Abu-Rustum Reem S, Bright Melissa, Moawad Nash, Weber LeBrun Emily, Roussos-Ross Kay, Christman Gregory, Rhoton-Vlasak Alice, Smulian John C
Department of Obstetrics and Gynecology, University of Florida, Gainesville, FL, USA.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):6180-6184. doi: 10.1080/14767058.2021.1909560. Epub 2021 May 27.
Assess women's perceptions of the impact of COVID-19 on their health care and well-being, access to and satisfaction with medical care due to the changes in delivery of care triggered by the pandemic.
An online survey of women having health care appointments in the outpatient facilities across all divisions of a Department of Obstetrics and Gynecology at a tertiary care referral center in North Central Florida. Patients had outpatient appointments that were scheduled, canceled or rescheduled, in person or by telemedicine, between 11 March 2020 and 11 May 2020, a time during which a COVID-19 stay-at-home order was enacted across our state. A total of 6,697 visits were planned. Patients with multiple visits were unified, leaving 6,044 unique patients to whom the survey was emailed between 20 July 2020 and 31 July 2020. The survey was closed on 21 August 2020. Analyses were focused on simple descriptive statistics to assess frequency of responses. Analyses of variance and chi-square analyses were conducted to compare outcomes when all cells were ≥ 10, based on sub-specialty and insurance status; otherwise, frequencies were examined for the entire sample only. Missing data were excluded listwise.
A total of 6044 patients were contacted. Completed surveys numbered 1,083 yielding a response rate of 17.9%. The most common sub-specialty visit was gynecology (56.7%) followed by obstetrics (31.5%,), pelvic floor disorders (4.8%), gynecological oncology (2.9%,), and reproductive endocrinology (0.5%). A substantial percentage of women had visits canceled (19.2%), rescheduled (32.8%) or changed (42.1%) to telemedicine. In our patient population, 32.6% were worried about visiting the clinic and 48.1% were worried about visiting the hospital. COVID-19 triggered changes were perceived to have a negative impact by 26.1% of respondents. Refusal of future telemedicine visits was by 17.2%, however, 75.2% would prefer to use both in-person and telemedicine visits.
During the initial COVID-19 surge with lockdown, the majority of survey respondents were following public health precautions. However, there were significant concerns amongst women related to obstetric and gynecologic medical appointments scheduled during that period. During pandemics, natural disasters and similar extreme circumstances, digital communication and telemedicine have the potential to play a critical role in providing reassurance and care. Nevertheless, given the concerns expressed by survey respondents, communication and messaging tools are needed to increase comfort and ensure equity with the rapidly changing methods of care delivery.
评估女性对2019冠状病毒病（COVID-19）对其医疗保健和福祉的影响的看法，以及由于疫情引发的医疗服务提供方式的变化而导致的医疗服务可及性和满意度。
对佛罗里达州中北部一家三级医疗转诊中心妇产科所有科室门诊设施中有医疗预约的女性进行在线调查。患者在2020年3月11日至2020年5月11日期间进行了门诊预约，这些预约被安排、取消或重新安排，预约方式为面对面或通过远程医疗，在此期间我们所在州颁布了COVID-19居家令。总共计划了6697次就诊。多次就诊的患者进行了合并，最终向6044名独立患者发送了调查问卷，时间为2020年7月20日至2020年7月31日。调查于2020年8月21日结束。分析重点是简单描述性统计，以评估回答的频率。基于亚专业和保险状况，当所有单元格≥10时，进行方差分析和卡方分析以比较结果；否则，仅对整个样本的频率进行检查。缺失数据按列表排除。
共联系了6044名患者。完成的调查问卷有1083份，回复率为17.9%。最常见的亚专业就诊是妇科（56.7%），其次是产科（31.5%）、盆底疾病（4.8%）、妇科肿瘤（2.9%）和生殖内分泌（0.5%）。相当比例的女性就诊被取消（19.2%）、重新安排（32.8%）或改为远程医疗（42.1%）。在我们的患者群体中，32.6%的人担心去诊所就诊，48.1%的人担心去医院就诊。26.1%的受访者认为COVID-19引发的变化产生了负面影响。17.2%的人拒绝未来的远程医疗就诊，然而，75.2%的人更愿意同时使用面对面和远程医疗就诊。
在COVID-19疫情初期封锁期间，大多数调查受访者都遵守了公共卫生预防措施。然而，在此期间安排的妇产科医疗预约引发了女性的重大担忧。在大流行、自然灾害和类似的极端情况下，数字通信和远程医疗有潜力在提供安心和护理方面发挥关键作用。尽管如此，鉴于调查受访者表达的担忧，需要沟通和信息传递工具来提高舒适度，并确保在快速变化的护理提供方式中实现公平。
