CESP, Villejuif, France
Department of Obstetrics and Gynecology, Poissy-Saint Germain Hospital, Poissy, France.
BMJ Open. 2024 May 7;14(5):e085621. doi: 10.1136/bmjopen-2024-085621.
Delineate the scope of teleconsultation services that can be effectively performed to provide women with comprehensive gynaecological and obstetrical care.
Based on the literature and experts' insights, we identified a list of gynaecological and obstetrical care practices suitable for teleconsultation. A three-round Delphi consensus survey was then conducted online among a panel of French experts. Experts using a 9-point Likert scale assessed the relevance of each teleconsultation practice in four key domains: prevention, gynaecology and antenatal and postnatal care. Consensus was determined by applying a dual-criteria approach: the median score on a 9-point Likert scale and the percentage of votes either below 5 or 5 and higher.
The study was conducted at a national level in France and involved multiple healthcare centres and professionals from various geographical locations.
The panel comprised 22 French experts with 19 healthcare professionals, including 12 midwives, 3 obstetricians-gynaecologists, 4 general practitioners and 3 healthcare system users. Participants were selected to include diverse practice settings encompassing hospital and private practices in both rural and urban areas.
The study's primary outcome was the identification of gynaecological and obstetrical care practices suitable for teleconsultation. Secondary outcomes included the level of professional consensus on these practices.
In total, 71 practices were included in the Delphi survey. The practices approved for teleconsultation were distributed as follows: 92% in prevention (n=12/13), 55% in gynaecology (n=18/33), 31% in prenatal care (n=5/16) and 12% in postnatal care (n=1/9). Lastly, 10 practices remained under discussion: 7 in gynaecology, 2 in prenatal care and 1 in postnatal care.
Our consensus survey highlights both the advantages and limitations of teleconsultations for women's gynaecological and obstetrical care, emphasising the need for careful consideration and tailored implementation.
阐明可以有效开展的远程咨询服务范围，为妇女提供全面的妇科和产科护理。
基于文献和专家的见解，我们确定了一系列适合远程咨询的妇科和产科护理实践。然后，在法国专家小组中进行了三轮在线 Delphi 共识调查。专家使用 9 分 Likert 量表评估了每个远程咨询实践在四个关键领域中的相关性：预防、妇科、产前和产后护理。通过应用双标准方法确定共识：9 分 Likert 量表上的中位数得分和低于 5 或 5 及以上的票数百分比。
该研究在法国全国范围内进行，涉及多个医疗中心和来自不同地理位置的专业人员。
该小组由 22 名法国专家组成，其中包括 19 名医疗保健专业人员，包括 12 名助产士、3 名妇产科医生、4 名全科医生和 3 名医疗保健系统用户。参与者的选择包括涵盖医院和农村和城市地区私人诊所的各种实践环境。
该研究的主要结果是确定适合远程咨询的妇科和产科护理实践。次要结果包括这些实践的专业共识水平。
共有 71 项实践被纳入 Delphi 调查。远程咨询批准的实践如下分布：预防（n=12/13）占 92%，妇科（n=18/33）占 55%，产前护理（n=5/16）占 31%，产后护理（n=1/9）占 12%。最后，有 10 项实践仍在讨论中：7 项在妇科，2 项在产前护理，1 项在产后护理。
我们的共识调查强调了远程咨询在妇女妇科和产科护理中的优势和局限性，强调需要仔细考虑和量身定制实施。
