Georgetown University School of Medicine, Washington, DC.
Division of Urogynecology and Reconstructive Pelvic Surgery, Yale University School of Medicine, New Haven, CT.
Urogynecology (Phila). 2023 Jun 1;29(6):545-551. doi: 10.1097/SPV.0000000000001310. Epub 2022 Dec 23.
Telemedicine was increasingly used to provide patients with an alternative to in-office visits during the COVID-19 pandemic. While previous studies have described the role of telemedicine for preoperative visits for other surgical specialties, the role of this modality in preoperative visits for gynecologic surgery has not been thoroughly explored.
The aims of the study are to explore and compare patient experience, decision making, and satisfaction among women undergoing telemedicine or in-person preoperative visits.
This was a qualitative study of women who underwent a preoperative appointment with a urogynecologic surgeon or minimally invasive gynecologic surgeon at a single academic institution from April to May of 2021. Data were collected using semistructured phone interviews, which focused on visit content, visit type decision making, surgical preparedness/confidence, and past surgical experiences. Interviews were thematically analyzed until theoretical saturation was achieved in accordance with grounded theory.
Theoretical saturation occurred with 20 interviews. Participants were evenly divided between in-person and telemedicine visits. Major themes included visit content, experience/quality, surgeon perception, and surgical preparedness. Advantages of telemedicine visits were convenience and safety. Advantages of in-person visits were social factors, perceived medical or surgical severity, and preoperative physical examination. Disadvantages for telemedicine visits included technology concerns and difficulty accessing preoperative materials. The disadvantage of an in-person visit was the inability to have family present because of COVID hospital policy restrictions. Participants in both groups felt prepared for surgery and reported high satisfaction with their care.
Decision making for selecting an in-person or telemedicine visit is complex and involves balancing multiple advantages and disadvantages. Participant experience was similar for both visit types with high satisfaction.
在 COVID-19 大流行期间，远程医疗越来越多地被用于为患者提供替代门诊就诊的选择。虽然之前的研究已经描述了其他外科专业的术前远程医疗的作用，但这种模式在妇科手术术前访问中的作用尚未得到充分探索。
本研究旨在探讨和比较接受远程医疗或面对面术前就诊的女性患者的体验、决策和满意度。
这是一项对 2021 年 4 月至 5 月期间在一家学术机构接受泌尿科或微创妇科外科医生术前预约的女性进行的定性研究。数据通过半结构化电话访谈收集，重点关注就诊内容、就诊类型决策、手术准备/信心以及既往手术经历。访谈按照扎根理论进行主题分析，直到达到理论饱和。
通过 20 次访谈达到理论饱和。参与者在面对面和远程医疗就诊之间平分秋色。主要主题包括就诊内容、体验/质量、外科医生看法和手术准备。远程医疗就诊的优势在于方便和安全。面对面就诊的优势在于社交因素、感知的医疗或手术严重程度以及术前体检。远程医疗就诊的缺点包括技术问题和难以获取术前材料。面对面就诊的缺点是由于 COVID 医院政策限制，无法让家人陪同。两组参与者都感到为手术做好了准备，并对他们的护理表示高度满意。
选择面对面或远程医疗就诊的决策是复杂的，涉及到平衡多种优缺点。两种就诊类型的患者体验相似，满意度都很高。
