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2.
Eur Heart J Digit Health ; 5(3): 356-362, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38774365

RESUMO

Aims: Electroanatomical mapping (EAM) systems are essential for the treatment of cardiac arrhythmias. The EAM system is usually operated by qualified staff or field technical engineers from the control room. Novel remote support technology allows for remote access of EAM via online services. Remote access increases the flexibility of the electrophysiological lab, reduces travel time, and overcomes hospital access limitations especially during the COVID-19 pandemic. Here, we report on the feasibility and safety of EAM remote access for cardiac ablation procedures. Methods and results: Mapping and ablation were achieved by combining the EnsiteX™ EAM system and the integrated Ensite™ Connect Remote Support software, together with an integrated audiovisual solution system for remote support (Medinbox). Communication between the operator and the remote support was achieved using an incorporated internet-based common communication platform (Zoom™), headphones, and high-resolution cameras. We investigated 50 remote access-assisted consecutive electrophysiological procedures from September 2022 to February 2023 (remote group). The data were compared with matched patients (n = 50) with onsite support from the control room (control group). The median procedure time was 100 min (76, 120; remote) vs. 86 min (60, 110; control), P = 0.090. The procedural success (both groups 100%, P = 0.999) and complication rate (remote: 2%, control: 0%, P = 0.553) were comparable between the groups. Travel burden could be reduced by 11 280 km. Conclusion: Remote access for EAM was feasible and safe in this single-centre study. Procedural data were comparable to procedures with onsite support. In the future, this new solution might have a great impact on facilitating electrophysiological procedures.

3.
Eur Heart J Digit Health ; 5(3): 379-383, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38774368

RESUMO

Aims: Invasive haemodynamic monitoring of heart failure (HF) is used to detect deterioration in an early phase thereby preventing hospitalizations. However, this invasive approach is costly and presently lacks widespread accessibility. Hence, there is a pressing need to identify an alternative non-invasive method that is reliable and more readily available. In this pilot study, we investigated the relation between wrist-derived photoplethysmography (PPG) signals and the invasively measured pulmonary capillary wedge pressure (PCWP). Methods and results: Fourteen patients with aortic valve stenosis who underwent transcatheter aortic valve replacement with concomitant right heart catheterization and PPG measurements were included. Six unique features of the PPG signals [heart rate, heart rate variability, systolic amplitude (SA), diastolic amplitude, crest time (CT), and large artery stiffness index (LASI)] were extracted. These features were used to estimate the continuous PCWP values and the categorized PCWP (low < 12 mmHg vs. high ≥ 12 mmHg). All PPG features resulted in regression models that showed low correlations with the invasively measured PCWP. Classification models resulted in higher performances: the model based on the SA and the model based on the LASI both resulted in an area under the curve (AUC) of 0.86 and the model based on the CT resulted in an AUC of 0.72. Conclusion: These results demonstrate the capability to non-invasively classify patients into clinically meaningful categories of PCWP using PPG signals from a wrist-worn wearable device. To enhance and fully explore its potential, the relationship between PPG and PCWP should be further investigated in a larger cohort of HF patients.

4.
Sleep Breath ; 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38755506

RESUMO

PURPOSE   : Continuous positive airway pressure (CPAP) is often the treatment of choice for obstructive sleep apnea (OSA). Short-term adherence and early perceived benefits are the best predictors of long-term adherence. The aim of this study was to determine the effect of telemonitoring in the first period of treatment with CPAP (auto-titrating PAP) on compliance and the long-term outcome. METHODS: Patients aged between 18-75 years old with symptomatic severe OSA (apnea-hypopnea index (AHI) ≥ 30) requiring CPAP therapy were included in this single-blind, single-centre, randomised, controlled trial. They were divided into 2 groups (telemonitored standard clinical care versus standard clinical care without telemonitoring). RESULTS: A total of 230 patients (115 patients/group) were included (mean age 54 ± 16.6 years, BMI 32.6 ± 5.4 kg/m2, ESS 13.1 ± 6.2, AHI 47.5 ± 14.8/hr). At week 10 compliance was similar in both groups (telemonitoring vs control 6:27 and 6:35 h, respectively, p = 0.57), as were AHI (2.4; 2.4/hr, p = 0.89) and ESS (5.8; 4.9, p = 0.22). The number of contacts of a patient with a healthcare professional was significantly higher during the follow-up from week 3 until week 10 (0.25; 0.13, p = 0.03). The number of patients who could be evaluated after 1 year was equally distributed in both groups (104; 104, p = 1.00), as were compliance (6:43; 6:49 h, p = 0.59) and residual AHI (1.9; 2.2/hr, p = 0.41). CONCLUSIONS: In patients with severe OSA with standard intensive follow-up during the initial weeks of CPAP therapy and good compliance, telemonitoring did not improve CPAP compliance nor the clinical outcome in the short or long term. The practical consequences can be highly relevant for patients and healthcare professionals.

5.
J Patient Exp ; 11: 23743735241253557, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38756453

RESUMO

The demand for digital platforms in managing heart failure (HF) is expected to increase with promising effects on readmission and health expenditure. The study aims to explore current post-discharge management strategies and identify the need and acceptance of digital platforms, to ensure the development of a user-friendly mobile application for HF patients. Using a cross-sectional analytical research design, 90 consecutive patients diagnosed with HF who were discharged from a Tertiary Care Center were enrolled. Tele-interview was conducted using a self-developed and validated tool. The mean age of participants was 55.54 ± 10.33 years. The participants' adherence to HF management strategies was low in terms of physical exercise and weight monitoring. More than one-third were willing to self-record their measurements and use a mobile application. The common mobile application features requested were medication information/reminder (88.6%), health education (84.3%), chat with nurses (84.3%), physical activity (81.4%), symptoms (78.6%), diet (78.6%) and weight management (72.9%). The findings from this initial phase of mobile development are expected to help leverage better development of digital interventions for HF patients.

6.
JMA J ; 7(2): 286-287, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38721082
8.
Am J Otolaryngol ; 45(4): 104330, 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38723377

RESUMO

OBJECTIVE: To investigate patient attitudes towards desire for and barriers to utilizing telemedicine visits for head and neck oncology care. METHODS: This is a retrospective analysis of data from cross-sectional survey responses collected via prospectively administered questionnaire to 616 adult patients during their clinical visit to a tertiary care head and neck surgical oncology clinic. Responses to questions investigating interest in telemedicine and potential barriers were collated with patient demographics, measures of rurality, and insurance status. Interest in telemedicine appointments was the assessed primary outcome. RESULTS: Of 616 survey respondents, 315 (51 %) indicated interest in telemedicine visits. Limitations in access to technology (17.5 %) and lack of reliable internet connection (13.14 %) were identified as key barriers to telemedicine use. Lack of interest in telemedicine was associated with older age (OR 0.97 [95%CI 0.96-0.98]), governmental insurance (0.43 [0.31-0.60]) and, retired work status (0.48 [0.33-0.69]). Women (1.43 [1.04-1.97]) and patients who reported access to compatible electronic devices (41.05 [14.88-113.20]) and reliable internet connection (20.94 [8.34-52.60]) were more likely to be interested in telemedicine appointments. Respondents also indicated preference for a "hands on" examination over telemedicine appointments. CONCLUSION: Nearly 1 in 2 patients evaluated in a tertiary care head and neck surgical oncology clinic expressed reticence regarding telemedicine for clinical visits. Limited access to technology platforms and unreliable internet remain key concerns for these patients. Understanding the needs and attitudes of specific patient populations may be important for organizations pivoting to telemedicine platforms to ensure equity in healthcare access. LEVEL OF EVIDENCE: Retrospective analysis of prospectively collected cross-sectional survey.

9.
Cureus ; 16(4): e57554, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38707089

RESUMO

The idea of the "metaverse" is a relatively recent technological development. The industries that are most supportive of these developments include finance, entertainment, and communication. In addition to these, the healthcare domain has been added to the list of domains that benefit from the metaverse recently. Within the metaverse, research is being conducted on a wide range of medical topics, including conferences and seminars, surgical simulators, awareness campaigns, research projects, and much more. The metaverse is a flexible and highly customizable virtual digital platform that can be configured to suit specific needs, making it an adaptable instrument for medical advancement. These domains, together with their benefits and drawbacks, are thoroughly covered in this review article, which raises the discussion of the need for medical productivity. These studies have undergone a minimum amount of research and experimentation, and the findings are fair from an investigative standpoint. This review article's major goal is to make a provocative remark about metaverse domains and how they have already been used and might be used as an essential operational tool in the field of medicine in the future. Consequently, the objective of the present study is to review the current literature on post-COVID-19 pandemic development that connected the metaverse with the prevention and treatment of diseases, medical education and training, and expansion of available functionalities in research settings.

10.
Int J Nurs Sci ; 11(2): 258-275, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38707688

RESUMO

Objective: Mobile health applications (apps) have gained significant popularity and widespread utilization among patients with coronary heart disease (CHD). The objective of this study is to evaluate the effects of mHealth apps on clinical outcomes and health behaviors in patients with CHD. Methods: Databases were searched from inception until December 2023, including Cochrane Library, PubMed, EMBASE, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Service System (SinoMed), Wanfang Data, China Science and Technology Journal Database (VIP), for randomized controlled trials (RCTs) regarding the effectiveness of mHealth apps in patients with CHD. Two researchers conducted a comprehensive review of the literature, extracting relevant data and evaluating each study's methodological quality separately. The meta-analysis was performed utilizing Review Manager v5.4 software. Results: A total of 34 RCTs were included, with 5,319 participants. The findings demonstrated that using mHealth apps could decrease the incidence of major adverse cardiac events (RR = 0.68, P = 0.03), readmission rate (RR = 0.56, P < 0.001), total cholesterol (WMD = -0.19, P = 0.03), total triglycerides (WMD = -0.24, P < 0.001), waist circumference (WMD = -1.92, P = 0.01), Self-Rating Anxiety Scale score (WMD = -6.70, P < 0.001), and Self-Rating Depression Scale score (WMD = -7.87, P < 0.001). They can also increase the LVEF (WMD = 6.50, P < 0.001), VO2 max (WMD = 1.89, P < 0.001), 6-min walk distance (6MWD) (WMD = 19.43, P = 0.004), Morisky Medication Adherence Scale-8 score (WMD = 0.96, P = 0.004), and medication adherence rate (RR = 1.24, P = 0.03). Nevertheless, there is no proof that mHealth apps can lower low-density lipoprote in cholesterol, blood pressure, BMI, or other indicator (P > 0.05). Conclusion: Mobile health apps have the potential to lower the incidence of major adverse cardiac events (MACEs), readmission rates, and blood lipids in patients with CHD. They can also help enhance cardiac function, promote medication adherence, and alleviate symptoms of anxiety and depression. To further corroborate these results, larger-scale, multi-center RCTs with longer follow-up periods are needed.

11.
Rev Panam Salud Publica ; 48: e40, 2024.
Artigo em Espanhol | MEDLINE | ID: mdl-38707778

RESUMO

Objectives: Describe the current legislation on electronic medical records (EMR) and telehealth in Latin American countries and analyze the treatment of confidentiality and professional secrecy. Methods: Between March and September 2022, a survey of the regulations in force in 21 Latin American countries was conducted at two levels: the existence of legislation on EMR and telehealth, and the treatment of confidentiality and professional secrecy in EMR and telehealth. A data extraction form was prepared for each country. Data were collected from official on-line sources. The information was analyzed qualitatively and synthesized in tables when possible. Results: The use of EMR is legally regulated in 16 countries. Nineteen countries have legislation on telehealth. All the countries analyzed safeguard confidentiality and professional secrecy through regulations. However, confidentiality and professional secrecy are mentioned in 11 countries in the context of telehealth, and in only nine countries in the context of EMR. Conclusions: Since the start of this century, Latin America has made progress in the legislation of digital tools for health care, such as EMR and telehealth. There is also interest in ethical issues related to the use of EMR and telehealth, particularly confidentiality and professional secrecy, aspects that should be strengthened in digital health.


Objetivo: Descrever a legislação vigente sobre prontuários eletrônicos e telessaúde nos países da América Latina e analisar o tratamento da confidencialidade e do sigilo profissional. Métodos: Entre março e setembro de 2022, realizou-se um levantamento sobre a regulamentação vigente nos 21 países latino-americanos incluídos no estudo, em dois níveis: i) existência de legislação sobre prontuários eletrônicos e telessaúde; e ii) tratamento da confidencialidade e do sigilo profissional em prontuários eletrônicos e telessaúde. Uma planilha para extração de dados foi elaborada para cada país. Os dados foram coletados de fontes oficiais disponíveis on-line. Foi realizada uma análise qualitativa das informações, que foram resumidas em tabelas, quando possível. Resultados: O uso dos prontuários eletrônicos é legalmente regulamentado em 16 países. Quanto à telessaúde, 19 países têm legislação sobre essa ferramenta. Todos os países analisados protegem a confidencialidade e o sigilo profissional por meio de regulamentação. No entanto, no contexto da telessaúde, eles são mencionados em 11 países; já no contexto dos prontuários eletrônicos, em apenas 9 países. Conclusões: Desde o início dos anos 2000, a América Latina vem avançando em relação à legislação sobre ferramentas digitais na atenção à saúde, como prontuários eletrônicos e telessaúde. Há também interesse nas questões éticas relacionadas ao uso de prontuários eletrônicos e telessaúde, especialmente em relação à confidencialidade e ao sigilo profissional, embora esses aspectos precisem ser reforçados na saúde digital.

12.
J Pak Med Assoc ; 74(4 (Supple-4)): S145-S150, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38712423

RESUMO

Tele-dentistry encompasses all sorts of digital technologies that involve the exchange of patient's clinical data from a distant site for the provision of dental health care. Tele-dentistry has emerged from the concept of telemedicine, which has been in practice since the 19th century. In recent times, an upsurge in the digital technologies was noted, which has made the possibility of remote access to dental care. The outbreak of COVID- 19 pandemic has restricted the normal routine ways of clinical practice. In these challenging times, tele-dentistry serves as effective platform for providing dental health care. Tele-dentistry has vast applications across various disciplines of dentistry, including preventive dentistry, paediatric dentistry, oral medicine, and oral pathology etc. In these pandemic times, tele-dentistry can be efficiently used for identification of dental emergencies, allowing effective triage and subsequent management. There are different communication platforms available for tele-dentistry. The most common technologies used are web-based video conferencing and smart phone-based applications. As the clinicians are not aware of these digital technologies utilised in tele-dentistry, there are certain challenges associated with its use. In conclusion, tele-dentistry serves as an effective tool in providing health care in challenging times, but it has been underutilised by the dental fraternity. The legislative authorities should establish proper standard protocols to ensure the safety and confidentiality of patient information while using these digital platforms.


Assuntos
COVID-19 , Assistência Odontológica , Telemedicina , Humanos , COVID-19/epidemiologia , Telemedicina/métodos , Assistência Odontológica/métodos , SARS-CoV-2 , Smartphone
13.
J Cosmet Dermatol ; 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38713003

RESUMO

BACKGROUND: Oral finasteride and topical minoxidil are the current standard of care for male androgenetic alopecia and a combination of the two treatments can be considered for greater efficacy. Clinical trials of topical finasteride have also yielded promising results, but routine care data are lacking. AIMS: To examine patient-reported outcomes of men with androgenetic alopecia who received topical finasteride admixed with minoxidil compared to the current standard of care (oral finasteride). METHODS: Retrospective, cross-sectional study with data from a German direct-to-consumer teledermatology platform between December 2021 and January 2023. Patient-reported outcomes were collected through voluntary follow-up questionnaires provided after 6 weeks on topical finasteride/minoxidil or oral finasteride treatment. RESULTS: A total of 1545 patients who received topical finasteride/minoxidil treatment were included; 238 (15.4%) participated in the follow-up questionnaire. At week six, 62.2% (148/238) reported positive changes in their hair appearance, and 44.1% (105/238) reported an improvement of self-esteem. Treatment-related adverse events were reported in 11.8% (28/238). Full treatment adherence was observed in 74.4% (177/238). Comparing the topical treatment group to those receiving oral finasteride, lower treatment adherence was reported, along with higher rates of local adverse events; no difference was found in the incidence of sexual adverse events. CONCLUSION: Based on patient-reported outcomes, topical finasteride/minoxidil seems to be effective and well tolerated, but not superior to oral finasteride. Lower treatment adherence for topical usage must be considered when considering treatment options. Additional real-world data are needed to further evaluate the efficacy and safety of topical finasteride/minoxidil.

14.
Digit Health ; 10: 20552076241249280, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38715973

RESUMO

Objective: The usage of digital information and communication technologies in European healthcare is growing. Unlike numerous technological possibilities, the present use of these technologies and perspectives towards them in relation to otolaryngology care have so far been of less interest. This study evaluates the utilisation of and attitudes towards digital information and communication technologies in cross-sectoral otolaryngology care among German patients. Methods: A structured interview-based study was conducted at the outpatient facility of a tertiary hospital in Germany. It focused on chief complaints, current use of digital technologies, estimated benefits of increased digital technology use in otolaryngology care, and sociodemographic data. The detailed statistical analysis employed Chi-squared tests and multivariate logistic regression. Results: A total of 208 otolaryngology patients completed the interview. Digital communication technologies exhibited a high penetration rate (91.8%) and were regularly used in daily life (78.7%) and for health reasons (73.3%). Younger age (p ≤ 0.003) and higher education levels (p ≤ 0.008) were significantly correlated with the increased digital communication technology use. The overall potential of eHealth technologies was rated significantly higher by younger patients (p ≤ 0.001). The patients' chief complaints showed no significant influence on the current and potential use of these technologies for cross-sectoral otolaryngology care. Conclusion: Regardless of their chief complaints, German otolaryngology patients regularly use digital information and communication technologies for health reasons and express interest in their further use for cross-sectoral care. To enhance digital patient communication in otolaryngology, attention should be given to treatment quality, usability, data security and availability and financial remuneration for service providers.

15.
Soins Psychiatr ; 45(352): 13-16, 2024.
Artigo em Francês | MEDLINE | ID: mdl-38719353

RESUMO

A group-based online psycho-education program for adults with attention deficit hyperactivity disorder (ADHD) and their families has been set up by a multi-professional psychiatric team. Feedback from users has mainly shown benefits in terms of improving self-esteem, destigmatization and accessibility to care. This suggests a real interest in developing this care offer in the pathway of ADHD adults.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Educação de Pacientes como Assunto , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/enfermagem , Adulto , Autoimagem , Psicoterapia de Grupo/métodos , França , Masculino , Feminino , Criatividade , Instrução por Computador , Comunicação Interdisciplinar , Equipe de Assistência ao Paciente , Estigma Social , Colaboração Intersetorial , Internet , Acessibilidade aos Serviços de Saúde , Comportamento Cooperativo
16.
Sleep Breath ; 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38720151

RESUMO

PURPOSE: This study assessed the feasibility of telephone follow-up consultations (TC) using an online data sharing and editing function (Airview™), as alternative to standard out-clinic follow-up consultations (SC) on adherence to continuous positive airway pressure (CPAP) in obstructive sleep apnea (OSA) patients. Furthermore, we investigated compliance to follow-up consultations and examined potential influencing factors, including baseline AHI (apnea-hypopnea-index), age, and distance from home to the hospital on consultation compliance. METHODS: Two hundred OSA patients, with AHI ≥ 5 were randomly assigned (1:1) to receive TC or SC with follow-up after one month and 12 month of CPAP initiation. Adherence goal was defined as achieving ≥ 4 h of CPAP use daily in 70% of the days in a 365-days period. RESULTS: The proportion of participants achieving CPAP adherence was non-significantly lower in the TC group compared to the SC group (TC: 30% versus SC: 36%, adjusted OR 0.84, p = 0.59). Of participants who completed the study, the TC group had a significant average of 107 min less use of CPAP compared to the SC group (p = 0.048). However, a higher proportion of participants was compliant to consultations in the TC group. The only influencing factor found was increasing baseline AHI, which might be a predictor for compliance to consultations and adherence to CPAP therapy. CONCLUSION: TC might serve as substitute for SC in some part of the OSA population. If TC becomes a part of CPAP therapy management, it is important to consider patient characteristics and treatment-related issues to prevent decline in adherence.

17.
J Neuromuscul Dis ; 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38728200

RESUMO

Neuromuscular diseases (NMDs), in their phenotypic heterogeneity, share quite invariably common issues that involve several clinical and socio-economical aspects, needing a deep critical analysis to develop better management strategies. From diagnosis to treatment and follow-up, the development of technological solutions can improve the detection of several critical aspects related to the diseases, addressing both the met and unmet needs of clinicians and patients. Among several aspects of the digital transformation of health and care, this congress expands what has been learned from previous congresses editions on applicability and usefulness of technological solutions in NMDs. In particular the focus on new solutions for remote monitoring provide valuable insights to increase disease-specific knowledge and trigger prompt decision-making. In doing that, several perspectives from different areas of expertise were shared and discussed, pointing out strengths and weaknesses on the current state of the art on topic, suggesting new research lines to advance technology in this specific clinical field.

18.
J Occup Health ; 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38729214

RESUMO

OBJECTIVES: This study aimed to evaluate the non-inferiority of online counseling over face-to-face counseling for specific health guidance (SHG). METHODS: This prospective observational study was conducted using specific health checkup (SHC) and SHG data of individuals with health insurance in Japan. We analyzed data from 1,431 participants who met the inclusion criteria, including those who underwent online or face-to-face counseling between April 1, 2020 and March 31, 2021, and received an SHC in the following year but no earlier than 90 days after their first counseling session. Assessed variables comprised demographics, counseling methods, and SHC results, including baseline questionnaire findings and body mass index (BMI) at follow-up. We performed inverse probability of treatment weighting (IPTW) using propensity scores, with changes in BMI as the objective variable and the counseling method as the explanatory variable. We set the non-inferiority margin to 0.175, based on a previous study. RESULTS: The online and face-to-face counseling groups comprised 455 (31.8%) and 976 (68.2%) participants, respectively. The number of men and mean age were 214 (47.0%) and 49.9 years (standard deviation: 6.9 years), respectively, in the online counseling group and 491 (50.3%) and 51.1 years (7.6 years), respectively, in the face-to-face counseling group. IPTW using propensity scores revealed a regression coefficient (95% confidence interval) of -0.014 (-0.157, 0.129) for the online group compared to the face-to-face group (p=.847). The confidence interval was within the non-inferiority margin. CONCLUSIONS: The effects of online counseling on BMI are likely non-inferior to those of face-to-face counseling.

20.
LGBTQ Fam ; 20(3): 190-200, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38721330

RESUMO

Telemedicine may help improve access to gender-affirming care for transgender and gender diverse (TGD) adolescents. Parents or guardians (i.e., caregivers) of TGD adolescents play a critical role in supporting TGD adolescents in accessing this care. The purpose of this study was to explore caregivers' perspectives regarding their adolescent receiving pediatric gender-affirming care via telemedicine to help providers and health systems optimize this modality for future care delivery. Caregivers (n=18) of TGD adolescents ages 14-17 participated in semi-structured, individual interviews that were transcribed and analyzed qualitatively. Caregivers cited participating in visits from their home environment, decreased anxiety, COVID safety, ability to have more family members attend, no transportation demands, and effective delivery of care as advantages of telemedicine. Disadvantages included dysphoria or discomfort with self-image, impersonal provider-patient interactions, video teleconferencing fatigue, difficulty with portal navigation, connectivity issues, and lack of privacy. Caregivers largely deferred to their child's preference regarding the choice of visit modality, but many reported a preference for the first to be conducted in-person, and follow-up and less complex visits via telemedicine. Health systems should consider these perspectives as they adapt telemedicine infrastructure to better meet the needs of patients and their families.

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