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评估 COVID-19 大流行期间在西南悉尼通过远程医疗为儿童提供诊断性发育评估的效果:临床医生和家庭的观点。

Evaluation of telehealth in delivering diagnostic developmental assessments for children in South Western Sydney during the COVID-19 pandemic: Clinician and family perspectives.

机构信息

Department of Community Paediatrics, Primary and Community Health, South Western Sydney Local Health District, Sydney, New South Wales, Australia.

University of New South Wales, School of Medicine and Health, Sydney, New South Wales, Australia.

出版信息

J Paediatr Child Health. 2024 Oct;60(10):579-585. doi: 10.1111/jpc.16637. Epub 2024 Aug 16.

Abstract

AIMS

Children with neuro-developmental disorders faced significant challenges in accessing services during the COVID-19 pandemic. Telehealth has been adopted by health services globally to facilitate access to clinical services. Our aims were to evaluate the utility of the telehealth modality for providing developmental assessment services and explore enablers and barriers to using telehealth, in a culturally diverse and socioeconomically disadvantaged population in Sydney.

METHODS

We reviewed telehealth developmental assessments in South Western Sydney conducted between 1 April and 30 June 2020. Data were collated on demographics; telehealth modality; diagnostic formulation; recommendations; and requested follow up. We conducted retrospective semi-structured telephone interviews with 79 families and 11 clinicians about their telehealth experience. Thematic analysis was carried out on the open text responses.

RESULTS

Of 205 children assessed across six sites, median age was 48 months; 45% were assessed with video and 55% with telephone only. Diagnostic formulation and therapeutic recommendations were provided for 203 (99%) children and 138 (67%) were asked to come for face-to-face follow-up. The majority of families (76%) were satisfied or extremely satisfied with telehealth. Median clinician satisfaction was 3.5 out of 5, whilst clinician confidence with diagnostic formulation was 4 out of 5. Qualitative data revealed a range of barriers and enablers.

CONCLUSION

Telehealth was a successful modality for contributing to the assessment journey for children with neuro-developmental disorders in our culturally, linguistically and socioeconomically diverse clinical population in the context of a pandemic lockdown. We discuss the potential for telehealth modalities in child developmental assessments beyond the pandemic.

摘要

目的

患有神经发育障碍的儿童在 COVID-19 大流行期间在获得服务方面面临重大挑战。全球卫生服务机构已采用远程医疗来方便提供临床服务。我们的目的是评估远程医疗模式在为具有文化多样性和社会经济劣势的悉尼人群提供发育评估服务方面的效用,并探讨使用远程医疗的促进因素和障碍。

方法

我们回顾了 2020 年 4 月 1 日至 6 月 30 日期间在西南悉尼进行的远程医疗发育评估。收集了人口统计学数据;远程医疗模式;诊断制定;建议;以及要求的后续行动。我们对 79 个家庭和 11 名临床医生进行了回顾性半结构式电话访谈,了解他们的远程医疗体验。对开放文本回复进行了主题分析。

结果

在六个地点评估的 205 名儿童中,中位数年龄为 48 个月;45%的儿童接受视频评估,55%的儿童仅接受电话评估。为 203 名(99%)儿童提供了诊断制定和治疗建议,有 138 名(67%)儿童被要求进行面对面随访。大多数家庭(76%)对远程医疗感到满意或非常满意。临床医生的满意度中位数为 5 分中的 3.5 分,而临床医生对诊断制定的信心为 5 分中的 4 分。定性数据揭示了一系列障碍和促进因素。

结论

在大流行封锁期间,远程医疗是为我们具有文化、语言和社会经济多样性的临床人群中的神经发育障碍儿童提供评估服务的成功模式。我们讨论了远程医疗模式在儿童发育评估中的潜在应用,不仅限于大流行期间。

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