Pediatric Clinic, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
Front Public Health. 2023 Aug 29;11:1249299. doi: 10.3389/fpubh.2023.1249299. eCollection 2023.
The aim of the study was to evaluate the satisfaction of the use of telemedicine and telenursing in children and young adults with Type 1 Diabetes (T1D) using Advanced Hybrid Closed Loop systems (AHCL) with a focus on the role of connectivity, data download and the ease of technical steps in the set and sensor change procedures.
An online anonymous survey was administered to AHCL users. The questionnaire consisted of five Clusters: Cluster A-B-C included questions related to the general satisfaction in the use of telemedicine, Cluster D was focused on the role of data download and connectivity, Cluster E was related to satisfaction in telenursing and Cluster F to the perception of ease of execution of the technical steps like changing the infusion set and the sensor.
We collected 136 completed questionnaires. 83.8% of AHCL users were overall satisfied with the quality of the telemedicine service. 88.2% of patients downloaded AHCL data before visits and the overall quality of televisits (data sharing, connectivity, ease of use) was satisfactory for 85.3% of users. Telenursing support during set and sensor change procedures was considered effective by 98% of AHCL users. The sensor and insulin infusion set change procedure is perceived as different for the two systems: set change simpler for Medtronic ( = 0.011) users, while sensor change was simpler for Tandem users ( = 0.009).
Telemedicine and telenursing have an essential role in diabetology and are highly appreciated in AHCL users. The nurse support in the education of the use of AHCL systems is effective and must be implemented. Unfortunately, not all patients have the technological tools needed for downloading data at home and using telemedicine services; this represents an important challenge for the future of diabetology and for the equity in accessibility to care.
本研究旨在评估使用先进混合闭环系统（AHCL）的儿童和青少年 1 型糖尿病（T1D）患者对远程医疗和远程护理的满意度，重点关注连接性、数据下载以及在设置和传感器更换过程中技术步骤的易用性的作用。
对 AHCL 用户进行了在线匿名调查。问卷由五个聚类组成：聚类 A-B-C 包括与远程医疗使用的总体满意度相关的问题，聚类 D 专注于数据下载和连接性的作用，聚类 E 与远程护理的满意度相关，聚类 F 与更换输注套件和传感器等技术步骤的执行感知相关。
我们共收集了 136 份完整的问卷。83.8%的 AHCL 用户对远程医疗服务的质量总体满意。88.2%的患者在就诊前下载了 AHCL 数据，85.3%的用户对远程就诊（数据共享、连接性、易用性）的整体质量感到满意。98%的 AHCL 用户认为在设置和传感器更换过程中的远程护理支持是有效的。传感器和胰岛素输注套件更换程序对于两种系统的感知不同：美敦力（ = 0.011）用户认为套件更换更简单，而对于 Tandem 用户，传感器更换更简单（ = 0.009）。
远程医疗和远程护理在糖尿病学中具有重要作用，深受 AHCL 用户的赞赏。在 AHCL 系统使用教育方面，护士提供的支持是有效的，必须实施。不幸的是，并非所有患者都拥有在家下载数据和使用远程医疗服务所需的技术工具；这是糖尿病学未来和护理可及性公平性的一个重要挑战。
