Telemedicine and other care models in pediatric rheumatology: an exploratory study of parents' perceptions of barriers to care and care preferences.
Telemedicine and other care models in pediatric rheumatology: an exploratory study of parents' perceptions of barriers to care and care preferences.
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DOI：
10.1186/s12969-017-0184-y
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发表时间：
2017-07-11
期刊：
影响因子：
--
通讯作者：
Correll CK
中科院分区：
文献类型：
--
作者：
Bullock DR;Vehe RK;Zhang L;Correll CK
美国儿科风湿病工作人员致力于为儿童提供儿科风湿病护理的使命。由于儿科风湿病专家的数量和分布有限，远程医疗已被提议作为满足这一使命的一种方式，但采用这种方式的速度比预期的要慢。本研究的目的是探讨家长的角度对障碍，以获得儿科风湿病护理，并探讨可接受的远程医疗和其他替代护理模式。在六周的时间内，所有新的和返回的讲英语的父母/监护人访问一个单一的中心的患者提供了一个机会，完成一项调查，评估的障碍，以照顾和兴趣的替代模式的照顾。使用描述性统计分析应答。调查回复率为72%（159/221）。28%（45/159）的人前往儿科风湿病诊所的时间超过3小时，43%（65/152）的人报告旅行不方便。绝大多数受访者（95%，144/152）报告说，他们更喜欢面对面的访问，而不是远程医疗。无论受访者是否报告前往诊所不方便还是方便，这种偏好都是相似的（不方便92%，60/65;方便97%，84/87; p = 0.2881），尽管那些报告旅行不方便的人也报告了更大的困难，有几个障碍，以照顾。那些熟悉远程医疗的人更有可能报告对远程医疗的偏好超过亲自访问（27%，3/11 vs 3%，4/140; p = 0.0087）。大多数人（63%，97/154）可以接受外展诊所的选择;然而，成人风湿病学和共享护理选择的接受程度较低（分别为22%，35/156和34%，53/156）。在调查答复者中，即使在注意到旅行不便的情况下，也更倾向于亲自就诊，而不是远程医疗。远程医疗的普及提高了其可接受性。大多数人接受外联诊所。最终，父母的观点可以塑造可接受的方式来解决障碍并提供可获得的护理。本文的在线版本（doi：10.1186/s12969-017-0184-y）包含补充材料，可供授权用户使用。
The United States pediatric rheumatology workforce is committed to a mission of providing children access to pediatric rheumatology care. With a limited number and distribution of pediatric rheumatologists, telemedicine has been proposed as one way to meet this mission, yet the adoption of this modality has been slower than expected. The purpose of this study was to explore the parent perspective on barriers to accessing pediatric rheumatology care and to explore the acceptability of telemedicine and other alternative care models. Over a period of six weeks, all new and return English-speaking parents/guardians of patients visiting a single center were offered an opportunity to complete a survey which assessed barriers to care and interest in alternative models of care. Responses were analyzed using descriptive statistics. Survey response rate was 72% (159/221). Twenty-eight percent (45/159) traveled more than three hours to the pediatric rheumatology clinic, and 43% (65/152) reported travel as inconvenient. An overwhelming majority of respondents (95%, 144/152) reported a preference for in-person visits over the option of telemedicine. This preference was similar regardless of whether respondents reported travel to the clinic as inconvenient vs convenient (inconvenient 92%, 60/65; convenient 97%, 84/87; p = 0.2881) and despite those reporting travel as inconvenient also reporting greater difficulty with several barriers to care. Those familiar with telemedicine were more likely to report a preference for telemedicine over in-person visits (27%, 3/11 vs 3%, 4/140; p = 0.0087). The option of an outreach clinic was acceptable to a majority (63%, 97/154); however, adult rheumatology and shared-care options were less acceptable (22%, 35/156 and 34%, 53/156 respectively). Among survey respondents, in-person visits were preferred over the option of telemedicine, even when travel was noted to be inconvenient. Telemedicine familiarity increased its acceptability. Outreach clinics were acceptable to a majority. Ultimately, the parent perspective can shape acceptable ways to address barriers and provide accessible care. The online version of this article (doi:10.1186/s12969-017-0184-y) contains supplementary material, which is available to authorized users.
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DOI：
10.1186/s12969-016-0116-2
发表时间：
2016-09-20
期刊：
Pediatric rheumatology online journal
影响因子：
--
作者：
Kessler EA;Sherman AK;Becker ML
通讯作者：
Becker ML
影响因子：
4.7
作者：
Call, Vaughn R. A.;Erickson, Lance D.;Bair, Byron
通讯作者：
Bair, Byron
影响因子：
2.5
作者：
Correll, Colleen K.;Spector, Logan G.;Vehe, Richard K.
通讯作者：
Vehe, Richard K.
影响因子：
3.5
作者：
O'Connor S;Hanlon P;O'Donnell CA;Garcia S;Glanville J;Mair FS
通讯作者：
Mair FS
采用远程医疗：从试点阶段到常规交付。
影响因子：
3.5
作者：
Zanaboni P;Wootton R
通讯作者：
Wootton R