A sense of belonging: A meta‐ethnography of the experience of patients with chronic obstructive pulmonary disease receiving care through telemedicine

Aim To synthesize the qualitative research in the literature addressing how patients with chronic obstructive pulmonary disease experience care received by telemedicine. Design Meta‐ethnography. Data Sources Twelve studies, published from 2013 – 2018, were identified by a search of relevant systematic databases in June 2017, including updated searches performed in June 2018. Review Methods The studies were reviewed and critically appraised independently by three researchers. The review followed the seven steps of meta‐ethnography developed by Noblit and Hare, including a line‐of‐argument synthesis. Results The synthesis revealed three second‐order constructs: presence, transparency, and ambivalence. Using a line‐of‐argument synthesis, a model was developed that showed patients’ experience of a sense of belonging when receiving care by telemedicine. Conclusion This meta‐ethnography contributes to the existing and contradictory evidence base of telemedicine to chronic obstructive pulmonary disease patients. It addresses and adds renewed understanding of who would benefit from telemedicine and why, by illustrating the interrelationship between the conditions of telemedicine care, the severity of COPD, and the need for connectedness and emphasizes that the need to belong in telemedicine care increases with the progression of illness burden and severity. Impact The present study endorses the view that the patients with a severe illness burden are likely to benefit the most when receiving care by telemedicine. However, the benefits rely on the fact that the telemedicine interventions involve emotional, social, and clinical support, including regular contact with healthcare professionals, to meet the requirements to belong. 目的 总结文献中关于慢性阻塞性肺疾病患者如何接受远程医疗护理的定性研究。 设计 人口学荟萃分析。 资料来源 通过2017年6月对相关系统数据库进行的检索,包括2018年6月进行的最新检索,确定了2013年至2018年发表的12项研究。 综述方法 这些研究由三位研究人员独立进行评价和批判性评估。评价遵循了Noblit和Hare提出的人口学荟萃分析的七个步骤,包括论点总结法。 结果 此次总结揭示了三个二级结构:存在、透明度和矛盾情绪。采用论点总结法,开发了一个模型,该模型反映了患者在接受远程医疗护理时的归属感体验。 结论 人口学荟萃分析为慢性阻塞性肺疾病患者远程医疗护理提供了现有的、矛盾性证明的证据基础。通过说明远程医疗护理的条件,慢性阻塞性肺病(COPD)的严重程度和对连通性的需要之间的相互关系,提出并补充了关于谁将受益于远程医疗护理以及为什么受益的全新理解,并强调,远程医疗护理需求会随着疾病负担和严重程度的增加而增加。 影响 本研究支持的观点是,有严重疾病负担的患者在接受远程医疗护理时可能受益最大。然而,这些好处取决于这样一个事实,即,远程医疗干预涉及情感、社会和临床支持,包括与医护专业人员的定期接触,以满足归属感的要求。