Department of Health, Human Performance, and Recreation/Office for Sport Concussion Research, University of Arkansas, Fayetteville (Dr Elbin); Schmieding Developmental Center, University of Arkansas for Medical Sciences, Lowell (Ms Stephenson and Dr Lipinski); Inova Sports Medicine Concussion Program, Fairfax, Virginia (Dr Womble); Baylor Scott & White Sports Concussion Program, Frisco, Texas (Drs Reynolds and Covert); and Department of Orthopedic Surgery, UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Kontos).
J Head Trauma Rehabil. 2022;37(4):213-219. doi: 10.1097/HTR.0000000000000707. Epub 2021 Jul 26.
To conduct a pilot study of caregiver ratings of therapeutic alliance and patient satisfaction outcomes between telehealth and in-person concussion clinical care in male and female adolescent athletes.
Outpatient neuropsychology concussion clinic.
Fifteen patients (aged 15.40 ± 1.35 years; 33% female) with a concussion and their accompanying caregivers ( n = 15; 87% female) were randomly assigned to an in-person clinic visit and 15 patients (aged 15.13 ± 1.25 years; 40% female) with a concussion and their accompanying caregivers ( n = 15; 73% female) were randomly assigned to a telehealth clinic visit.
A prospective, randomized design.
Therapeutic alliance and patient satisfaction scores.
Therapeutic alliance scores were not significantly different for patients in the in-person or telehealth setting, and caregiver therapeutic alliance scores were significantly higher for the in-person condition than for the telehealth condition. There were no significant differences between in-person and telehealth session satisfaction scores for patients on depth, smoothness, positivity, arousal, and bad-good outcomes. Patient and caregiver satisfaction with the clinical setting was high (ie, General Endorsement).
Telehealth is feasible for assessing and interpreting clinical concussion examination, interview, and neurocognitive findings, which are perceived by patients and their caregivers to be comparable with in-person care. Positive satisfaction scores also serve to reinforce the need for healthcare providers to seek ways to actively engage with patients and their caregivers through elements of communicative skills such as active listening, building patient rapport, encouraging patient autonomy, and providing an adequate amount of time for interaction and questions. Telehealth for concussion care is increasing in implementation across health systems, and demand is likely to grow in light of the current COVID-19 pandemic and advances in telehealth delivery.
在男性和女性青少年运动员中，对远程医疗和面对面的脑震荡临床护理的治疗联盟和患者满意度结果进行 caregiver 评分的初步研究。
门诊神经心理学脑震荡诊所。
15 名患有脑震荡的患者（年龄 15.40±1.35 岁；33%为女性）及其随行照顾者（n=15；87%为女性）被随机分配到面对面诊所就诊，15 名患有脑震荡的患者（年龄 15.13±1.25 岁；40%为女性）及其随行照顾者（n=15；73%为女性）被随机分配到远程医疗诊所就诊。
前瞻性、随机设计。
治疗联盟和患者满意度评分。
面对面或远程医疗环境中的患者治疗联盟评分无显著差异，面对面条件下照顾者的治疗联盟评分显著高于远程医疗条件。患者在深度、流畅度、积极性、唤醒度和好坏结果方面对面对面和远程医疗治疗的满意度无显著差异。患者和照顾者对临床环境的满意度很高（即普遍认可）。
远程医疗可用于评估和解释临床脑震荡检查、访谈和神经认知结果，患者及其照顾者认为这些结果与面对面护理相当。积极的满意度评分也有助于强化医疗保健提供者的需求，通过积极倾听、建立患者融洽关系、鼓励患者自主以及提供足够的互动和提问时间等沟通技巧的要素，积极与患者及其照顾者互动。远程医疗在医疗系统中的实施正在增加，并且由于当前 COVID-19 大流行和远程医疗服务的进步，需求可能会增长。
