子专业。

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