Raatz Madeline, Ward Elizabeth C, Marshall Jeanne, Burns Clare L
Speech Pathology Department, Queensland Children's Hospital, Brisbane, QLD 4101, Australia.
School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD 4072, Australia.
Children (Basel). 2021 Nov 1;8(11):989. doi: 10.3390/children8110989.
There is currently limited evidence supporting the use of telepractice to conduct bottle-feeding assessments. This study aimed to investigate the inter-rater reliability of bottle-feeding assessments conducted via synchronous telepractice (real-time videoconferencing). Secondary aims were to investigate parent and clinician satisfaction. Bottle-feeding skills of 30 children (aged 1 month-2 years) were simultaneously assessed by a telepractice SP (T-SP) at a remote location and an in-person SP (IP-SP) at the family home. A purpose-designed assessment form was used to evaluate: (1) developmental level (screen only), (2) state, color, and respiration, (3) oral motor skills, (4), infant oral reflexes, (5) tongue tie (screen only), (6) non-nutritive suck, (7) bottle-feeding, (8) overall feeding skills and (9) recommendations. Results of the T-SP and IP-SP assessments were compared using agreement statistics. Parents reported perceptions of telepractice pre and post session, and also rated post-session satisfaction. The telepractice SP completed a satisfaction questionnaire post-appointment. The majority of assessment components (45/53, 85%) met the agreement criteria (≥80% exact agreement). Difficulties were noted for the assessment of palate integrity, gagging during non-nutritive suck assessment, and 6 components of the tongue tie screen. Parent and clinician satisfaction was high; SPs reported that they would offer telepractice services to 93% of families again in the future. Overall, the results demonstrated that most components of a bottle-feeding assessment could be reliably completed via synchronous telepractice in family homes. However, further research is required to improve the reliability of some intra-oral assessment components.
目前，支持使用远程医疗进行奶瓶喂养评估的证据有限。本研究旨在调查通过同步远程医疗（实时视频会议）进行奶瓶喂养评估时评分者间的可靠性。次要目的是调查家长和临床医生的满意度。30名1个月至2岁儿童的奶瓶喂养技能由远程地点的远程医疗言语病理学家（T-SP）和家庭中的面对面言语病理学家（IP-SP）同时进行评估。使用专门设计的评估表来评估：（1）发育水平（仅筛查），（2）状态、肤色和呼吸，（3）口腔运动技能，（4）婴儿口腔反射，（5）舌系带（仅筛查），（6）非营养性吸吮，（7）奶瓶喂养，（8）整体喂养技能和（9）建议。使用一致性统计方法比较T-SP和IP-SP评估的结果。家长报告了对远程医疗前后的看法，并对会后满意度进行了评分。远程医疗言语病理学家在预约后完成了一份满意度问卷。大多数评估项目（45/53，85%）符合一致性标准（精确一致性≥80%）。在评估腭完整性、非营养性吸吮评估期间的作呕情况以及舌系带筛查的6个项目时发现了困难。家长和临床医生的满意度较高；言语病理学家报告称，他们未来会再次为93%的家庭提供远程医疗服务。总体而言，结果表明，奶瓶喂养评估的大多数项目可以通过家庭中的同步远程医疗可靠地完成。然而，需要进一步研究以提高一些口腔内评估项目的可靠性。
