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针对癫痫儿童的远程医疗有效且能减轻焦虑,与医疗环境无关。

Telehealth for Children With Epilepsy Is Effective and Reduces Anxiety Independent of Healthcare Setting.

作者信息

Klotz Kerstin Alexandra, Borlot Felippe, Scantlebury Morris H, Payne Eric T, Appendino Juan Pablo, Schönberger Jan, Jacobs Julia

机构信息

Department of Neuropediatrics and Muscle Disorders, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany.

Faculty of Medicine, Epilepsy Center, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany.

出版信息

Front Pediatr. 2021 Jun 10;9:642381. doi: 10.3389/fped.2021.642381. eCollection 2021.

Abstract

The use of telemedicine has grown exponentially as an alternative to providing care to patients with epilepsy during the pandemic. We investigated the impact of the current pandemic among children with epilepsy from two distinct pediatric epilepsy centers. We also compared perceptions among those who received telemedicine against those who did not. We developed a questionnaire and invited families followed in Freiburg, Germany, and Calgary, Alberta, Canada, to participate during the initial 9 months of the pandemic. The survey contained 32 questions, 10 of which were stratified according to telemedicine exposure. One hundred twenty-six families (80 in Freiburg, 46 in Calgary) participated, and 40.3% received telemedicine care. Most children (mean age 10.4 years, 5.1) had chronic epilepsy but poorly controlled seizures. Negative impacts were reported by 36 and 65% of families who had to reschedule appointments for visits and diagnostics, respectively. Nearly two-thirds of families reported no change in seizure frequency, while 18.2% reported either worsening or improvement of seizures. Although most families did not note behavioral changes, 28.2% reported behavior worsening. Families who received telemedicine care had a statistically significant reduction of parental self-reported anxiety level after virtual visits compared to those who did not experience telemedicine. Families with telemedicine consultations were more likely to consider future virtual care (84 vs. 65.2% of those without), even after the pandemic. Patient data safety, easy access to specialized services, and consistency with the same healthcare provider were graded as important in both centers, while a shorter waiting time was most relevant in Calgary. In our cohort, some children with epilepsy experienced increased seizures and worsening behavior during the first 9 months of the current pandemic. In addition, our data suggest that telemedicine might reduce parental anxiety symptoms, and families who experienced telehealth were more positive and open to similar appointments in the future.

摘要

在疫情期间,远程医疗作为为癫痫患者提供护理的一种替代方式,其使用呈指数级增长。我们调查了来自两个不同儿科癫痫中心的癫痫患儿受当前疫情的影响。我们还比较了接受远程医疗和未接受远程医疗的人群的看法。我们设计了一份问卷,并邀请了在德国弗莱堡和加拿大艾伯塔省卡尔加里接受随访的家庭在疫情的最初9个月参与。该调查包含32个问题,其中10个问题根据远程医疗接触情况进行了分层。126个家庭(弗莱堡80个,卡尔加里46个)参与了调查,40.3%的家庭接受了远程医疗护理。大多数儿童(平均年龄10.4岁,标准差5.1)患有慢性癫痫但癫痫发作控制不佳。分别有36%和65%的家庭报告称,他们不得不重新安排就诊和诊断预约,这带来了负面影响。近三分之二的家庭报告癫痫发作频率没有变化,而18.2%的家庭报告癫痫发作要么恶化要么改善。尽管大多数家庭没有注意到行为变化,但28.2%的家庭报告行为恶化。与未体验过远程医疗的家庭相比,接受远程医疗护理的家庭在虚拟就诊后,父母自我报告的焦虑水平在统计学上有显著降低。即使在疫情之后,接受远程医疗咨询的家庭也更有可能考虑未来的虚拟护理(84%对未接受远程医疗的家庭中的65.2%)。患者数据安全、易于获得专科服务以及与同一位医疗服务提供者的连贯性在两个中心都被评为重要因素,而等待时间较短在卡尔加里最为相关。在我们的队列中,一些癫痫患儿在当前疫情的前9个月癫痫发作增加且行为恶化。此外,我们的数据表明,远程医疗可能会减轻父母的焦虑症状,并且体验过远程医疗的家庭对未来类似预约更为积极和开放。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ea0/8222691/9d939372b8f3/fped-09-642381-g0001.jpg

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