评估儿童和青少年自闭症谱系障碍和注意缺陷/多动障碍及其照顾者的远程精神评估满意度:随机对照试验。

IF 2.3 Q2 PEDIATRICS
Shunya Kurokawa, Yuko Kawade, Kensuke Nomura, Nana Hosogane, Takashi Nagasawa, Yu Matsumoto, Shuichi Morinaga, Yuriko Kaise, Ayana Higuchi, Akiko Goto, Naoko Inada, Masaki Kodaira, Taishiro Kishimoto
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引用次数: 0

摘要

背景:患有注意力缺陷/多动障碍(ADHD)和自闭症谱系障碍(ASD)的儿童和青少年在获得医疗服务时往往面临结构性和心理障碍,包括经济成本、漫长的等待时间和参加新的医疗环境的压力。COVID-19大流行加速了远程医疗服务的采用,以克服这些挑战。然而,很少有研究评估被诊断为神经发育障碍的儿童和青少年及其照顾者在使用远程精神治疗时的满意度,特别是在日本。目的:本研究旨在通过对诊断为ADHD或ASD的儿童和青少年及其照顾者进行远程精神病学评估来评估满意度,并确定与高满意度水平相关的因素。方法:共68例6-17岁确诊为ADHD或ASD的患者及其照顾者参与本研究。参与者从日本庆应义塾大学医院和四个合作机构招募。每个病人和他们的护理人员都进行了两次评估,一次是面对面的,另一次是通过远程精神病学评估(远程视频工具),以随机顺序进行。在完成这两项评估后,参与者使用5分李克特量表完成了一份满意度问卷,该问卷涵盖了音频和视频质量、无缝沟通、感知温暖、减轻负担和行为自然的能力等方面。采用Spearman秩相关系数和多元回归分析来确定与总体满意度相关的因素。结果:在患者中,70%(47/67)的人表示对远程精神病学评估“满意”或“非常满意”,88%(60/68)的护理人员表示类似的满意度。多元回归分析显示,在儿童中,高满意度与无缝观看屏幕,减少医院就诊负担以及在评估期间自然说话的能力有关。对于看护者来说,视觉清晰度和孩子的自然行为是关键因素。结论:远程精神病学评估是为诊断为ADHD或ASD的儿童和青少年及其照顾者提供护理的一种有效和实用的选择,提供了高水平的满意度。技术可靠性和减少的旅行负担大大促进了积极的经验。然而,确保儿童和青少年在远程评估过程中表现自然并感到温暖,对于最大限度地提高他们的满意度至关重要。远程精神病学服务可以提高卫生保健的质量,使其成为临床实践的宝贵补充工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Evaluating Telepsychiatric Assessment Satisfaction in Children and Adolescents With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder and Their Caregivers: Randomized Controlled Trial.

Evaluating Telepsychiatric Assessment Satisfaction in Children and Adolescents With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder and Their Caregivers: Randomized Controlled Trial.

Evaluating Telepsychiatric Assessment Satisfaction in Children and Adolescents With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder and Their Caregivers: Randomized Controlled Trial.

Background: Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often face structural and psychological barriers in accessing medical care, including economic costs, long wait times, and stress of attending new medical environments. The COVID-19 pandemic accelerated the adoption of telehealth services to overcome these challenges. However, few studies have assessed the satisfaction levels of children and adolescents diagnosed with neurodevelopmental disorders and their caregivers when they use telepsychiatry, particularly in Japan.

Objective: This study aimed to evaluate satisfaction by conducting telepsychiatric assessments in children and adolescents diagnosed with ADHD or ASD and their caregivers and to identify factors associated with higher satisfaction levels.

Methods: A total of 68 patients aged 6-17 years with a confirmed diagnosis of ADHD or ASD and their caregivers participated in this study. The participants were recruited from Keio University Hospital and four collaborating institutions in Japan. Each patient and their caregiver underwent two assessment sessions, one face-to-face and the other via telepsychiatric assessment (a remote video tool), in a randomized order. Upon completing both assessments, the participants completed a satisfaction questionnaire using a 5-point Likert scale that covered aspects such as audio and video quality, seamless communication, perceived warmth, reduced burden, and the ability to behave naturally. Spearman rank correlation coefficients and multiple regression analyses were performed to identify factors associated with overall satisfaction.

Results: Among the patients, 70% (47/67) reported being "satisfied" or "very satisfied" with the telepsychiatric assessment, and 88% (60/68) of caregivers reported similar satisfaction levels. Multiple regression analysis showed that in children, high satisfaction was associated with seamless viewing of the screen, reduced burden of hospital visits, and the ability to speak naturally during the assessment. For caregivers, visual clarity and the child's natural behavior were crucial factors.

Conclusions: Telepsychiatric assessments are an effective and practical option to provide care for children and adolescents diagnosed with ADHD or ASD and their caregivers, offering high levels of satisfaction. Technical reliability and reduced travel burden significantly contributed to positive experiences. However, ensuring that children and adolescents behave naturally and feel a sense of warmth during remote assessment is crucial to maximizing their satisfaction. Telepsychiatric services can enhance the quality of health care, making them valuable supplementary tools for clinical practice.

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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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