囊性纤维化患者远程医疗内分泌护理的满意度与担忧
Satisfaction and Concerns with Telemedicine Endocrine Care of Patients with Cystic Fibrosis.
作者信息
Ahmed Rahat, Greenfield Margaret, Morley Christopher P, Desimone Marisa
机构信息
Division of Endocrinology, Diabetes and Metabolism, State University of New York at Upstate Medical University, Syracuse, New York, USA.
Department of Public Health and Preventative Medicine, State University of New York at Upstate Medical University, Syracuse, New York, USA.
出版信息
Telemed Rep. 2022 Mar 21;3(1):93-100. doi: 10.1089/tmr.2021.0053. eCollection 2022.
INTRODUCTION
Patients with chronic health conditions are at high risk for severe COVID-19 infections, making telemedicine for patients with cystic fibrosis (CF) and cystic fibrosis-related diabetes (CFRD) particularly relevant. There are limited data regarding provider perspectives on caring for patients with CF using telemedicine, particularly for those with CFRD.
METHODS
Surveys were administered to patients with CF (with and without CFRD) and to adult and pediatric endocrinologists who specialize in CF. Data were collected using Research Electronic Data Capture; -tests were used to compare total mean scores of Likert scale questions. The differences in responses were performed using one-way analysis of variance followed by Tukey's Honest Significant Difference test. Variables were assessed for normality and we performed the Mann-Whitney test. No change in the results of the hypothesis test was found. All results were analyzed using SPSS version 27.
RESULTS
Eighteen patients ( = 9 CFRD) and 21 providers responded. Both groups reported high satisfaction with telemedicine overall (83.3%; 71.4%), convenience (94.4%; 85.7%), and adequate time during the visit (94.4%; 76.2%), and the majority would recommend telemedicine to others (94.4%; 95.2%). Lack of in-person examination components was of more concern to providers than patients: height/weight ( < 0.001), vitals ( < 0.001), and glycated hemoglobin ( < 0.001). There was no difference in provider perception in treatment of CFRD compared to type 1 diabetes (T1D). Common themes of open-ended questions included ease in attending telemedicine appointments (patients) and decrease in "no shows" (providers).
DISCUSSION
Patient and provider satisfaction with telemedicine was high. The lack of typical components of face-to-face visits was more concerning for providers when compared to patients. Provider concern regarding lack of components specific to diabetes was similar regarding CFRD and T1D.
引言
患有慢性健康疾病的患者感染重症 COVID-19 的风险很高，这使得针对囊性纤维化（CF）和囊性纤维化相关糖尿病（CFRD）患者的远程医疗尤为重要。关于医疗服务提供者对使用远程医疗护理 CF 患者，特别是 CFRD 患者的看法的数据有限。
方法
对患有 CF（有和没有 CFRD）的患者以及专门从事 CF 治疗的成人和儿科内分泌学家进行了调查。使用研究电子数据采集系统收集数据；使用 t 检验比较李克特量表问题的总平均分。使用单因素方差分析，然后进行 Tukey 诚实显著性差异检验来分析反应差异。对变量进行正态性评估，并进行 Mann-Whitney 检验。未发现假设检验结果有变化。所有结果均使用 SPSS 27 版进行分析。
结果
18 名患者（n = 9 例 CFRD）和 21 名医疗服务提供者做出了回应。两组总体上对远程医疗的满意度都很高（83.3%；71.4%），对便利性的满意度很高（94.4%；85.7%），对就诊时有足够时间的满意度也很高（94.4%；76.2%），并且大多数人会向他人推荐远程医疗（94.4%；95.2%）。与患者相比，医疗服务提供者更担心缺乏面对面检查环节：身高/体重（P < 0.001）、生命体征（P < 0.001）和糖化血红蛋白（P < 0.001）。与 1 型糖尿病（T1D）相比，医疗服务提供者对 CFRD 治疗的看法没有差异。开放式问题的共同主题包括参加远程医疗预约的便利性（患者）和“爽约”情况的减少（医疗服务提供者）。
讨论
患者和医疗服务提供者对远程医疗的满意度很高。与患者相比，医疗服务提供者更担心缺乏面对面就诊的典型环节。医疗服务提供者对 CFRD 和 T1D 缺乏糖尿病特定环节的担忧相似。
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