Background COVID-19-related physical distancing measures necessitated widespread adoption of virtual care (i.e. telephone or videoconference), but patients, caregivers and healthcare providers raised concerns about its implementation and sustainability given barriers faced by older adults. Objective To describe barriers and facilitators experienced by people accessing and providing virtual care in a geriatric medicine clinic. Design Qualitative semi-structured interview study. Setting and participants We recruited and interviewed 20 English-speaking patients, caregivers and healthcare providers who participated in virtual care at St. Michael’s Hospital’s geriatric medicine clinic, Toronto, Canada, between 22 October 2020 and 23 January 2021. Methods We analyzed data in two stages: framework analysis and deductive coding to the Theoretical Domains Framework. Results We included six healthcare providers, seven patients and seven caregivers. We identified eight themes: impact of the COVID-19 pandemic on virtual care uptake, complexity of virtually caring for older adults, uncertain accuracy of virtual assessments, inequity in access to virtual care, importance of caring for the patient-caregiver dyad, assimilating technology into the lives of older adults, impact of technology-related factors on virtual care uptake and impact of clinic processes on integration of virtual care into outpatient care. Further, we identified knowledge, skills, belief in capabilities, and environmental context and resources as key barriers and facilitators to uptake. Conclusions Patients, caregivers and healthcare providers believe that there is a role for virtual care after COVID-19-related physical distancing measures relax, but we must tailor implementation of virtual care programs for older adults based on identified barriers and facilitators.

中文翻译：

---

老年医学诊所虚拟护理的障碍和促进因素：对患者、护理人员和医疗保健提供者观点的半结构化访谈研究

背景与 COVID-19 相关的物理距离措施需要广泛采用虚拟护理（即电话或视频会议），但鉴于老年人面临的障碍，患者、护理人员和医疗保健提供者对其实施和可持续性提出了担忧。目的描述人们在老年医学诊所访问和提供虚拟护理时遇到的障碍和促进因素。设计定性半结构化访谈研究。设置和参与者 我们招募并采访了 20 名讲英语的患者、护理人员和医疗保健提供者，他们于 2020 年 10 月 22 日至 2021 年 1 月 23 日期间在加拿大多伦多圣迈克尔医院的老年医学诊所参加了虚拟护理。方法 我们分析了两个数据阶段：理论领域框架的框架分析和演绎编码。结果 我们包括六名医疗保健提供者、七名患者和七名护理人员。我们确定了八个主题：COVID-19 大流行对虚拟护理的影响、虚拟护理老年人的复杂性、虚拟评估的不确定性、获得虚拟护理的不公平、照顾病人-护理人员的重要性、同化技术进入老年人的生活，技术相关因素对虚拟护理的影响以及诊所流程对虚拟护理与门诊护理整合的影响。此外，我们将知识、技能、对能力的信念以及环境背景和资源确定为关键障碍和促进因素。结论患者，