Children's Hospital of Orange County, Orange, CA, USA.
Telemed J E Health. 2011 Jun;17(5):383-7. doi: 10.1089/tmj.2010.0153. Epub 2011 Apr 14.
Childhood obesity is a serious health concern, especially in rural areas. Its management involves in-depth lifestyle and psychosocial assessment as well as patient-centered counseling. Telemedicine has increased the ability of patients in rural areas to obtain subspecialty consultations. Our objective was to determine whether a significant difference in quality of care, as measured by parent satisfaction, existed between consultations for childhood obesity delivered face to face and by telemedicine.
We performed a pilot study in which questionnaires were distributed to parents of children under 12 years of age who had received consultations for childhood obesity at a university-affiliated pediatric weight management clinic, either face to face or by telemedicine. The questionnaires assessed various aspects of quality of care and patient-centered care including consulting providers' listening skills, ease of understanding instructions delivered to patients and their families, and the comfort level of parents in discussing health concerns.
A total of 54 surveys were collected (22 telemedicine, 32 face-to-face). Of those, 25 (10 telemedicine, 15 face-to-face) met inclusion criteria. There was no difference in overall parent satisfaction with consultations between the two groups. However, parents rated telemedicine visits slightly lower than face-to-face visits when asked whether the provider explained things about the child's health in a way that was easy to understand (p=0.01). All parents of children who had received care via telemedicine said that they would participate in telemedicine consultations again.
In our pilot, there was no significant difference in parent satisfaction between consultations for childhood obesity delivered face to face and by telemedicine. Therefore, preliminary evidence suggests that childhood obesity care delivered by telemedicine can improve access to quality patient-centered care in underserved rural areas. An important limitation is our sample size, which was not large enough to determine whether satisfaction in the telemedicine group was greater than in the face-to-face group.
儿童肥胖是一个严重的健康问题，尤其是在农村地区。其管理需要深入的生活方式和心理社会评估，以及以患者为中心的咨询。远程医疗增加了农村地区患者获得专科咨询的能力。我们的目的是确定通过面对面和远程医疗提供的儿童肥胖咨询在护理质量方面是否存在显著差异，这可以通过家长满意度来衡量。
我们进行了一项试点研究，向在大学附属儿科体重管理诊所接受儿童肥胖咨询的 12 岁以下儿童的家长分发了问卷，这些咨询是通过面对面或远程医疗进行的。问卷评估了护理质量和以患者为中心的护理的各个方面，包括咨询提供者的倾听技巧、患者及其家属理解医嘱的难易程度，以及家长在讨论健康问题时的舒适度。
共收集了 54 份问卷（远程医疗 22 份，面对面 32 份）。其中，25 份（远程医疗 10 份，面对面 15 份）符合纳入标准。两组家长对咨询的总体满意度没有差异。然而，当被问及提供者是否以易于理解的方式解释孩子健康的相关内容时，家长认为远程医疗就诊的评分略低于面对面就诊（p=0.01）。所有接受过远程医疗服务的儿童家长都表示他们愿意再次参加远程医疗咨询。
在我们的试点研究中，面对面和远程医疗提供的儿童肥胖咨询在家长满意度方面没有显著差异。因此，初步证据表明，远程医疗提供的儿童肥胖护理可以改善服务不足的农村地区获得以患者为中心的优质护理的机会。一个重要的限制是我们的样本量，它还不够大，无法确定远程医疗组的满意度是否大于面对面组。
