Morgan Gareth J, Craig Brian, Grant Brian, Sands Andrew, Doherty Nicola, Casey Frank
Department of Paediatric Cardiology, Royal Belfast Hospital for Sick Children, Royal Group of Hospitals, Belfast, Ireland.
Congenit Heart Dis. 2008 Sep-Oct;3(5):317-24. doi: 10.1111/j.1747-0803.2008.00205.x.
Centralization of pediatric cardiology services into a small number of tertiary centers and the particular stress that accompanies diagnosis and surgical management of severe congenital heart disease (CHD) renders psychological support for families and clinical monitoring of patients following discharge increasingly important. Telemedicine has an increasing role in clinical and academic medicine. Improvements in quality and reliability of videoconferencing systems have allowed this to become a useful diagnostic tool.
This study aimed to assess the benefits of home monitoring by videoconferencing compared with contacting by telephone only, in terms of decreasing anxiety levels and clinical monitoring in the postdischarge period.
We performed a prospective, controlled study of children with a recent diagnosis of severe CHD and those recovering from palliative or corrective surgery for severe CHD. We used standardized anxiety scores to assess anxiety after discharge in families followed up by home videoconferencing or telephone calls and assessed the clinical information available through videoconferencing or telephone calls by structured questionnaires.
Videoconferencing decreased anxiety levels compared with telephone calls (P < .05). Improved clinical information was available in the videoconferencing group, resulting in more appropriate and timely hospital attendance.
Videoconferencing is acceptable to parents and physicians and provides a more effective form of follow-up in terms of clinical observation and parental anxiety levels.
儿科心脏病服务集中于少数几个三级中心,以及严重先天性心脏病(CHD)诊断和手术管理所带来的特殊压力,使得对家庭的心理支持以及出院后患者的临床监测变得越来越重要。远程医疗在临床和学术医学中的作用日益增强。视频会议系统质量和可靠性的提高使其成为一种有用的诊断工具。
本研究旨在评估与仅通过电话联系相比,视频会议进行家庭监测在降低出院后焦虑水平和临床监测方面的益处。
我们对近期诊断为严重CHD的儿童以及因严重CHD接受姑息或矫正手术正在康复的儿童进行了一项前瞻性对照研究。我们使用标准化焦虑评分来评估通过家庭视频会议或电话随访的家庭出院后的焦虑情况,并通过结构化问卷评估通过视频会议或电话可获得的临床信息。
与电话相比,视频会议降低了焦虑水平(P <.05)。视频会议组可获得更好的临床信息,从而使住院就诊更恰当、更及时。
视频会议为家长和医生所接受,并且在临床观察和家长焦虑水平方面提供了一种更有效的随访形式。