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在新冠疫情期间及之后加速脑瘫远程医疗服务

Accelerating Telemedicine for Cerebral Palsy During the COVID-19 Pandemic and Beyond.

作者信息

Ben-Pazi Hilla, Beni-Adani Liana, Lamdan Ron

机构信息

Multidiciplinary Movement Disorders Clinic, Pediatric Orthopedic Department, Assuta Ashdod, Ashdod, Israel.

Pediatric Neurology, South Region, Leumit Health Services, Ashdod, Israel.

出版信息

Front Neurol. 2020 Jun 26;11:746. doi: 10.3389/fneur.2020.00746. eCollection 2020.

Abstract

The effects of COVID-19 extend beyond the pandemic and are expected to transform healthcare in various ways, many of which remain unknown. With social distancing, telemedicine may become the preferred communication channel between caregivers and patients. Implications for cerebral palsy (CP) children are that this will pose a challenge within this transformation. CP, as a discreet entity, is not considered a risk factor. However, specific comorbidities in individuals with CP, such as chronic lung disease, are known as COVID-19 risk factors. The overall risk for the CP population is probably a factor of age and comorbidities. Staying at home for CP children is both a challenge and an opportunity. Escalation of behavioral conflicts or improved participation and equality within the household may emerge. Interestingly, restricted mobility for the general population narrows existing gaps of ambulation. Telemedicine is the primary way of providing services for chronic conditions during the pandemic and is expected to expand beyond pre-Coronavirus era use. The advantages of telemedicine vary, more so during pandemic times, according to severity, restrictions, and availably of telemedicine. A multidisciplinary therapeutic presence is more accessible with telemedicine, bringing together various specialties and approaches to the child's natural environment. Accessible, continuous care is expected to lower comorbidities, as demonstrated for other chronic conditions. Enhanced monitoring is crucial for younger children as devastating complications, such as hip dysplasia, could be minimized. Last but not least, we will discuss digital health care as an accelerator for participatory medicine, including networked patients and families, as responsible drivers of their health as full partners.

摘要

新冠疫情的影响超出了大流行范畴,预计将在多方面改变医疗保健模式,其中许多影响仍不明朗。由于社交距离的要求,远程医疗可能会成为医护人员与患者之间首选的沟通渠道。这对脑瘫儿童意味着在这种转变过程中会面临挑战。脑瘫作为一种独特的病症,本身不被视为风险因素。然而,脑瘫患者的某些特定合并症,如慢性肺病,却是已知的新冠风险因素。脑瘫人群面临的总体风险可能与年龄和合并症有关。对脑瘫儿童来说,居家既是挑战也是机遇。可能会出现行为冲突加剧的情况,也可能家庭内部的参与度和平等性会有所改善。有趣的是,普通人群行动受限缩小了现有的行走能力差距。远程医疗是疫情期间为慢性病提供服务的主要方式,预计其应用范围将超过新冠疫情前的时代。远程医疗的优势各不相同,在疫情期间,根据其严重程度、限制条件和可用性,差异更为明显。通过远程医疗更容易实现多学科治疗参与,将各种专业和方法整合到儿童的自然环境中。正如其他慢性病的情况所示,可及的持续护理有望降低合并症的发生。加强监测对年幼儿童至关重要,因为像髋关节发育不良这样的严重并发症可以尽量减少。最后但同样重要的是,我们将讨论数字医疗作为参与式医疗的加速器,包括联网的患者和家庭,他们作为健康的责任驱动者,是完全的合作伙伴。

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