Division of General Pediatrics, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA; Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA 19146, USA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA.
Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA.
Child Abuse Negl. 2018 Nov;85:47-57. doi: 10.1016/j.chiabu.2018.08.009. Epub 2018 Sep 11.
Childhood sexual abuse is a common cause of morbidity and mortality. All victims should receive a timely comprehensive medical exam. Currently there is a critical shortage of child abuse pediatricians who can complete the comprehensive child sexual abuse examination. Telemedicine has emerged as an innovative way to provide subspecialty care to this population. Despite the growing popularity of telemedicine, no literature exists describing patient and caregiver perceptions of telemedicine for this sensitive exam.
To explore caregiver and adolescent perspectives of the use of telemedicine for the child sexual abuse examination and discover factors that drive satisfaction with the technology.
Caregivers and adolescents who presented for a child sexual abuse medical evaluation at our county's child advocacy center.
We completed semi structured interviews of 17 caregivers and 10 adolescents. Guided by the Technology Acceptance Model interviews assessed perceptions about: general feelings with the exam, prior use of technology, feelings about telemedicine, and role of the medical team. Interviews were audio-recorded, transcribed, coded and analyzed using content analysis with constant comparative coding. Recruitment ended when thematic saturation was reached.
There was an overwhelming positive response to telemedicine. Participants reported having a good experience with telemedicine regardless of severity of sexual abuse or prior experience with technology. Behaviors that helped patients and caregivers feel comfortable included a clear explanation from the medical team and professionalism demonstrated by those using the telemedicine system.
Telemedicine was widely accepted by adolescents and caregivers when used for the child sexual abuse examination.
儿童性虐待是发病率和死亡率的一个常见原因。所有受害者都应及时接受全面的医学检查。目前，能够完成全面儿童性虐待检查的儿科虐待医生严重短缺。远程医疗已经成为向这一人群提供专科医疗服务的一种创新方式。尽管远程医疗越来越受欢迎，但没有文献描述过患者和照顾者对这种敏感检查使用远程医疗的看法。
探讨照顾者和青少年对远程医疗用于儿童性虐待检查的看法，并发现推动对该技术满意度的因素。
在我们县的儿童倡导中心进行儿童性虐待医学评估的照顾者和青少年。
我们对 17 名照顾者和 10 名青少年进行了半结构化访谈。访谈以技术接受模型为指导，评估了他们对以下方面的看法：对检查的一般感受、之前使用技术的感受、对远程医疗的感受以及医疗团队的作用。访谈进行了录音、转录、编码和分析，采用内容分析和恒定性比较编码。当达到主题饱和度时，招募结束。
远程医疗得到了压倒性的积极回应。无论性虐待的严重程度或之前使用技术的经验如何，参与者都报告说他们对远程医疗有很好的体验。帮助患者和照顾者感到舒适的行为包括医疗团队的清晰解释以及使用远程医疗系统的人员表现出的专业性。
当远程医疗用于儿童性虐待检查时，青少年和照顾者普遍接受。
