Cincinnati Children's Center for Heart Disease and Mental Health, Heart Institute and the Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, OH, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Cardiol Young. 2023 Feb;33(2):280-287. doi: 10.1017/S1047951122000579. Epub 2022 Feb 24.
COVID-19 has markedly impacted the provision of neurodevelopmental care. In response, the Cardiac Neurodevelopmental Outcome Collaborative established a Task Force to assess the telehealth practices of cardiac neurodevelopmental programmes during COVID-19, including adaptation of services, test protocols and interventions, and perceived obstacles, disparities, successes, and training needs.
A 47-item online survey was sent to 42 Cardiac Neurodevelopmental Outcome Collaborative member sites across North America within a 3-week timeframe (22 July to 11 August 2020) to collect cross-sectional data on practices.
Of the 30 participating sites (71.4% response rate), all were providing at least some clinical services at the time of the survey and 24 sites (80%) reported using telehealth. All but one of these sites were offering new telehealth services in response to COVID-19, with the most striking change being the capacity to offer new intervention services for children and their caregivers. Only a third of sites were able to carry out standardised, performance-based, neurodevelopmental testing with children and adolescents using telehealth, and none had completed comparable testing with infants and toddlers. Barriers associated with language, child ability, and access to technology were identified as contributing to disparities in telehealth access.
Telehealth has enabled continuation of at least some cardiac neurodevelopmental services during COVID-19, despite the challenges experienced by providers, children, families, and health systems. The Cardiac Neurodevelopmental Outcome Collaborative provides a unique platform for sharing challenges and successes across sites, as we continue to shape an evidence-based, efficient, and consistent approach to the care of individuals with CHD.
COVID-19 对神经发育护理的提供产生了显著影响。为此,心脏神经发育结局协作组织成立了一个工作组,以评估 COVID-19 期间心脏神经发育项目的远程医疗实践,包括服务、测试方案和干预措施的调整,以及感知到的障碍、差异、成功和培训需求。
在 3 周的时间内(2020 年 7 月 22 日至 8 月 11 日),向北美 42 个心脏神经发育结局协作组织成员单位发送了一份 47 项的在线调查,以收集实践方面的横断面数据。
在参与的 30 个站点中(71.4%的回复率),所有站点在调查时都提供了至少一些临床服务,并且 24 个站点(80%)报告使用了远程医疗。除了一个站点外,所有这些站点都针对 COVID-19 提供了新的远程医疗服务,最显著的变化是为儿童及其照顾者提供新的干预服务的能力。只有三分之一的站点能够使用远程医疗对儿童和青少年进行标准化、基于表现的神经发育测试,而且没有一个站点对婴儿和幼儿完成了可比的测试。语言、儿童能力和获得技术的障碍被确定为导致远程医疗获取差异的因素。
尽管提供者、儿童、家庭和卫生系统都面临挑战,但远程医疗在 COVID-19 期间使至少一些心脏神经发育服务得以继续。心脏神经发育结局协作组织为在各个站点之间共享挑战和成功提供了一个独特的平台,因为我们继续制定基于证据、高效和一致的 CHD 患者护理方法。