Williams Michael
Child and Adolescent Health Service, Mackay Base Hospital, Mackay, Queensland, Australia.
J Paediatr Child Health. 2021 Jan;57(1):109-113. doi: 10.1111/jpc.15149. Epub 2020 Sep 3.
To evaluate rural paediatric diabetic telehealth clinics including whether they meet clinical standards, provide equivalent care to central clinics, families were satisfied and difficulties were encountered.
An audit of a telehealth service for children and adolescents with type 1 diabetes mellitus at four rural sites was conducted. The case notes for each patient for 2019 were reviewed to determine if standards of paediatric diabetic care were met. Interviews were conducted at a clinic at each site with the child, parent(s) and staff attending the clinics. A retrospective review of difficulties in service provision was undertaken with staff.
Nineteen children and adolescents were seen in the telehealth clinics over the year. Eighteen (95%) were seen four times with point-of-care measurement of glycosylated haemoglobin (HbA1c) and growth by the consultant paediatrician and diabetic nurse educator. Complication screening was achieved on time for 15 (78%) patients, with the remaining patients having had the tests ordered. Eleven (56%) patients were reviewed by a dietician, six (33%) by social worker and five (27%) by psychologist. All patients and parents reported receiving good support for their diabetes without any preferring to attend the central clinic. There were no significant technical difficulties.
Providing paediatric diabetic care through a telehealth service at rural hospitals meets standards of care and was provided without technical difficulties. It is preferred by patients and their parents to attending a central clinic. A model of service is presented that may be replicated elsewhere in Australia.
评估农村儿科糖尿病远程医疗诊所，包括其是否符合临床标准、是否能提供与中心诊所同等的护理、家庭是否满意以及是否遇到困难。
对四个农村地区为1型糖尿病儿童和青少年提供的远程医疗服务进行了审核。查阅了2019年每位患者的病历，以确定是否符合儿科糖尿病护理标准。在每个地区的一家诊所，对就诊的儿童、家长和工作人员进行了访谈。与工作人员一起对服务提供过程中的困难进行了回顾性审查。
该年度远程医疗诊所共接待了19名儿童和青少年。其中18名（95%）接受了4次就诊，由儿科顾问医生和糖尿病护士教育者进行糖化血红蛋白（HbA1c）即时检测和生长发育监测。15名（78%）患者按时完成了并发症筛查，其余患者已安排了相关检查。11名（56%）患者接受了营养师的评估，6名（33%）接受了社会工作者的评估，5名（27%）接受了心理学家的评估。所有患者和家长均表示在糖尿病护理方面得到了良好的支持，没有人更倾向于前往中心诊所就诊。未出现重大技术困难。
通过农村医院的远程医疗服务提供儿科糖尿病护理符合护理标准，且没有技术困难。患者及其家长更倾向于这种方式，而非前往中心诊所。本文提出了一种服务模式，可在澳大利亚其他地区推广。
