MMAT (quality assessment tool) for the review.

BackgroundTelemedicine is increasingly used within healthcare worldwide. More is known about its efficacy in treating different conditions and its application to different contexts than about service-users’ and practitioners’ experiences or how best to support implementation.AimsTo review adult service-users’ experiences of synchronous video consultations with nurses, allied health professionals and psychological therapists, find out how consultations impact different groups of service-users and identify requirements for their conduct at individual, organisational, regional, and national levels.MethodCINAHL, Embase, Medline, PsycINFO Scopus were searched for papers published between 01/01/2018 and 19/03/2021. One reviewer independently reviewed citations and a second reviewed those excluded by the first, in a liberal accelerated approach. Quality assessment was undertaken using the Mixed Methods Appraisal Tool and data were synthesised narratively.Results65 papers were included. Service-users’ experiences of video consultations ranged from feelings of connection to disconnection and ease of access to challenges to access. Many were excluded from video consultation services or research, for example because of lack of access to technology. Individual service-users required clear orientation and ongoing technical support, whereas staff needed support to develop technical and online-relational skills. At organisational levels, technology needed to be made available to users through equipment loan or service models such as hub-and-spoke; services required careful planning and integration within organisational systems; and security needed to be assured. Regional and national requirements related to interorganisational cooperation and developing functionality.ConclusionTo support safe and equitable video consultation provision, we recommend: (1) providers and researchers consider how to maximise participation, for example through inclusive consent processes and eligibility criteria; (2) sharing video consultation user guides and technical support documentation; and (3) continuing professional development for practitioners, focusing on the technical and relational skills that service-users value, such as the ability to convey empathy online.

背景 远程医疗（Telemedicine）在全球医疗保健领域的应用日益普及。相较于医疗服务使用者（service-users）与从业者的使用体验，以及如何为远程医疗落地提供最优支持，目前学界对其治疗不同病症的疗效，以及在不同场景下的应用方式已有更为充分的认知。
研究目的 本研究旨在梳理成年医疗服务使用者接受护士、辅助医疗专业人员（allied health professionals）与心理治疗师提供的同步视频会诊（synchronous video consultations）的体验，明确此类会诊对不同群体医疗服务使用者的影响，并识别在个体、组织、区域及国家层面开展此类会诊所需的支撑条件。
研究方法 检索了2018年1月1日至2021年3月19日期间发表的、收录于CINAHL、Embase、Medline、PsycINFO及Scopus数据库的文献。研究采用宽松加速评审流程：由1名评审员独立筛选文献题录，另1名评审员复核首轮评审排除的文献。研究采用混合方法评价工具（Mixed Methods Appraisal Tool）开展质量评估，并以叙述性合成法整合研究数据。
研究结果 最终纳入65篇文献。医疗服务使用者对视频会诊的体验呈现多元特征：既有联结感与便捷的就诊体验，也存在疏离感与就诊障碍。诸多使用者因缺乏技术设备支持，被排除在视频会诊服务或相关研究之外。个体层面的医疗服务使用者需要清晰的引导与持续的技术支持，而医护人员则需要培训以提升技术操作与线上人际沟通能力。组织层面，需通过设备租赁或枢纽-分支（hub-and-spoke）等服务模式为使用者提供技术支持；医疗服务需进行周密规划并融入现有组织系统；同时需保障会诊的安全性。区域与国家层面的需求则涉及跨组织协作与功能体系建设。
研究结论 为保障视频会诊服务的安全性与公平性，本研究提出以下建议：（1）服务提供方与研究人员应考量如何最大化参与者覆盖范围，例如通过包容性的知情同意流程与资格准入标准；（2）共享视频会诊用户指南与技术支持文档；（3）为从业者提供持续职业发展培训，重点提升医疗服务使用者所重视的技术能力与人际沟通能力，例如在线传递共情的能力。