Research Article
BibTex RIS Cite

Family physicians' opinions on examination fear and telemedicine during the pandemic

Year 2023, Volume: 8 Issue: 5, 124 - 129, 12.10.2023
https://doi.org/10.22391/fppc.1345672

Abstract

Introduction: During Covid-19 pandemic, many hospitals closed their outpatient clinics because of the high number of inpatients and individuals turned to their family physicians for medical care. In this study, we aimed to evaluate the opinions of family physicians regarding examination phobia and telemedicine video examinations during the pandemic.
Methods: This was a single-centered, cross-sectional study. The participating physicians completed a questionnaire with 28 questions including their sociodemographic data, whether they performed examination during the pandemic, telemedicine knowledge and opinions on telemedicine. Statistical analysis was conducted using SPSS 20 software package and statistical significance was set at p<0.05.
Results: 364 family physicians participated in our study and 163 of them (44.8%) reported hesitation while examining patients, with the majority (53.8%; n=196) expressing anxiety about oropharyngeal examinations. 211 of them (58%) reported having knowledge of telemedicine. The majority of family physicians thought that follow-ups and prescriptions for chronic diseases, repeat prescriptions, and post-treatment control examinations could be performed online whereas pregnant, postpartum, infant, and child follow-ups could not. While 40% (n=146) didn’t want to provide services via video/telephone examination, 32.7% (n=119) wanted to and 27.2% (n=99) undecided. 86.8% (n=316) of them believed that telemedicine video/telephone examination could result in legal problems. Participants estimated that less than 25% of their daily patients were suitable for telemedicine, and that less than 25% had access to the necessary technology. However, 55.8% (n=203) of family physicians believed that patients would be interested in telemedicine, and 59.6% (n=216) thought that providing such services would increase their workload. Being undecided about providing services through telemedicine was more common among women (p=0.029), while unwillingness to provide online services increased with age and years of occupation (p=0.024, p=0.004, respectively).
Conclusion: Telemedicine, which has come to the forefront with the development of technology today, was seen as an opportunity to reduce contact with patients during the pandemic. However, our study found that family physicians believed that telemedicine services would increase their workload and that a large portion of society was not ready for this system.
Keywords: Telemedicine, telehealth, covid 19, family physician.

Ethical Statement

Ethical committee approval was obtained from Health Science University Sisli Hamidiye Etfal Training and Research Hospital Clinical Research Ethics Committee protocol dated 22.02.2022 and numbered 3421.

References

  • 1. Combi C, Pozzani G, Pozzi G. Telemedicine for developing countries a survey and some design issues. Appl Clin Inf 2016;7:1025–50. https://doi.org/10.4338/ACI-2016-06-R-0089
  • 2. World Health Organization. Telemedicine: Opportunities and developments in Member States: report on the second global survey on eHealth. Available at: https://apps.who.int/iris/handle/10665/44497 (Access Date: 10.08.2023)
  • 3. Kruse CS, Williams K, Bohls J, Shaamsi, W. Telemedicine and health policy: A systematic review. Heal Policy Technol. 2021;10(1):209–29. https://doi.org/10.1016/j.hlpt.2020.10.006
  • 4. Urquart AC, Antoniotti NM, Berg RL. Telemedicine-an efficient and cost-effective approach in parathyroid surgery. Laryngoscope. 2011;121(7):1422-25. https://doi.org/10.1002/lary.21812
  • 5. Wood PR, Caplan L. Outcomes, satisfaction, and costs of a rheumatology telemedicine program: A longitudinal evaluation. J Clin Rheumatol. 2019;25(1):41-4. https://doi.org/10.1097/RHU.0000000000000778
  • 6. Korkmaz S, Hosman I. [Telemedicine applications in health sector: a research in volving telemedicine application dimensions] (in Turkish). Int J Health Manage Strategies Res 2018;4(3):251–63.
  • 7. Sungur C. [Patient satisfaction in telemedicine applications: A systematic review] (in Turkish). Hacettepe Health Administration J. 2020;23(3):505–22.
  • 8. Turkish Ministiry of Health. Directive on the Procedures and Principles of Tele Health Service Application. 2015. Available at: https://www.noroloji.org.tr/TNDData/Uploads/files/telesaglikservisi%20uygulamaesasveusulleri129075.pdf (Access Date: 10.08.2023)
  • 9. Lukas H, Xu C, Yu Y, Gao W. Emerging telemedicine tools for remote Covid-19 diagnosis, monitoring, and management. ACS Nano. 2020;14(12):16180. https://doi.org/10.1021/acsnano.0c08494
  • 10. Gokseven Y, Curebal B, Turkoz D, Yazla B, Ozmen S, Zeren Ozturk G, et al. Evaluation of the Covid-19 triage results in an education family practice center. Anatol J Fam Med. 2022;5(1):12–6. https://doi.org/10.5505/anatoljfm.2021.26928
  • 11. Yilmaz ZU, Duman S, Ozturk GZ, Ozdemir HM, Gunindi Hogan G, Karatas E. Evaluating the home isolation of Covid-19 patients in primary care. J Ideas Heal. 2021;4(2):357–64. https://doi.org/10.47108/jidhealth.Vol4.Iss2.106
  • 12. Onal S, Kaya GG. [Remote patient follow-up and tele-medicine in the pandemic process and its place in primary care] (in Turkish). Clin Med Fam Pract J. 2020;12(3):98–106.
  • 13. Gelmez Tas B, Ozceylan G, Zeren Ozturk G, Toprak D. Evaluation of job strain of family physicians in Covid-19 pandemic period- An example from Turkey. J Community Health. 2021;46:777–85. https://doi.org/10.1007/s10900-020-00950-5
  • 14. Gelfman DM. Will the traditional physical examination be another casualty of Covid-19? Am J Med. 2021;134(3):299–300. https://doi.org/10.1016/j.amjmed.2020.10.026
  • 15. Hyman P. The disappearance of the primary care physical examination-losing touch. JAMA Intern Med. 2020;180(11):1417–8. https://doi.org/10.1001/jamainternmed.2020.3546
  • 16. Esmeray O, Oner C, Cetin H, Simsek EE. [Evaluation of the covid-19 pandemia experience of a family health center.] (in Turkish). Acta Med Micomedia 2021;4(2):56–63.
  • 17. Farrer LM, Batterham PJ, Gulliver A, Morse A, Calear AL, McCallum S, et al. The factors associated with telehealth use and avoidance during the Covid-19 pandemic: longitudinal survey. J Med Internet Res. 2023;25(1):e43798. https://doi.org/10.2196/43798
  • 18. Li P, Liu X, Mason E, Hu G, Zhou Y, Li W, et al. How telemedicine integrated into China’s anti-Covid-19 strategies: case from a National Referral Center. BMJ Heal Care Informatics. 2020;27(3):100164. https://doi.org/10.1136/bmjhci-2020-100164
  • 19. Grüne S. Anamnesis and clinical examination. DMW - Dtsch Medizinische Wochenschrift. 2016;141(01):24–7. https://doi.org/10.1055/s-0041-106337
  • 20. Kocaballi AB, Coiera E, Tong HL, White SJ, Quiroz JC, Rezazadegan F, et al. A network model of activities in primary care consultations. J Am Med Inform Assoc. 2019;26(10):1074. https://doi.org/10.1093/jamia/ocz046
  • 21. Martinez KA, Rood M, Jhangiani N, Kou L, Rose S, Boissy A, et al. Patterns of use and correlates of patient satisfaction with a large nationwide direct to consumer telemedicine service. J Gen Intern Med. 2018;33(10):1768–73. https://doi.org/10.1007/s11606-018-4621-5
  • 22. Loeb AE, Rao SS, Ficke JR, Morris CD, Riley LH, Levin AS. Departmental experience and lessons learned with accelerated introduction of telemedicine during the Covid-19 crisis. J Am Acad Orthop Surg. 2020;28(11):E469–76. https://doi.org/10.5435/JAAOS-D-20-00380
  • 23. Chaet D, Clearfield R, Sabin JE, Skimming K. Ethical practice in telehealth and telemedicine. J Gen Intern Med. 2017;32(10):1136. https://doi.org/10.1007/s11606-017-4082-2
  • 24. Chou E, Hsieh YL, Wolfshohl J, Green F, Bhakta T. Onsite telemedicine strategy for coronavirus (Covid-19) screening to limit exposure in ED. Emerg Med J. 2020;37(6):335–7. https://doi.org/10.1136/emermed-2020-209645
  • 25. Golinelli D, Boetto E, Carullo G, Nuzzolese AG, Landini MP, Fantini MP. Adoption of Digital Technologies in Health Care During the COVID-19 Pandemic: Systematic Review of Early Scientific Literature. J Med Internet Res 2020;22(11):e22280. https://doi.org/10.2196/22280
  • 26. Hong YR, Lawrence J, Williams Jr D, Mainous III A. Population-level interest and telehealth capacity of us hospitals in response to Covid-19: cross-sectional analysis of Google search and national hospital survey data. JMIR Public Heal Surveill. 2020;6(2)e18961. https://doi.org/10.2196/18961
  • 27. Keshvardoost S, Bahaadinbeigy K, Fatehi F. Role of Telehealth in the Management of Covid-19: Lessons Learned from Previous SARS, MERS, and Ebola Outbreaks. Telemed J H Health. 2020;26(7):850–2. https://doi.org/10.1089/tmj.2020.0105
  • 28. Prasad A, Brewster R, Newman JG, Rajasekaran K. Optimizing your telemedicine visit during the Covid‐19 pandemic: Practice guidelines for patients with head and neck cancer. Head Neck. 2020;42(6):1317. https://doi.org/10.1002/hed.26197
  • 29. Ho A, Quick O. Leaving patients to their own devices? Smart technology, safety and therapeutic relationships. BMC Med Ethics. 2018;19(1):18. https://doi.org/10.1186/s12910-018-0255-8
  • 30. Botrugno C. Towards an ethics for telehealth. Nurs Ethics. 2019;26(2):357–67. https://doi.org/10.1177/0969733017705004

Aile hekimlerinin pandemi döneminde muayene fobisi ve online görüntülü muayene hakkındaki görüşleri

Year 2023, Volume: 8 Issue: 5, 124 - 129, 12.10.2023
https://doi.org/10.22391/fppc.1345672

Abstract

Giriş: Covid-19 pandemisinde birçok hastane yatan hasta yoğunluğundan polikliniklerini kapatmış ve bireyler tıbbi gereksinimleri için aile hekimlerine yönelmiştir. Bu çalışmada, pandemi sürecinde aile hekimlerinin muayene fobisi ve online görüntülü muayene hakkındaki görüşlerini değerlendirmeyi amaçladık.
Yöntem: Bu çalışma, tek merkezli ve kesitsel nitelikte bir çalışmadır. Hekimlere sosyodemografik verilerinin değerlendirildiği sorular ile tarafımızca hazırlanan pandemide muayene durumları ile online muayene hakkında bilgi durumu ve hekimlerin online muayene hakkında görüşlerini sorgulayan 28 sorudan oluşan bilgi formu uygulandı. p<0,05 istatistiksel olarak anlamlı kabul edilerek, istatistiksel analizde SPSS 20 paket programı kullanıldı.
Bulgular: Çalışmaya 364 aile hekimi katılmış ve bunların 163'ü (%44,8) hastaları muayene ederken çekindiğini belirtirken, en çok orofarinks muayenesinden çekindiklerini belirtmişlerdi (%53,8; n=196). Çalışmamıza katılan aile hekimlerinin %58 (n=211)’i online muayeneyi bildiğini ifade etmiştir. Aile hekimlerinin çoğunluğu kronik hastalıkların takip ve reçetelerinin, reçete tekrarlarının ve tedavi sonrası kontrol muayenelerinin online muayene üzerinden yapılabileceğini, gebe, lohusa, bebek ve çocuk takiplerinin ise yapılamayacağını düşünmekteydi. Aile hekimlerinin pandemi sürecinde %40(n=146) online muayene ile hizmet vermek istemezken; %32,7 (n=119)istemekte, %27,2 (n=99)’u kararsızdı. Aile Hekimlerinin %86.8 (n=316)’i online muayenenin hukuksal sorunlara yol açabileceğini düşünmektedir. Katılımcılar günlük hastalarının %25’inden azının online muayeneye uygun olduğunu ve kullanabilecek imkanların %25’inden azının sahip olduğunu düşünmekteydi. Ancak yine de Aile Hekimlerinin %55,8’i (n=203) hastaların buna ilgi göstereceğini ve %59,6’sı (n=216) iş yükünü arttıracağı fikrindeydi. Online muayene yoluyla hizmet sunma konusunda kararsız olma kadınlar arasında daha yaygınken (p=0,029), online hizmet sunma konusundaki isteksizlik yaş ve meslek yılı ile artmaktadır (sırasıyla p=0,024, p=0,004). Pandemi döneminde hasta muayene etme fobisi bulunan aile hekimleri online muayene hizmeti vermeye daha istekliydi (p=0,007). Ancak koruyucu ekipman kullanımına dikkat etme ile online muayene hizmeti sunma arasında anlamlı bir ilişki bulunmamıştır (p=0,069).
Sonuç: Günümüzde teknolojinin gelişmesiyle birlikte ön plana çıkan online muayene, pandemi döneminde hastalarla teması azaltmak için bir fırsat olarak görülmüştür. Ancak çalışmamız, aile hekimlerinin online muayenenin iş yüklerini artıracağına inandıklarını ve toplumun büyük bir kısmının bu sisteme hazır olmadığını ortaya koydu.
Anahtar Kelimeler: Tele tıp, tele sağlık, covid 19, aile hekimliği

Ethical Statement

Ethical committee approval was obtained from Health Science University Sisli Hamidiye Etfal Training and Research Hospital Clinical Research Ethics Committee protocol dated 22.02.2022 and numbered 3421.

References

  • 1. Combi C, Pozzani G, Pozzi G. Telemedicine for developing countries a survey and some design issues. Appl Clin Inf 2016;7:1025–50. https://doi.org/10.4338/ACI-2016-06-R-0089
  • 2. World Health Organization. Telemedicine: Opportunities and developments in Member States: report on the second global survey on eHealth. Available at: https://apps.who.int/iris/handle/10665/44497 (Access Date: 10.08.2023)
  • 3. Kruse CS, Williams K, Bohls J, Shaamsi, W. Telemedicine and health policy: A systematic review. Heal Policy Technol. 2021;10(1):209–29. https://doi.org/10.1016/j.hlpt.2020.10.006
  • 4. Urquart AC, Antoniotti NM, Berg RL. Telemedicine-an efficient and cost-effective approach in parathyroid surgery. Laryngoscope. 2011;121(7):1422-25. https://doi.org/10.1002/lary.21812
  • 5. Wood PR, Caplan L. Outcomes, satisfaction, and costs of a rheumatology telemedicine program: A longitudinal evaluation. J Clin Rheumatol. 2019;25(1):41-4. https://doi.org/10.1097/RHU.0000000000000778
  • 6. Korkmaz S, Hosman I. [Telemedicine applications in health sector: a research in volving telemedicine application dimensions] (in Turkish). Int J Health Manage Strategies Res 2018;4(3):251–63.
  • 7. Sungur C. [Patient satisfaction in telemedicine applications: A systematic review] (in Turkish). Hacettepe Health Administration J. 2020;23(3):505–22.
  • 8. Turkish Ministiry of Health. Directive on the Procedures and Principles of Tele Health Service Application. 2015. Available at: https://www.noroloji.org.tr/TNDData/Uploads/files/telesaglikservisi%20uygulamaesasveusulleri129075.pdf (Access Date: 10.08.2023)
  • 9. Lukas H, Xu C, Yu Y, Gao W. Emerging telemedicine tools for remote Covid-19 diagnosis, monitoring, and management. ACS Nano. 2020;14(12):16180. https://doi.org/10.1021/acsnano.0c08494
  • 10. Gokseven Y, Curebal B, Turkoz D, Yazla B, Ozmen S, Zeren Ozturk G, et al. Evaluation of the Covid-19 triage results in an education family practice center. Anatol J Fam Med. 2022;5(1):12–6. https://doi.org/10.5505/anatoljfm.2021.26928
  • 11. Yilmaz ZU, Duman S, Ozturk GZ, Ozdemir HM, Gunindi Hogan G, Karatas E. Evaluating the home isolation of Covid-19 patients in primary care. J Ideas Heal. 2021;4(2):357–64. https://doi.org/10.47108/jidhealth.Vol4.Iss2.106
  • 12. Onal S, Kaya GG. [Remote patient follow-up and tele-medicine in the pandemic process and its place in primary care] (in Turkish). Clin Med Fam Pract J. 2020;12(3):98–106.
  • 13. Gelmez Tas B, Ozceylan G, Zeren Ozturk G, Toprak D. Evaluation of job strain of family physicians in Covid-19 pandemic period- An example from Turkey. J Community Health. 2021;46:777–85. https://doi.org/10.1007/s10900-020-00950-5
  • 14. Gelfman DM. Will the traditional physical examination be another casualty of Covid-19? Am J Med. 2021;134(3):299–300. https://doi.org/10.1016/j.amjmed.2020.10.026
  • 15. Hyman P. The disappearance of the primary care physical examination-losing touch. JAMA Intern Med. 2020;180(11):1417–8. https://doi.org/10.1001/jamainternmed.2020.3546
  • 16. Esmeray O, Oner C, Cetin H, Simsek EE. [Evaluation of the covid-19 pandemia experience of a family health center.] (in Turkish). Acta Med Micomedia 2021;4(2):56–63.
  • 17. Farrer LM, Batterham PJ, Gulliver A, Morse A, Calear AL, McCallum S, et al. The factors associated with telehealth use and avoidance during the Covid-19 pandemic: longitudinal survey. J Med Internet Res. 2023;25(1):e43798. https://doi.org/10.2196/43798
  • 18. Li P, Liu X, Mason E, Hu G, Zhou Y, Li W, et al. How telemedicine integrated into China’s anti-Covid-19 strategies: case from a National Referral Center. BMJ Heal Care Informatics. 2020;27(3):100164. https://doi.org/10.1136/bmjhci-2020-100164
  • 19. Grüne S. Anamnesis and clinical examination. DMW - Dtsch Medizinische Wochenschrift. 2016;141(01):24–7. https://doi.org/10.1055/s-0041-106337
  • 20. Kocaballi AB, Coiera E, Tong HL, White SJ, Quiroz JC, Rezazadegan F, et al. A network model of activities in primary care consultations. J Am Med Inform Assoc. 2019;26(10):1074. https://doi.org/10.1093/jamia/ocz046
  • 21. Martinez KA, Rood M, Jhangiani N, Kou L, Rose S, Boissy A, et al. Patterns of use and correlates of patient satisfaction with a large nationwide direct to consumer telemedicine service. J Gen Intern Med. 2018;33(10):1768–73. https://doi.org/10.1007/s11606-018-4621-5
  • 22. Loeb AE, Rao SS, Ficke JR, Morris CD, Riley LH, Levin AS. Departmental experience and lessons learned with accelerated introduction of telemedicine during the Covid-19 crisis. J Am Acad Orthop Surg. 2020;28(11):E469–76. https://doi.org/10.5435/JAAOS-D-20-00380
  • 23. Chaet D, Clearfield R, Sabin JE, Skimming K. Ethical practice in telehealth and telemedicine. J Gen Intern Med. 2017;32(10):1136. https://doi.org/10.1007/s11606-017-4082-2
  • 24. Chou E, Hsieh YL, Wolfshohl J, Green F, Bhakta T. Onsite telemedicine strategy for coronavirus (Covid-19) screening to limit exposure in ED. Emerg Med J. 2020;37(6):335–7. https://doi.org/10.1136/emermed-2020-209645
  • 25. Golinelli D, Boetto E, Carullo G, Nuzzolese AG, Landini MP, Fantini MP. Adoption of Digital Technologies in Health Care During the COVID-19 Pandemic: Systematic Review of Early Scientific Literature. J Med Internet Res 2020;22(11):e22280. https://doi.org/10.2196/22280
  • 26. Hong YR, Lawrence J, Williams Jr D, Mainous III A. Population-level interest and telehealth capacity of us hospitals in response to Covid-19: cross-sectional analysis of Google search and national hospital survey data. JMIR Public Heal Surveill. 2020;6(2)e18961. https://doi.org/10.2196/18961
  • 27. Keshvardoost S, Bahaadinbeigy K, Fatehi F. Role of Telehealth in the Management of Covid-19: Lessons Learned from Previous SARS, MERS, and Ebola Outbreaks. Telemed J H Health. 2020;26(7):850–2. https://doi.org/10.1089/tmj.2020.0105
  • 28. Prasad A, Brewster R, Newman JG, Rajasekaran K. Optimizing your telemedicine visit during the Covid‐19 pandemic: Practice guidelines for patients with head and neck cancer. Head Neck. 2020;42(6):1317. https://doi.org/10.1002/hed.26197
  • 29. Ho A, Quick O. Leaving patients to their own devices? Smart technology, safety and therapeutic relationships. BMC Med Ethics. 2018;19(1):18. https://doi.org/10.1186/s12910-018-0255-8
  • 30. Botrugno C. Towards an ethics for telehealth. Nurs Ethics. 2019;26(2):357–67. https://doi.org/10.1177/0969733017705004

Details

Primary Language English
Subjects Family Medicine
Journal Section Original Research
Authors

Beray GELMEZ TAŞ 0000-0002-7126-0024

Güzin ZEREN OZTURK 0000-0001-7730-2929

Seda ÖZMEN SEVER 0000-0002-2451-6074

Saliha Büşra AKSU 0000-0003-0432-6801

Publication Date October 12, 2023
Submission Date August 18, 2023
Acceptance Date September 22, 2023
Published in Issue Year 2023Volume: 8 Issue: 5

Cite

APA GELMEZ TAŞ, B., ZEREN OZTURK, G., ÖZMEN SEVER, S., AKSU, S. B. (2023). Family physicians’ opinions on examination fear and telemedicine during the pandemic. Family Practice and Palliative Care, 8(5), 124-129. https://doi.org/10.22391/fppc.1345672
AMA GELMEZ TAŞ B, ZEREN OZTURK G, ÖZMEN SEVER S, AKSU SB. Family physicians’ opinions on examination fear and telemedicine during the pandemic. Fam Pract Palliat Care. October 2023;8(5):124-129. doi:10.22391/fppc.1345672
Chicago GELMEZ TAŞ, Beray, Güzin ZEREN OZTURK, Seda ÖZMEN SEVER, and Saliha Büşra AKSU. “Family physicians’ Opinions on Examination Fear and Telemedicine During the Pandemic”. Family Practice and Palliative Care 8, no. 5 (October 2023): 124-29. https://doi.org/10.22391/fppc.1345672.
EndNote GELMEZ TAŞ B, ZEREN OZTURK G, ÖZMEN SEVER S, AKSU SB (October 1, 2023) Family physicians’ opinions on examination fear and telemedicine during the pandemic. Family Practice and Palliative Care 8 5 124–129.
IEEE B. GELMEZ TAŞ, G. ZEREN OZTURK, S. ÖZMEN SEVER, and S. B. AKSU, “Family physicians’ opinions on examination fear and telemedicine during the pandemic”, Fam Pract Palliat Care, vol. 8, no. 5, pp. 124–129, 2023, doi: 10.22391/fppc.1345672.
ISNAD GELMEZ TAŞ, Beray et al. “Family physicians’ Opinions on Examination Fear and Telemedicine During the Pandemic”. Family Practice and Palliative Care 8/5 (October 2023), 124-129. https://doi.org/10.22391/fppc.1345672.
JAMA GELMEZ TAŞ B, ZEREN OZTURK G, ÖZMEN SEVER S, AKSU SB. Family physicians’ opinions on examination fear and telemedicine during the pandemic. Fam Pract Palliat Care. 2023;8:124–129.
MLA GELMEZ TAŞ, Beray et al. “Family physicians’ Opinions on Examination Fear and Telemedicine During the Pandemic”. Family Practice and Palliative Care, vol. 8, no. 5, 2023, pp. 124-9, doi:10.22391/fppc.1345672.
Vancouver GELMEZ TAŞ B, ZEREN OZTURK G, ÖZMEN SEVER S, AKSU SB. Family physicians’ opinions on examination fear and telemedicine during the pandemic. Fam Pract Palliat Care. 2023;8(5):124-9.

Family Practice and Palliative Care       ISSN 2458-8865       E-ISSN 2459-1505