The covid-19 pandemic and the usability of telehealth in a midlife women's health integrated care program.

BACKGROUND: Telehealth has emerged as an alternative to conventional, face-to-face visits, and the COVID pandemic has hastened its introduction. Telephone appointments make use of an easy-to-use and accessible technology. AIM: To investigate the usability of telephone-based telehealth in a women's health outpatient clinic and whether this may be affected by the severity of the COVID pandemic. METHOD: A telephone survey was prepared to explore two usability domains: interaction quality (4 items) and satisfaction, preference and future use (6 items). Women were selected from two periods during the COVID pandemic when the infection rates were high and low. RESULTS: The survey was completed by 106 women (60 when the prevalence of COVID was high, mean age 53.58 years, and 46 when it was low, mean age 48.59 years) out of the 153 women who had a telephone appointment. The severity of the COVID pandemic showed an effect on responses. Women were less enthusiastic about using the telephone during the period of low COVID prevalence, as shown by lower scores on 3 of the 4 items of the first domain [I had enough time; I would have understood better in person; I would have expressed myself better in person (p < 0.001 for comparison between groups on each of the 3 items)], and on 4 of the 6 items in the second domain [satisfied with quality of care (p < 0.001), or with the information received (p = 0.018); use of telephone in future (p < 0.001); preference to try other technologies in future (p < 0.001)]. Overall, women expressed a preference for in-person visits regardless of COVID prevalence rates. CONCLUSION: Telephone calls were a feasible alternative to face-to-face visits in a women's health outpatient clinic, but the pandemic pressure modified usability parameters. Respondents preferred in-person visits at any pandemic stage.

Circuito asistencial de la paciente con síndrome de vejiga hiperactiva / Care circuit of the patient with overactive bladder syndrome

Objetivo: determinar diferencias asistenciales en las pacientes con síndrome de vejiga hiperactiva en diferentes regiones de España e identificar ámbitos de mejora. Material y métodos: 106 especialistas en ginecología participaron en 12 sesiones regionales dirigidas mediante una metodología de brainstorming estructurado y se agregaron los datos obtenidos. Resultados: el rol de los médicos de atención primaria en la sospecha de la patología, y el de los especialistas en ginecología en el diagnóstico y tratamiento se destacó como relevante en la mayoría de sesiones. Se identificaron diferencias en la accesibilidad a Unidades de Suelo Pélvico y en la disponibilidad de personal de enfermería especializado, entre otros. Se propuso la formación y la generación de nueva evidencia para estandarizar el circuito asistencial. Conclusiones: el circuito asistencial de las pacientes varía entre las distintas regiones de España. La formación del personal asistencial y la creación de nueva evidencia sobre su tratamiento pueden ayudar a mejorarlo (AU)

Objective: To describe differences in the care of patients with overactive bladder among the different regions in Spain, as well as to identify fields of improvement. Methods: 106 gynecologists participate in 12 regional meetings run by a structured brainstorming methodology. Data were obtained and shown together. Results: The role of general practitioners in clinical suspicion and the role of gynecologists in diagnoses and treatment were reported as relevant in most of the meetings. Among others, differences in accessibility to units specialized in pelvic floor disorders and in the availability of specialized nurses were identified along the meetings. Training to health professionals in pelvic floor disorders and the creation of new evidence were identified as measures to standardize the healthcare of patients with overactive bladder. Conclusions: The healthcare journey of patients with overactive bladder differs from one to another region in Spain. Training and new evidence may help improve such healthcare (AU)