Department of Nutrition and Dietetics, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
School of Health Professions, University of Plymouth, Plymouth, UK.
J Hum Nutr Diet. 2020 Dec;33(6):881-889. doi: 10.1111/jhn.12750. Epub 2020 Apr 2.
Children with chronic kidney disease require specialist renal paediatric dietetic care, regardless of disease severity or geographical location; however, under-resourcing makes this challenging. Videoconsultation may offer a solution but research exploring its acceptability is limited. The present study explored parent/carer and child perspectives of videoconsultation as an alternative or supplement to existing regional dietetic care.
Children and families using a regional paediatric nephrology service were recruited through purposeful sampling techniques. Renal paediatric dietitians used existing hospital software to host videoconsultations with families. Perspectives were subsequently explored in telephone interviews with the children, their parents and separately with the renal dietitians. Data were transcribed verbatim and an inductive framework analysis conducted.
Twelve families took part in the study, comprising 13 parents and five children (aged 9 months to 14 years). Two renal dietitians were also interviewed. Six themes emerged which were 'Logistics', 'Understanding Information', 'Family Engagement', 'Establishing Trust', 'Willingness to Change' and 'Preferences'. Satisfaction with the videoconsultations was high, with no data security fears and only minor privacy concerns. Parents reported that screen-sharing software enhanced their understanding, generating greater discussion and engagement compared to clinic and telephone contacts. Parents praised efficiencies and improved access to specialist advice, requesting that videoconsultations supplement care. Children preferred videoconsultations outright.
Dietetic videoconsultations were acceptable to families and perceived to be a feasible, high-quality complement to regional specialist dietetic care. Enhanced understanding and engagement might improve self-care in adolescents. The acceptability and feasibility of videoconsultations could address inequitable regional service provision.
患有慢性肾脏疾病的儿童无论疾病严重程度或地理位置如何，都需要接受专业的儿科肾脏营养师的治疗，但资源不足使得这具有挑战性。视频咨询可能是一种解决方案，但目前研究对其可接受性的研究有限。本研究探讨了父母/照顾者和儿童对视频咨询的看法，将其作为替代或补充现有区域营养师的治疗方法。
通过有针对性的抽样技术招募使用区域儿科肾病服务的儿童及其家庭。肾脏儿科营养师使用现有的医院软件与家庭进行视频咨询。随后通过与儿童、其父母和单独与肾脏营养师的电话访谈来探讨观点。数据逐字转录，并进行了归纳框架分析。
共有 12 个家庭参加了研究，包括 13 名父母和 5 名儿童（年龄 9 个月至 14 岁）。也采访了两名肾脏营养师。出现了六个主题，分别是“后勤”、“理解信息”、“家庭参与”、“建立信任”、“愿意改变”和“偏好”。视频咨询的满意度很高，没有数据安全担忧，只有轻微的隐私问题。父母报告说，屏幕共享软件增强了他们的理解，与诊所和电话联系相比，产生了更多的讨论和参与。父母称赞效率提高了，并且更容易获得专业建议，要求视频咨询作为补充治疗。儿童更喜欢视频咨询。
家庭接受营养师的视频咨询，并认为这是一种可行的、高质量的区域专科营养师治疗的补充方法。增强理解和参与可能会改善青少年的自我护理。视频咨询的可接受性和可行性可以解决区域服务提供的不公平问题。
