Kahn Nicole F, Anan Yomna H, Bocek Kevin M, Christakis Dimitri A, Richardson Laura P, Pratt Wanda, Sequeira Gina M
Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States.
Division of Adolescent Medicine, Seattle Children's Hospital, Seattle, WA, United States.
JMIR Pediatr Parent. 2023 Feb 14;6:e42378. doi: 10.2196/42378.
Access to virtual care has increased since the beginning of the COVID-19 pandemic, yet little is known about transgender and gender-diverse (TGD) youth's experiences and perspectives on receiving care via telemedicine.
The purpose of this study was to explore these experiences to (1) inform necessary changes to the provision of pediatric gender-affirming care and (2) help providers and health systems determine if and how telemedicine should be made available post pandemic.
Youth (aged 14-17 years) who completed a telemedicine visit in the Seattle Children's Gender Clinic were invited to participate in a semistructured interview exploring perceived advantages or disadvantages of telemedicine and preferred visit modalities. Interview transcriptions were analyzed by 2 research team members using an inductive thematic analysis framework.
A total of 15 TGD youth completed an interview. Commonly cited advantages of telemedicine were convenience and comfort with having visits in their own environments. Reported disadvantages included technical issues, discomfort with the impersonal nature, lack of familiarity with the platform, and privacy concerns. Overall, slightly more youth preferred in-person visits over telemedicine, referencing both specific characteristics of the clinical visit (ie, initial vs return and complexity) and proximity to the clinic as reasons for this preference. Although a plurality of TGD youth preferred in-person visits, they also recognized the value of telemedicine and the impact it may have in facilitating access to care.
Given the variations in needs and visit complexity, our study supports the provision of both in-person and telemedicine modalities as options for pediatric gender-affirming care.
自新冠疫情开始以来，虚拟医疗服务的可及性有所提高，但对于跨性别和性别多样化（TGD）青少年通过远程医疗接受护理的经历和观点却知之甚少。
本研究旨在探索这些经历，以（1）为儿科性别肯定性护理的提供做出必要改变提供信息，（2）帮助医疗服务提供者和医疗系统确定疫情后是否以及如何提供远程医疗服务。
邀请在西雅图儿童医院性别诊所完成远程医疗就诊的14至17岁青少年参加半结构化访谈，探讨远程医疗的感知优势或劣势以及偏好的就诊方式。2名研究团队成员使用归纳主题分析框架对访谈转录本进行分析。
共有15名TGD青少年完成了访谈。远程医疗的常见优势包括便利性以及在自己环境中就诊时的舒适感。报告提到的劣势包括技术问题、对非人性化性质感到不适、对平台不熟悉以及隐私担忧。总体而言，略多于半数青少年更喜欢面对面就诊而非远程医疗，他们提到临床就诊的具体特征（即初次就诊与复诊以及复杂性）以及与诊所的距离作为这种偏好的原因。尽管多数TGD青少年更喜欢面对面就诊，但他们也认识到远程医疗的价值及其在促进获得护理方面可能产生的影响。
鉴于需求和就诊复杂性的差异本研究支持提供面对面和远程医疗两种方式作为儿科性别肯定性护理的选择。
