Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA, USA.
T.H. Chan School of Medicine, University of Massachusetts, Worcester, MA, USA.
Spinal Cord. 2022 May;60(5):451-456. doi: 10.1038/s41393-022-00790-1. Epub 2022 Mar 28.
Uncontrolled clinical pilot study.
To assess usage, perceived impact, and satisfaction with a telemedicine program among individuals with spinal cord injury (tele-SCI).
Community-based.
Participants (N = 83) were recruited from acute SCI inpatient rehabilitation and outpatient SCI care at a community hospital to participate in a 6-month tele-SCI intervention administered by SCI subspecialty board-certified physiatrists via iPad FaceTime. In addition to monthly follow up interview calls, psychosocial and Quality of Life (QoL) measures were collected at baseline and post-intervention. A program satisfaction survey was also collected post-intervention.
Seventy-five percent of participants engaged in tele-SCI visits (Median [IQR]: 2.5 [2.0, 4.0]) for a total of 198 tele-SCI visits. Bladder and bowel concerns were the leading topics discussed during tele-SCI visits, followed by neurological, pain, and functional concerns. Tele-SCI users resided further away (Median miles [IQR] - 114[73-177] vs. 81[46-116], p = 0.023) and reported seeking more clinical advice (Median [IQR] - 1.5[0-4.0] vs. 0[0-1.0], p = 0.002) compared to non-tele-SCI users. All other clinical utilization, baseline characteristics, psychosocial measures, and QoL did not differ among those who used tele-SCI and those who did not. The satisfaction survey suggested satisfaction with the tele-SCI intervention (89%), study equipment (89%), staff responsiveness (100%), and improved motivation for self-monitoring of health (71%).
Study findings suggest that tele-SCI is a feasible modality for providing general SCI care. Further research is required to examine longer-term efficacy of remotely-provided care among individuals living with SCI.
非对照临床初步研究。
评估脊髓损伤(远程 SCI)患者对远程医疗计划的使用情况、感知影响和满意度。
基于社区。
参与者(N=83)是从急性脊髓损伤住院康复和社区医院门诊脊髓损伤护理中招募的,以参与由脊髓损伤专科委员会认证的物理治疗师通过 iPad FaceTime 进行的为期 6 个月的远程 SCI 干预。除了每月的随访电话外,还在基线和干预后收集社会心理和生活质量(QoL)测量值。干预后还收集了一项计划满意度调查。
75%的参与者进行了远程 SCI 就诊(中位数[IQR]:2.5[2.0, 4.0]),总共进行了 198 次远程 SCI 就诊。膀胱和肠道问题是远程 SCI 就诊中讨论的主要话题,其次是神经、疼痛和功能问题。远程 SCI 用户居住的距离更远(中位数英里[IQR]-114[73-177]与 81[46-116],p=0.023),并报告寻求更多的临床建议(中位数[IQR]-1.5[0-4.0]与 0[0-1.0],p=0.002)与非远程 SCI 用户相比。其他临床利用、基线特征、社会心理测量和 QoL 在使用远程 SCI 和不使用远程 SCI 的患者之间没有差异。满意度调查表明,患者对远程 SCI 干预(89%)、研究设备(89%)、员工响应能力(100%)和提高自我健康监测的动机(71%)感到满意。
研究结果表明,远程 SCI 是提供一般 SCI 护理的可行方式。需要进一步研究远程提供护理在脊髓损伤患者中的长期效果。