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泌尿外科肿瘤门诊远程医疗与面对面会诊的随机对照试验

Telehealth vs face-to-face consultations in a urological oncology clinic: a randomised controlled trial.

作者信息

Armany David, Katelaris Athos, Dhar Ankur, Alghazo Omar, Wood Dale, Kim Lawrence H, Patel Manish I

机构信息

Department of Urology, Westmead Hospital, Sydney, Australia.

Speciality of Surgery, University of Sydney, Sydney, Australia.

出版信息

BJU Int. 2025 Apr;135 Suppl 3:37-43. doi: 10.1111/bju.16615. Epub 2024 Dec 4.

Abstract

OBJECTIVES

To determine the effectiveness of telehealth, among patients reviewed for urological oncological diseases, compared with standard face-to-face (F2F) consultations with regard to patient-reported satisfaction through use of a validated questionnaire.

MATERIALS AND METHODS

We conducted a single-centre randomised controlled trial in 126 patients recruited from the Crown Princess Mary Cancer Centres urological oncology clinics. Patients were randomised to either a telehealth audio-only (telephone) consultation group or a standard F2F consultation group for their next routine appointment. Validated questionnaires, using a 4-point Likert index scale, were completed at the end of the appointments. Questionnaire scores were analysed using the Mann-Whitney U-test. The primary outcome measured was patients' preference for type of consultation on subsequent follow-up. Secondary outcomes involved evaluation of efficiency, quality of care, ease of understanding, overall satisfaction, professionalism, limitations, and convenience.

RESULTS

A total of 63 patients in the F2F group and 53 patients in the telephone group completed and returned the validated questionnaires. Patients' preference for next follow-up was statistically significant, favouring the telephone group (P = 0.012). For the secondary outcomes, patients in the telephone group also reported greater satisfaction with regard to the efficiency and timing of the consultation (P = 0.005). Conversely, patients in the F2F group reported higher rates of satisfaction with regard to 'tests and follow-up' and the clinician's ability to deal with their issues, as compared to the telephone group (P = 0.002). Also, patients in the F2F group reported higher rates of perceived quality of consultation (P = 0.027).

CONCLUSION

Our study demonstrates that patients with urological oncological diseases attending routine follow-up generally prefer telehealth over F2F appointments. However, patients in the F2F group perceived that there was a higher quality of care in their consultation, and that the services provided were superior, in comparison to patients in the telehealth group. These are barriers to the widespread adoption of telehealth in urological oncology follow-up care and are rarely reported in the current literature.

摘要

目的

通过使用经过验证的问卷,确定在接受泌尿肿瘤疾病复查的患者中,远程医疗与标准面对面(F2F)会诊相比,在患者报告的满意度方面的有效性。

材料与方法

我们在从玛丽王妃癌症中心泌尿肿瘤诊所招募的126名患者中进行了一项单中心随机对照试验。患者被随机分配到远程医疗纯音频(电话)会诊组或标准F2F会诊组进行下一次常规预约。在预约结束时,使用4点李克特指数量表完成经过验证的问卷。问卷得分使用曼-惠特尼U检验进行分析。测量的主要结果是患者对后续随访会诊类型的偏好。次要结果包括对效率、护理质量、理解难易程度、总体满意度、专业程度、局限性和便利性的评估。

结果

F2F组共有63名患者和电话组53名患者完成并返还了经过验证的问卷。患者对下次随访的偏好具有统计学意义,倾向于电话组(P = 0.012)。对于次要结果,电话组的患者在会诊效率和时间安排方面也报告了更高的满意度(P = 0.005)。相反,与电话组相比,F2F组的患者在“检查和随访”以及临床医生处理其问题的能力方面报告了更高的满意度(P = 0.002)。此外,F2F组的患者报告的会诊质量感知率更高(P = 0.027)。

结论

我们的研究表明,接受常规随访的泌尿肿瘤疾病患者通常更喜欢远程医疗而不是F2F预约。然而,与远程医疗组的患者相比,F2F组的患者认为他们会诊中的护理质量更高,并且提供的服务更优。这些是远程医疗在泌尿肿瘤随访护理中广泛采用的障碍,并且在当前文献中很少报道。

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