触摸技术--严重先天性心脏病患儿家长的远程会诊体验:准实验队列研究。

IF 2.1 Q2 PEDIATRICS
Julie Elizabeth May McCullough, Marlene Sinclair, Jonathan Gillender, Brian McCrossan, Paul F Slater, Rosie Browne, Frank Casey
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引用次数: 0

摘要

背景:医学委员会建议将使用视频会议的远程会诊(RC)作为临床医生在 COVID-19 大流行期间为患者提供会诊的方法。如何在提供高质量医疗服务的同时促进远程会诊的开展取决于该技术的可用性和可接受性:本项目旨在调查家长在 COVID-19 大流行封锁期间使用视频会议技术为患有先天性心脏缺陷的儿童提供实时 RC 的体验:本研究采用准实验设计,以技术接受和使用统一理论模型为基础,该模型旨在解释和预测个人使用技术的意向。医疗团队向家长们告知了这项研究,在病房和诊所张贴了海报,并留有宣传单供浏览。临床医生对潜在参与者进行了筛选,最终确定了 33 名儿童和家长参加这项研究。干预措施是由医务人员利用安全的交互式视频会议平台(Pexip)进行基于网络的 RC。每名儿童及其母亲或父亲都接受了由同一位专科医生或护士进行的 8 次 RC。在咨询前和咨询后的首次、中期和最后一次活动中,使用网络问卷进行了测量;问题主要集中在 RC 的可接受性、可用性和临床适用性上。此外,还利用访谈录音对家长的经验进行了探讨,并进行了专题分析:共有 29 名年龄在 4-1052 天(平均 95 天,标准差 191.14 天)的儿童完成了该项目,作为常规护理的一部分,他们共接受了 189 次 RC。家长之前通过视频会议进行咨询的经验较少,但随着时间的推移,他们对该技术的使用和接受程度都有所提高。这项干预措施受到了所有家长的热烈欢迎,他们认为面对面的环节对于与孩子的医疗团队进行讨论特别有用。此外,家长们还注意到节省了时间、金钱和儿童保育费用:虽然面对面会诊被认为是病人护理的黄金标准,但医疗服务和医务人员面临的压力越来越大,这降低了面对面会诊的可用性。考虑到家长和患儿就诊的便利性和获得的额外益处,我们建议,在严重先天性心脏病患儿的管理中,混合会诊和护理模式即使不优于当面会诊,也与当面会诊具有同等作用,同时还能降低成本,减轻医疗服务机构和家长的压力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Touching Technology-Parents' Experiences of Remote Consultations for Children With Severe Congenital Cardiac Conditions: Quasi-Experimental Cohort Study.

Background: Remote consultations (RCs) using videoconferencing was recommended by the General Medical Council as the method for clinicians to provide patient consultations during the COVID-19 pandemic. Facilitating this while providing high-quality care depends on the usability and acceptability of the technology.

Objective: This project aimed to investigate parents' experiences of using videoconferencing technology for real-time RCs with children who had congenital heart defects during the COVID-19 pandemic lockdown.

Methods: This study's design was quasi-experimental and was underpinned by the Unified Theory of Acceptance and Use of Technology model that seeks to explain and predict an individual's intention to use a technology. Parents were informed of this study by the medical team, posters were made available in the wards and clinics, and leaflets were left for browsing. Clinician screening of potential participants led to the identification of 33 children and parents who were enrolled on this study. The intervention was a web-based RC by medical staff using a secure, interactive videoconferencing platform (Pexip). Each child and their mother or father received 8 RCs with the same specialist doctor or nurse. Measurements were taken using web-based questionnaires pre and post consultation at the first, middle, and last events; questions were focused on the acceptability, usability, and clinical applicability of RCs. Parents' experiences were explored using recorded interviews and analyzed thematically.

Results: In total, 29 children aged 4-1052 (mean 95, SD 191.14) days completed the project, receiving a total of 189 RCs as part of their routine care. Parents' prior experience of consultation via videoconference was low; however, as time progressed, their use and acceptance of the technology increased. The intervention was warmly received by all parents who found the face-to-face component particularly useful for discussion with their child's medical team. Furthermore, parents noted the savings on time, money, and childcare.

Conclusions: While in-person consultations are considered the gold standard of patient care, increasing pressures on health services and staff reduce availability. Given the ease of access and additional benefits experienced by parents and their children, it is proposed that hybrid models of consultation and care provision are equal, if not superior, to in-person consultations in the management of children with severe congenital heart defects while reducing costs and pressure on the health service and parents.

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来源期刊
JMIR Pediatrics and Parenting
JMIR Pediatrics and Parenting Medicine-Pediatrics, Perinatology and Child Health
CiteScore
5.00
自引率
5.40%
发文量
62
审稿时长
12 weeks
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