Vivas-Colmenares Grecia Victoria, Ramírez-Iglesias Jose Ruben, Martínez-Pérez Ana M
Health Sciences Faculty, School of Medicine, Universidad Internacional SEK (UISEK), Quito, Ecuador.
International Doctoral School, Universidad Rey Juan Carlos, Madrid, Spain.
Front Public Health. 2025 Jul 30;13:1606211. doi: 10.3389/fpubh.2025.1606211. eCollection 2025.
INTRODUCTION: Telemedicine reduces in-person appointments and extends healthcare services to rural areas. Despite its extended use after the COVID-19 pandemic, further analysis of educational applications and strategies is needed to better prepare parents and caregivers for postoperative pediatric care beyond routine clinical follow-up. Therefore, this review systematically evaluates the effectiveness of telemedicine interventions in educating parents or caregivers after pediatric surgery, with respect to caregiver knowledge and self-efficacy in postoperative care, caregiver satisfaction, and postoperative clinical outcomes. METHODS: Following the PRISMA guidelines, we searched three databases, PubMed, Scopus, and LILACS, for articles published between 2013 and 2023 that involved patients aged 0-18 years who underwent surgery and caregivers who received some form of education through telemedicine. We evaluated the effectiveness of telemedicine for educational purposes by assessing caregiver knowledge, satisfaction, and patient morbidities. Bias was analyzed using the RoB2 and ROBINS-I tools. The certainty of the presented evidence was assessed using the GRADE guidelines. The SWiM guideline was employed to report a structured narrative synthesis from the combined results. The protocol was registered in the International Prospective Register of Systematic Reviews (CRD42024545858). RESULTS: Four studies were included from 2,163 records initially registered: two randomized controlled trials (RCTs) and two uncontrolled before-after (UCBAs) studies. In the RCTs, caregiver knowledge was significantly higher in the telemedicine intervention group ( < 0.05); in one UCBA, caregiver knowledge increased over time. All studies reported high satisfaction with telemedicine, with the RCTs showing significantly higher satisfaction levels than control groups ( < 0.05). One UCBA also reported a significant improvement in patient continence. Bias was assessed as moderate in the RCTs and high in the UCBAs. The GRADE criteria indicate a certainty of evidence moderate for satisfaction and caregiver knowledge, and very low for morbidity and rate of complications or adverse events. DISCUSSION: Telemedicine-based educational tools show promise as a strategy for healthcare systems, achieving high acceptance levels. However, further research is required to refine the methodological approaches for implementing telemedicine in caregiver education within the postoperative setting. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024545858, identifier [CRD42024545858].
引言:远程医疗减少了面对面预约,并将医疗服务扩展到农村地区。尽管在新冠疫情后其使用范围有所扩大,但仍需要进一步分析教育应用和策略,以便让家长和护理人员更好地为小儿术后护理做好准备,而不仅仅是常规临床随访。因此,本综述系统评估了远程医疗干预在小儿外科手术后对家长或护理人员进行教育的有效性,涉及护理人员在术后护理方面的知识和自我效能、护理人员满意度以及术后临床结果。 方法:按照PRISMA指南,我们在三个数据库(PubMed、Scopus和LILACS)中搜索了2013年至2023年发表的文章,这些文章涉及年龄在0至18岁接受手术的患者以及通过远程医疗接受某种形式教育的护理人员。我们通过评估护理人员的知识、满意度和患者发病率来评估远程医疗用于教育目的的有效性。使用RoB2和ROBINS - I工具分析偏倚。使用GRADE指南评估所呈现证据的确定性。采用SWiM指南对综合结果进行结构化叙述性综合报告。该方案已在国际系统评价前瞻性注册库(CRD42024545858)中注册。 结果:从最初登记的2163条记录中纳入了四项研究:两项随机对照试验(RCT)和两项非对照前后对照(UCBA)研究。在RCT中,远程医疗干预组护理人员的知识水平显著更高(<0.05);在一项UCBA中,护理人员的知识水平随时间增加。所有研究均报告对远程医疗的满意度较高,RCT显示满意度水平显著高于对照组(<0.
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