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1.
BMC Fam Pract ; 22(1): 143, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34210284

RESUMO

BACKGROUND: Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams' delivery of mental health care. METHODS: A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. RESULTS: We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. CONCLUSIONS: From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care's capacity for mental health care for the duration of the pandemic and beyond.


Assuntos
COVID-19 , Prestação Integrada de Cuidados de Saúde/organização & administração , Serviços de Saúde Mental , Equipe de Assistência ao Paciente/organização & administração , Atenção Primária à Saúde , Telemedicina , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Feminino , Grupos Focais , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Saúde Mental/tendências , Serviços de Saúde Mental/normas , Serviços de Saúde Mental/provisão & distribuição , Ontário/epidemiologia , Padrões de Prática Médica/tendências , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Melhoria de Qualidade/organização & administração , SARS-CoV-2 , Telemedicina/métodos , Telemedicina/estatística & dados numéricos
2.
Prev Chronic Dis ; 18: E65, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34197284

RESUMO

INTRODUCTION: Telehealth plays a role in the continuum of care, especially for older adults during the COVID-19 pandemic. Our objective was to examine factors associated with the accessibility of telehealth services during the COVID-19 pandemic among older adults. METHODS: We analyzed the nationally representative Medicare Current Beneficiary Survey COVID-19 Rapid Response Supplement Questionnaire of beneficiaries aged 65 years or older. Two weighted multivariable logistic regression models were used to examine associations between usual providers who offered telehealth 1) during the COVID-19 pandemic and 2) to replace a regularly scheduled appointment. We examined factors including sociodemographic characteristics, comorbidities, and digital access and literacy. RESULTS: Of the beneficiaries (n = 6,172, weighted n = 32.4 million), 81.2% reported that their usual providers offered telehealth during the COVID-19 pandemic. Among those offered telehealth services, 56.8% reported that their usual providers offered telehealth to replace a regularly scheduled appointment. Disparities in accessibility of telehealth services by sex, residing area (metropolitan vs nonmetropolitan), income level, and US Census region were observed. Beneficiaries who reported having internet access (vs no access) (OR, 1.75, P < .001) and who reported ever having participated in video, voice, or conference calls over the internet before (vs not) (OR, 2.18, P < .001) were more likely to report having access to telehealth. Non-Hispanic Black beneficiaries (versus White) (OR, 1.57, P = .007) and beneficiaries with comorbidities (vs none) (eg, 2 or 3 comorbidities, OR, 1.25, 95% P = .044) were more likely to have their usual provider offer telehealth to replace a regularly scheduled appointment. CONCLUSION: Although accessibility of telehealth has increased, inequities raise concern. Educational outreach and training, such as installing and launching an online web conferencing platform, should be considered for improving accessibility of telehealth to vulnerable populations beyond the COVID-19 pandemic.


Assuntos
COVID-19 , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Controle de Infecções/métodos , Medicare/estatística & dados numéricos , Telemedicina , Idoso , COVID-19/epidemiologia , COVID-19/prevenção & controle , Comorbidade , Estudos Transversais , Demografia , Feminino , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Disparidades em Assistência à Saúde/organização & administração , Humanos , Acesso à Internet/estatística & dados numéricos , Masculino , Determinação de Necessidades de Cuidados de Saúde , SARS-CoV-2 , Fatores Socioeconômicos , Telemedicina/métodos , Telemedicina/organização & administração , Telemedicina/estatística & dados numéricos , Estados Unidos/epidemiologia
3.
Curr Oncol ; 28(3): 2248-2259, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-34204531

RESUMO

Patients awaiting cancer treatment were classified as "vulnerable" and advised to shield to protect themselves from exposure to coronavirus during the pandemic. These measures can negatively impact patients. We sought to establish the feasibility and effects of a telehealth-delivered home-based prehabilitation program during the pandemic. Eligible patients were referred from multiple centers to a regional prehabilitation unit providing home-based prehabilitation. The enrolled patients received telehealth-delivered prehabilitation prior to surgery and/or during non-surgical cancer treatment, which included personalized training exercises, dietary advice, medical optimization therapies, and psychological support. The primary outcome was to investigate the feasibility of our program. The secondary outcome was to investigate the relationship between our program and patient-reported outcomes (PROs). The patients completed two questionnaires (the EQ-5D-3L and the FACIT-Fatigue Scale) pre- and post-intervention. A total of 182 patients were referred during the study period. Among the 139 (76%) patients that were enrolled, 100 patients completed the program, 24 patients have still to complete, and 15 have discontinued. A total of 66 patients were able to return completed questionnaires. These patients were recruited from colorectal, urology, breast, and cardiothoracic centers. The patients significantly improved their self-perceived health (p = 0.001), and fatigue (p = 0.000). Home-based prehabilitation is a feasible intervention. The PROs improved post-intervention.


Assuntos
COVID-19/epidemiologia , Neoplasias/terapia , Telemedicina/métodos , Idoso , Inglaterra , Exercício Físico , Estudos de Viabilidade , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Medicina de Precisão/métodos , Cuidados Pré-Operatórios , Exercício Pré-Operatório , Estudos Prospectivos , Qualidade de Vida , Resultado do Tratamento
4.
Biol Pharm Bull ; 44(7): 1019-1023, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1292126

RESUMO

To prevent cognitive decline, non-pharmacological therapies such as reminiscence for mild cognitive impairment (MCI) are required, however, the use of nursing homes was limited due to coronavirus disease 2019 (COVID-19). Therefore, the demand for remote-care is increasing. We hypothesized that immersive virtual reality (iVR) could be used more effectively than conventional reminiscence for anxiety. We first examined the effectiveness and safety of reminiscence using iVR (iVR reminiscence session) in patients with MCI. After COVID-19 imposed restriction on visiting nursing homes, we conducted online iVR reminiscence session (remote iVR reminiscence session) and compared its effectiveness with that of interpersonal iVR reminiscence session (face-to-face iVR reminiscence session). The results of two elderly with MCI suggested that iVR reminiscence could reduce anxiety and the burden of care without serious side effects. The effects of remote iVR reminiscence might be almost as effective as those of face-to-face one.


Assuntos
Ansiedade/terapia , Disfunção Cognitiva/terapia , Imagens, Psicoterapia/métodos , Telemedicina/métodos , Realidade Virtual , Idoso de 80 Anos ou mais , Ansiedade/diagnóstico , Ansiedade/psicologia , Disfunção Cognitiva/complicações , Disfunção Cognitiva/psicologia , Feminino , Humanos , Masculino , Aplicativos Móveis , Casas de Saúde , Satisfação do Paciente , Telemedicina/instrumentação , Resultado do Tratamento
5.
J Surg Oncol ; 124(2): 231-240, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34245572

RESUMO

Educating surgeons is a time-consuming process. In addition to theoretical knowledge, the practical tasks of surgical procedures must be mastered. Translation of such knowledge from mentor to mentee may be efficiently done by surgical telementoring (ST). This is a review on surgical telementoring. Recent technological advances have made this tool in surgical education more available and applicable but future applications of ST have to be wisely guided by high-quality trials.


Assuntos
Educação à Distância/métodos , Educação de Pós-Graduação em Medicina/métodos , Tutoria/métodos , Especialidades Cirúrgicas/educação , Telemedicina/métodos , Competência Clínica , Currículo , Educação à Distância/organização & administração , Educação de Pós-Graduação em Medicina/organização & administração , Europa (Continente) , Feedback Formativo , Humanos , Modelos Educacionais , América do Norte , Desenvolvimento de Programas
6.
J Surg Oncol ; 124(2): 241-245, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34245573

RESUMO

Surgical training does not end at the conclusion of residency training. Expansions in medical technology and surgical technique have created a steep learning curve for the young attending surgeon. The emergence of intraoperative telementoring has allowed experienced surgeons to guide learners through complex surgical cases remotely with the assistance of streaming video technology. Here, we describe the basics of telementoring, financial and legal considerations, and recommend hardware specifications for optimal use.


Assuntos
Educação à Distância/métodos , Educação de Pós-Graduação em Medicina/métodos , Tutoria/métodos , Especialidades Cirúrgicas/educação , Telemedicina/métodos , Tecnologia Educacional , Estudos de Viabilidade , Humanos , Modelos Educacionais , Estados Unidos
7.
J Surg Oncol ; 124(2): 216-220, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34245574

RESUMO

Team training and crisis management derive their roots from fundamental learning theory and the culture of safety that burgeoned forth from the industrial revolution through the rise of nuclear energy and aviation. The integral nature of telemedicine to many simulation-based activities, whether to bridge distances out of convenience or necessity, continues to be a common theme moving into the next era of surgical safety as newer, more robust technologies become available.


Assuntos
Educação à Distância/métodos , Educação de Pós-Graduação em Medicina/métodos , Equipe de Assistência ao Paciente , Assistência Perioperatória/educação , Treinamento por Simulação/métodos , Especialidades Cirúrgicas/educação , Procedimentos Cirúrgicos Operatórios/educação , Competência Clínica , Educação à Distância/organização & administração , Educação de Pós-Graduação em Medicina/organização & administração , Emergências , Humanos , Tutoria/métodos , Tutoria/organização & administração , Salas Cirúrgicas/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Segurança do Paciente/normas , Assistência Perioperatória/métodos , Assistência Perioperatória/normas , Treinamento por Simulação/organização & administração , Especialidades Cirúrgicas/normas , Procedimentos Cirúrgicos Operatórios/métodos , Procedimentos Cirúrgicos Operatórios/normas , Telemedicina/métodos , Telemedicina/organização & administração , Estados Unidos
8.
J Surg Oncol ; 124(2): 246-249, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34245577

RESUMO

The effective integration of robotic technology and surgical tools has played a vital role in advancing surgical care by enabling telepresence in surgery to provide mentorship and surgical care across long distances in the absence of surgeons. This article describes our experiences with advancing surgical education and innovation through telementoring community surgeons, establishing the world's first telerobotic surgical service, and the integration of Artificial Intelligence and robotics to provide remote surgical care and training.


Assuntos
Automação/métodos , Educação à Distância/métodos , Educação Médica Continuada/métodos , Cirurgia Geral/educação , Tutoria/métodos , Procedimentos Cirúrgicos Robóticos/educação , Telemedicina/métodos , Inteligência Artificial , Canadá , Competência Clínica , Educação à Distância/organização & administração , Educação Médica Continuada/organização & administração , Humanos , Missões Médicas , Tutoria/organização & administração , Procedimentos Cirúrgicos Robóticos/instrumentação , Procedimentos Cirúrgicos Robóticos/métodos , Telemedicina/organização & administração
9.
J Surg Oncol ; 124(2): 250-254, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34245580

RESUMO

Tele-education assisted mentorship in surgery (TEAMS) is a novel methodology for surgical skills training with remote, hands-on, high-fidelity, and low-cost simulation-based education and one-to-one mentorship with longitudinal assessments. We review the background, methodology, and our experience with implementing TEAMS as an adjunct to traditional methods of surgical education and mentorship.


Assuntos
Educação à Distância/métodos , Educação Médica Continuada/métodos , Cirurgia Geral/educação , Tutoria/métodos , Treinamento por Simulação/métodos , Telemedicina/métodos , Competência Clínica , Educação à Distância/organização & administração , Educação Médica Continuada/organização & administração , Cirurgia Geral/métodos , Humanos , Tutoria/organização & administração , Treinamento por Simulação/organização & administração , Telemedicina/organização & administração , Estados Unidos
10.
J Surg Oncol ; 124(2): 162-173, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34245579

RESUMO

The first era of the global proliferation of surgical advancements involved surgical infection rate and technique breakthroughs by Lister, Halsted, and others. This was propagated by letters, academic papers, and international visits. While success was achieved, it was at a suboptimal pace. In the current era of minimally invasive surgical approaches, these methods are inadequate. This paper chronicles the development and application of virtual learning and telementoring as force multipliers to speed procedural adoption and proliferation.


Assuntos
Educação à Distância/história , Educação de Pós-Graduação em Medicina/história , Tutoria/história , Procedimentos Cirúrgicos Minimamente Invasivos/educação , Treinamento por Simulação/história , Especialidades Cirúrgicas/educação , Telemedicina/história , Educação à Distância/métodos , Educação à Distância/tendências , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/tendências , História do Século XX , História do Século XXI , Humanos , Tutoria/métodos , Tutoria/tendências , Procedimentos Cirúrgicos Minimamente Invasivos/história , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/tendências , Treinamento por Simulação/métodos , Treinamento por Simulação/tendências , Especialidades Cirúrgicas/história , Especialidades Cirúrgicas/métodos , Especialidades Cirúrgicas/tendências , Telemedicina/métodos , Telemedicina/tendências , Estados Unidos
11.
Biol Pharm Bull ; 44(7): 1019-1023, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34193684

RESUMO

To prevent cognitive decline, non-pharmacological therapies such as reminiscence for mild cognitive impairment (MCI) are required, however, the use of nursing homes was limited due to coronavirus disease 2019 (COVID-19). Therefore, the demand for remote-care is increasing. We hypothesized that immersive virtual reality (iVR) could be used more effectively than conventional reminiscence for anxiety. We first examined the effectiveness and safety of reminiscence using iVR (iVR reminiscence session) in patients with MCI. After COVID-19 imposed restriction on visiting nursing homes, we conducted online iVR reminiscence session (remote iVR reminiscence session) and compared its effectiveness with that of interpersonal iVR reminiscence session (face-to-face iVR reminiscence session). The results of two elderly with MCI suggested that iVR reminiscence could reduce anxiety and the burden of care without serious side effects. The effects of remote iVR reminiscence might be almost as effective as those of face-to-face one.


Assuntos
Ansiedade/terapia , Disfunção Cognitiva/terapia , Imagens, Psicoterapia/métodos , Telemedicina/métodos , Realidade Virtual , Idoso de 80 Anos ou mais , Ansiedade/diagnóstico , Ansiedade/psicologia , Disfunção Cognitiva/complicações , Disfunção Cognitiva/psicologia , Feminino , Humanos , Masculino , Aplicativos Móveis , Casas de Saúde , Satisfação do Paciente , Telemedicina/instrumentação , Resultado do Tratamento
12.
Cutis ; 107(4): E37-E39, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34096860

RESUMO

The COVID-19 pandemic resulted in profound changes to most facets of medical practice. The field of dermatology has adapted by rapidly incorporating teledermatology as a means of evaluating, treating, and staying connected with our patients. Broader dermatology access, convenience to patients, and value to payers are benefits to this rapidly evolving practice model and suggest that teledermatology will be a part of day-to-day practice even as the worst of the pandemic is behind us. This interview provides one recent dermatology resident graduate's experiences incorporating teledermatology into his practice model and provides advice for future residents on preparing to do the same.


Assuntos
COVID-19/prevenção & controle , Consulta Remota/métodos , Dermatopatias/terapia , Telemedicina/métodos , COVID-19/epidemiologia , Dermatologia/normas , Humanos
14.
Biomed Res Int ; 2021: 6610045, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34159196

RESUMO

Background: This study is aimed at confirming the effectiveness of nonpharmaceutical interventions during the COVID-19 outbreak in Hubei, China. Methods: The data are all from the epidemic information released by the National Health Commission of the People's Republic of China and the Health Commission of Hubei Province. We used the multivariable linear regression by the SPSS 19.0 software: the cumulative number of confirmed cases, the cumulative number of cured cases, and the number of daily severe cases were taken as dependent variables, and the six policies, including the Joint Prevention and Control Mechanism of the State Council, lockdown Wuhan city, the first-level response to public health emergencies, the expansion of medical insurance coverage to suspected patients, mobile cabin hospitals, and counterpart assistance in Hubei province, were gradually entered into multiple linear regression models as independent variables. Results: The factors influencing the cumulative number of diagnosed cases ranged from large to small: mobile cabin hospitals and the expansion of medical insurance coverage to suspected patients. The factors influencing the cumulative number of cured cases ranged from large to small: counterpart support medical teams in Hubei province and mobile cabin hospitals. The factors influencing the number of daily severe cases ranged from large to small: mobile cabin hospitals and the expansion of medical insurance coverage to suspected patients. Conclusion: The mobile cabin hospital is a major reason for the successfully defeating COVID-19 in China. As COVID-19 pandemic spreads globally, the mobile cabin hospital is a successful experience in formulating policies to defeat COVID-19 for other countries in the outbreak phase.


Assuntos
Ambulâncias/estatística & dados numéricos , COVID-19/terapia , Controle de Doenças Transmissíveis/métodos , Pandemias/prevenção & controle , Saúde Pública/métodos , China/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Humanos , Seguro Médico Ampliado/normas , Modelos Lineares , Pacientes/estatística & dados numéricos , Políticas , Software , Telemedicina/métodos
15.
HERD ; 14(3): 34-48, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34075789

RESUMO

OBJECTIVE: This case study examines the implementation of inpatient telemedicine in COVID-19 intensive care units (ICUs) and explores the impact of shifting forms of visibility on the management of the unit, staff collaboration, and patient care. BACKGROUND: The COVID-19 crisis drove healthcare institutions to rapidly develop new models of care based on integrating digital technologies for remote care with transformations in the hospital-built environment. The Sheba Medical Center in Israel created COVID-19 ICUs in an underground structure with an open-ward layout and telemedicine control rooms to remotely supervise, communicate, and support the operations in the contaminated zones. One unit had a physical visual connection between the control room and the contaminated zone through a window, while the other had only a virtual connection with digital technologies. METHODS: The findings are based on semistructured interviews with Sheba medical staff, telemedicine companies, and the architectural design team and observations at the COVID-19 units during March-August 2020. RESULTS: The case study illustrates the implications of virtual and physical visibility on the management of the unit, staff collaboration, and patient care. It demonstrates the correlations between patterns of visibility and the users' sense of control, orientation in space, teamwork, safety, quality of care, and well-being. CONCLUSIONS: The case study demonstrates the limitations of current telemedicine technologies that were not designed for inpatient care to account for the spatial perception of the unit and the dynamic use of the space. It presents the potential of a hybrid model that balances virtual and physical forms of visibility and suggests directions for future research and development of inpatient telemedicine.


Assuntos
COVID-19/terapia , Unidades de Terapia Intensiva/organização & administração , Telemedicina/métodos , COVID-19/prevenção & controle , Arquitetura de Instituições de Saúde/métodos , Arquitetura de Instituições de Saúde/normas , Humanos , Controle de Infecções/métodos , Israel , Estudos de Casos Organizacionais , Isolamento de Pacientes/métodos , SARS-CoV-2 , Telemedicina/organização & administração
16.
Ann Fam Med ; 19(3): 274-276, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34180849

RESUMO

In 16 years of practice, I had never seen a patient light a cigarette or pour a glass of wine in front of me. Yet, that occurred at the very onset of the COVID-19 era, a time that has shattered any preconceived notions of what I might experience during a clinical visit. The COVID-19 pandemic has forced many physicians to approach patient care in completely different ways. While many have been providing care in hospitals, many more of us have had to stop seeing patients in person, shift to telemedicine, and consider other ways to improve the health of our patients. The rapid changes we have had to make in the last year have demonstrated the resiliency of our profession. This is a critical time to refocus and make sure that health care is person-centered, encompasses all modifiable health determinants, and helps individuals achieve health rather than primarily manage disease.


Assuntos
COVID-19 , Medicina de Família e Comunidade/métodos , Reforma dos Serviços de Saúde , Promoção da Saúde/métodos , Acesso aos Serviços de Saúde , Assistência Centrada no Paciente/métodos , Telemedicina/métodos , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Humanos , Medicina Integrativa/métodos , New York/epidemiologia , Pandemias , Relações Médico-Paciente
19.
PLoS One ; 16(6): e0252356, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1278174

RESUMO

BACKGROUND: Preliminary empirical data indicates a substantial impact of the COVID-19 pandemic on well-being and mental health. Individuals with minoritized sexual and gender identities are at a higher risk of experiencing such negative changes in their well-being. The objective of this study was to compare levels of well-being among cis-heterosexual individuals and individuals with minoritized sexual and gender identities during the COVID-19 pandemic. METHODS: Using data obtained in a cross-sectional online survey between April 20 to July 20, 2020 (N = 2332), we compared levels of well-being (WHO-5) across subgroups (cis-individuals with minoritized sexual identities, individuals with minoritized gender identities and cis-heterosexual individuals) applying univariate (two-sample t-test) and multivariate analysis (multivariate linear regression). RESULTS: Results indicate overall lower levels of well-being as well as lower levels of well-being in minoritized sexual or gender identities compared to cis-heterosexual individuals. Further, multivariate analyses revealed that living in urban communities as well as being in a relationship were positively associated with higher levels of well-being. Furthermore, a moderation analysis showed that being in a relationship reduces the difference between groups in terms of well-being. CONCLUSION: Access to mental healthcare for individuals with minoritized sexual and gender identities as well as access to gender-affirming resources should be strengthened during COVID-19 pandemic. Healthcare services with low barriers of access such as telehealth and online peer support groups should be made available, especially for vulnerable groups.


Assuntos
COVID-19/psicologia , Saúde Mental , Pandemias , Minorias Sexuais e de Gênero , Adolescente , Adulto , COVID-19/epidemiologia , Estudos Transversais , Identidade de Gênero , Alemanha/epidemiologia , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários , Telemedicina/métodos , Adulto Jovem
20.
Pediatr Rheumatol Online J ; 19(1): 93, 2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: covidwho-1277949

RESUMO

BACKGROUND: To characterize various aspects of telemedicine use by pediatric rheumatology providers during the recent pandemic including provider acceptability of telehealth practices, clinical reliability, and clinical appropriateness. METHODS: An electronic survey was generated and disseminated amongst the Childhood Arthritis and Rheumatology Research Alliance (CARRA) listserv (n = 547). Survey items were analyzed via descriptive statistics by question. RESULTS: The survey response rate was 40.8% (n = 223) with the majority of respondents in an attending-level role. We observed that musculoskeletal components of the exam were rated as the most reliable components of a telemedicine exam and 86.5% of survey respondents reported engaging the patient or patient caregiver to help conduct the virtual exam. However, 65.7% of providers reported not being able to elicit the information needed from a telemedicine visit to make a complete clinical assessment. We also noted areas of disagreement regarding areas of patient engagement and confidentiality. We found that approximately one-third (35.8%) of those surveyed felt that their level of burnout was increased due to telemedicine. CONCLUSION: In general, providers found exam reliability (specifically around focused musculoskeletal elements) in telemedicine visits but overall felt that they were unable to generate the information needed to generate a complete clinical assessment. Additionally, there were suggestions that patient engagement and confidentiality varied during telemedicine visits when compared to in-person clinical visits. Further qualitative work is needed to fully explore telemedicine use in pediatric rheumatology.


Assuntos
COVID-19/epidemiologia , Reumatologistas/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Cuidadores , Criança , Humanos , Doenças Musculoesqueléticas/diagnóstico , Exame Físico , Inquéritos e Questionários , Telemedicina/métodos
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