Kurokawa Shunya, Kawade Yuko, Nomura Kensuke, Hosogane Nana, Nagasawa Takashi, Matsumoto Yu, Morinaga Shuichi, Kaise Yuriko, Higuchi Ayana, Goto Akiko, Inada Naoko, Kodaira Masaki, Kishimoto Taishiro
Center for the Promotion of Interdisciplinary Research in Medicine and Life Science, Keio University School of Medicine, Mori JP Tower F7, 1-3-1, Azabudai, Minato-ku, Tokyo, 160-0041, Japan, 81 353633219.
Department of Child Psychiatry, Shimada Ryoiku Medical Center for Challenged Children, Tokyo, Japan.
JMIR Pediatr Parent. 2025 Sep 5;8:e69791. doi: 10.2196/69791.
Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often face structural and psychological barriers in accessing medical care, including economic costs, long wait times, and stress of attending new medical environments. The COVID-19 pandemic accelerated the adoption of telehealth services to overcome these challenges. However, few studies have assessed the satisfaction levels of children and adolescents diagnosed with neurodevelopmental disorders and their caregivers when they use telepsychiatry, particularly in Japan.
This study aimed to evaluate satisfaction by conducting telepsychiatric assessments in children and adolescents diagnosed with ADHD or ASD and their caregivers and to identify factors associated with higher satisfaction levels.
A total of 68 patients aged 6-17 years with a confirmed diagnosis of ADHD or ASD and their caregivers participated in this study. The participants were recruited from Keio University Hospital and four collaborating institutions in Japan. Each patient and their caregiver underwent two assessment sessions, one face-to-face and the other via telepsychiatric assessment (a remote video tool), in a randomized order. Upon completing both assessments, the participants completed a satisfaction questionnaire using a 5-point Likert scale that covered aspects such as audio and video quality, seamless communication, perceived warmth, reduced burden, and the ability to behave naturally. Spearman rank correlation coefficients and multiple regression analyses were performed to identify factors associated with overall satisfaction.
Among the patients, 70% (47/67) reported being "satisfied" or "very satisfied" with the telepsychiatric assessment, and 88% (60/68) of caregivers reported similar satisfaction levels. Multiple regression analysis showed that in children, high satisfaction was associated with seamless viewing of the screen, reduced burden of hospital visits, and the ability to speak naturally during the assessment. For caregivers, visual clarity and the child's natural behavior were crucial factors.
Telepsychiatric assessments are an effective and practical option to provide care for children and adolescents diagnosed with ADHD or ASD and their caregivers, offering high levels of satisfaction. Technical reliability and reduced travel burden significantly contributed to positive experiences. However, ensuring that children and adolescents behave naturally and feel a sense of warmth during remote assessment is crucial to maximizing their satisfaction. Telepsychiatric services can enhance the quality of health care, making them valuable supplementary tools for clinical practice.
患有注意力缺陷多动障碍（ADHD）和自闭症谱系障碍（ASD）的儿童和青少年在获得医疗服务时经常面临结构和心理障碍，包括经济成本、长时间等待以及进入新医疗环境的压力。2019年冠状病毒病（COVID-19）大流行加速了远程医疗服务的采用，以克服这些挑战。然而，很少有研究评估被诊断患有神经发育障碍的儿童和青少年及其照顾者使用远程精神病学服务时的满意度，尤其是在日本。
本研究旨在通过对被诊断患有ADHD或ASD的儿童和青少年及其照顾者进行远程精神病学评估来评估满意度，并确定与较高满意度相关的因素。
共有68名年龄在6至17岁、确诊患有ADHD或ASD的患者及其照顾者参与了本研究。参与者从庆应义塾大学医院和日本的四个合作机构招募。每位患者及其照顾者以随机顺序接受两次评估，一次面对面评估，另一次通过远程精神病学评估（一种远程视频工具）。完成两次评估后，参与者使用五点李克特量表完成一份满意度问卷，该问卷涵盖了音频和视频质量、无缝沟通、感知到的温暖、减轻的负担以及自然表现的能力等方面。进行斯皮尔曼等级相关系数和多元回归分析以确定与总体满意度相关的因素。
在患者中，70%（47/67）报告对远程精神病学评估“满意”或“非常满意”，88%（60/68）的照顾者报告了类似的满意度水平。多元回归分析表明，在儿童中，高满意度与屏幕的无缝观看、减少就诊负担以及在评估期间自然说话的能力相关。对于照顾者来说，视觉清晰度和孩子的自然行为是关键因素。
远程精神病学评估是为被诊断患有ADHD或ASD的儿童和青少年及其照顾者提供护理的一种有效且实用的选择，满意度较高。技术可靠性和减轻出行负担对积极体验有显著贡献。然而，确保儿童和青少年在远程评估期间自然表现并感受到温暖对于最大限度提高他们的满意度至关重要。远程精神病学服务可以提高医疗保健质量，使其成为临床实践中有价值的辅助工具。
