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Article ; Online: [Virtual consultations in paediatrics].

Nielsen, Ole Haubjerg / Teilmann, Grete Katrine

2021 Volume 183, Issue 25

Abstract: During the COVID-19 pandemic, telemedicine and virtual consultations have been rapidly implemented ... in paediatrics all over the world. Previous and current studies have shown satisfaction with telemedicine ... There is a need of developing guidelines and education in paediatric telemedicine, as argued ...

Abstract	During the COVID-19 pandemic, telemedicine and virtual consultations have been rapidly implemented in paediatrics all over the world. Previous and current studies have shown satisfaction with telemedicine, especially from a parental perspective. The largest barrier for implementation is technology. Some studies have found telemedicine equal to in-person visits. Only few studies have measured clinical outcomes, and the perspective of the child and adolescents as well as healthcare personal is rarely examined. There is a need of developing guidelines and education in paediatric telemedicine, as argued in this review.
MeSH term(s)	Adolescent ; COVID-19 ; Child ; Humans ; Pandemics ; Patient Satisfaction ; Pediatrics ; Referral and Consultation ; SARS-CoV-2 ; Telemedicine
Language	Danish
Publishing date	2021-06-25
Publishing country	Denmark
Document type	Journal Article ; Review
ZDB-ID	124102-3
ISSN	1603-6824 ; 0041-5782
ISSN (online)	1603-6824
ISSN	0041-5782
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Article ; Online: Exploring parental experiences of virtual paediatric neurodevelopmental consultations.

Finnegan, Rebecca / Flynn, Aoife / Flanagan, Orla

Irish journal of medical science

2021 Volume 191, Issue 2, Page(s) 807–808

Abstract: ... a neurodevelopmental service after a transition to virtual consultations.: Methods: Anonymous questionnaires were ... with previous face-to-face clinic appointments and virtual consultations (8.2/10). Individual aspects of virtual ... for a combined service of both virtual and face-to-face consultations.: Conclusions: This study highlights ...

Abstract	Objective: The coronavirus pandemic resulted in dramatic changes and challenges to healthcare practices. We endeavoured to establish the experiences of families of children attending a neurodevelopmental service after a transition to virtual consultations. Methods: Anonymous questionnaires were posted to parents of children registered in virtual clinics over a 10-week period. Results: Thirty parental questionnaires were completed. Parents reported a very high level of satisfaction (8.2/10) with previous face-to-face clinic appointments and virtual consultations (8.2/10). Individual aspects of virtual consultations received very positive ratings. Overall, 77% of parents highlighted a future preference for a combined service of both virtual and face-to-face consultations. Conclusions: This study highlights the high level of parental satisfaction with the service, but especially satisfaction with the unplanned transition to virtual clinics. Virtual clinics cannot replace the holistic approach gained from face-to-face consultations; however, we identified their benefits of convenience and accessibility for our vulnerable population. In response, we have developed an integrated outpatient service involving both forms of consultation to potentiate satisfaction and adapt to meet the needs of our patients. The suggested proforma that has been developed offers a simple structure for undertaking a virtual consultation that can be adapted to different specialities, integrating the suggestions provided by our service users.
MeSH term(s)	COVID-19 ; Child ; Humans ; Pandemics ; Parents ; Referral and Consultation ; SARS-CoV-2
Language	English
Publishing date	2021-03-23
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-021-02583-6
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Article ; Online: A Solution Focused Approach of Delivering Virtual Paediatric Diabetes Consultations During the COVID-19 Pandemic.

Woodger, Katherine / Bray, Dominic / Welsh, Charlotte / Ng, Sze M

Clinical child psychology and psychiatry

2021 Volume 27, Issue 1, Page(s) 177–184

Abstract: ... from paediatric diabetes patients and their parents or carers regarding virtual consultations, using a solution ... The onset of the COVID-19 global pandemic rapidly accelerated the use of virtual consultations ... consultation. Of those surveyed, 86% recommended video consultations to be part of their diabetes care ...

Abstract	The onset of the COVID-19 global pandemic rapidly accelerated the use of virtual consultations into everyday practice. A solution focused approach (SFA) has been established in paediatric diabetes care, resulting in positive clinical outcomes and communication. The aim of this study was to assess feedback from paediatric diabetes patients and their parents or carers regarding virtual consultations, using a solution focused approach, in a hospital setting. An electronic survey was sent to patients following their virtual consultation. Of those surveyed, 86% recommended video consultations to be part of their diabetes care. Qualitative data showed reduced travel time, comfort, reduced need for parking and convenience as the highest areas improved through video consultations. Clinical care was shown to be positive and addressed patients concerns, the majority of respondents (84%) reported that the appointment was about what they wanted it to be about. Using the solution focused model helped overcome the challenges faced with virtual consultations particularly with concerns surrounding safeguarding issues, confidentiality, audio/video difficulties and also helped to support the patient journey.
MeSH term(s)	COVID-19 ; Child ; Diabetes Mellitus ; Humans ; Pandemics ; Referral and Consultation ; SARS-CoV-2
Language	English
Publishing date	2021-12-23
Publishing country	England
Document type	Journal Article
ZDB-ID	1324235-0
ISSN	1461-7021 ; 1359-1045
ISSN (online)	1461-7021
ISSN	1359-1045
DOI	10.1177/13591045211058336
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Article ; Online: Virtual consultations: delivering outpatient clinics in paediatric surgery during the COVID-19 pandemic.

Charnell, A M / Hannon, E / Burke, D / Iredale, M R / Sutcliffe, J R

Annals of pediatric surgery

2020 Volume 16, Issue 1, Page(s) 49

Abstract: ... observed (telephone and video), with follow-up calls to families following the consultations.: Results ... care. As a tertiary paediatric surgery unit in the UK, completing remote clinics was a new experience ... to define and address issues when delivering remote clinics in paediatric surgery. Remote clinics were ...

Abstract	Background: The COVID-19 pandemic has resulted in many changes to clinical practice, including the introduction of remote clinics. Those familiar with remote clinics have reported benefits to their use, such as patient satisfaction and cost benefits; however, ongoing challenges exist, including delivering optimal patient-centred care. As a tertiary paediatric surgery unit in the UK, completing remote clinics was a new experience for most of our surgical team. We completed a service evaluation early into the COVID-19 pandemic aiming to define and address issues when delivering remote clinics in paediatric surgery. Remote clinics were observed (telephone and video), with follow-up calls to families following the consultations. Results: Eight paediatric surgeons were observed during their remote clinics (telephone Conclusions: There must be strong support from management and appropriate departments for successful integration of remote clinics. Surgical trainees and their training should be considered when implementing remote clinics. Our learning from the pandemic may support those considering integrating remote clinics in the future.
Language	English
Publishing date	2020-11-30
Publishing country	England
Document type	Journal Article
ZDB-ID	2641593-8
ISSN	2090-5394 ; 2090-5394
ISSN (online)	2090-5394
ISSN	2090-5394
DOI	10.1186/s43159-020-00060-w
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Article ; Online: Virtual reality and behaviour management in paediatric dentistry: a systematic review.

Barros Padilha, Diana Xavier de / Veiga, Nélio Jorge / Mello-Moura, Anna Carolina Volpi / Nunes Correia, Patrícia

BMC oral health

2023 Volume 23, Issue 1, Page(s) 995

Abstract: ... procedures varied greatly, from first consultations to infiltration of local anaesthetic and other invasive ... Background: Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry ... current evidence-based guidance on the usage of VR in the clinical practice of paediatric dentistry ...

Abstract	Background: Virtual reality (VR) has emerged as an innovative tool in medicine and dentistry, improving anxiety and pain management in children. The immersive and interactive environments of VR technology facilitate positive engagement of young patients during dental procedures via distraction, potentially reducing anxiety levels and improving treatment experience. The aim of this review was to provide current evidence-based guidance on the usage of VR in the clinical practice of paediatric dentistry. Methods: A systematic review was conducted according to the PRISMA guidelines with the following research question using the PICO format: Does VR (I) effectively manage anxiety and pain (O) during a paediatric dental consultation (P) compared to alternative behavioural control techniques (C)? PubMed/Medline®, SCOPUS and Web of Science databases were searched and analysed. Results: A total of 22 randomised control trials were included in this review. These studies have shown that VR is a highly effective method of behaviour management, successfully alleviating pain and anxiety in children during dental treatment, surpassing traditional tools. Selected studies included participants with a large age range and dental procedures varied greatly, from first consultations to infiltration of local anaesthetic and other invasive procedures. VR was mostly used during treatment delivery and different immersive VR techniques were considered. Behaviour, anxiety and pain scales were used to determine efficacy and patient satisfaction. Conclusions: VR offers an engaging and immersive experience, effectively diverting patients' attention away from the clinical environment, fostering a positive and enjoyable treatment experience. However, it is important to acknowledge the limitations of existing studies and the need for further research to enhance the understanding of VR's full potential in paediatric dentistry.
MeSH term(s)	Child ; Humans ; Pediatric Dentistry ; Pain ; Anxiety ; Pain Management ; Virtual Reality
Language	English
Publishing date	2023-12-12
Publishing country	England
Document type	Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2091511-1
ISSN	1472-6831 ; 1472-6831
ISSN (online)	1472-6831
ISSN	1472-6831
DOI	10.1186/s12903-023-03595-7
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Article ; Online: Virtual consultation in paediatric urology during the COVID-19 pandemic: The effect of pathology on the outcome.

ElAgami, Hesham / Woodward, Benjamin / Awolaran, Gbenga / Kalidasan, Varadarajan

Journal of telemedicine and telecare

2022 Volume 28, Issue 7, Page(s) 539–546

Abstract: Introduction: Virtual consultation (VC) has exponentially increased during the COVID-19 pandemic ... four consultations were assessed. One hundred and fourteen in phase 1 and 30 from phase 2. Mean age 7.2 ... before integrating it into the routine practice. Some paediatric urology patients can potentially be excellent ...

Abstract	Introduction: Virtual consultation (VC) has exponentially increased during the COVID-19 pandemic. Lessons from using this modality during the pandemic will need to be appraised carefully before integrating it into the routine practice. Some paediatric urology patients can potentially be excellent candidates for routine VC. Objectives: Investigate the ability of clinicians to make management plans using VCs and identify accordingly the group of patients that can benefit from routine VC. Evaluate the routine use of VC without travel restrictions. Methods: Designed in two phases. Phase 1, during the lockdown, prospective collection of data after the consultation assessing the clinician satisfaction in making a decision by VC. The results were then divided according to the patient pathology; internal organ pathology (IOP), functional urological pathology (FUP) or external organ pathology (EOP). Data was then analysed to demonstrate if different outcomes can be related to the pathology. Phase 2 after the ease of the lockdown to judge the lessons learnt looking at the same parameters in patients who are selected to receive VC and evaluate journey saved by the patients, measured in miles. Results: One hundred and forty-four consultations were assessed. One hundred and fourteen in phase 1 and 30 from phase 2. Mean age 7.2 years. In phase 1, 57% of patients were reviewed by consultants and 72% were followed up. Thirty-seven per cent had IOP, 24.5% FUP and 38.5% EOP. Clinicians were more likely to reach a decision with patients with IOP and FUP Discussion: VC for paediatric urology patients was employed effectively to avoid hospital contact during the lockdown. From the lessons learnt that patients with IOP and FUP can continue to benefit from VC after the ease of lockdown without compromising the decision making. VC is a viable way to structure services in the future for selected paediatric urology conditions.
MeSH term(s)	COVID-19/epidemiology ; Child ; Communicable Disease Control ; Humans ; Pandemics ; Prospective Studies ; Referral and Consultation ; Urology
Language	English
Publishing date	2022-03-07
Publishing country	England
Document type	Journal Article
ZDB-ID	1340281-x
ISSN	1758-1109 ; 1357-633X
ISSN (online)	1758-1109
ISSN	1357-633X
DOI	10.1177/1357633X221076967
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Article ; Online: Virtual health care for children: Parental willingness to adopt virtual health-care technologies.

Lawrence, Joanna / Measey, Mary-Anne / Hoq, Monsurul / Hiscock, Harriet / Rhodes, Anthea

Journal of paediatrics and child health

2022 Volume 58, Issue 8, Page(s) 1323–1329

Abstract: Aim: To understand parental awareness and appetite for virtual health modalities, including ... associated with greater awareness and appetite for virtual health.: Methods: Nationally ... Results: 1981 (59.4% response rate) parents completed the survey. 39.9% were aware of virtual health care ...

Abstract	Aim: To understand parental awareness and appetite for virtual health modalities, including asynchronous communication and remote monitoring. To understand which socio-demographic characteristics are associated with greater awareness and appetite for virtual health. Methods: Nationally representative survey of Australian parents, recruited via an online panel in February 2021 as part of the Royal Children's Hospital National Child Health Poll. Participants were randomly selected from the consumer panel. Results: 1981 (59.4% response rate) parents completed the survey. 39.9% were aware of virtual health care, defined by digital technology and medical devices to support remote monitoring. Higher levels of awareness were associated with being male, having previous teleconsultation experience, higher education attainment and employment. Most parents reported an appetite for asynchronous communication using an app or website to either provide information prior to a consult (65.9%), provide a photo of a rash or similar (61.7%) or receive medical advice (58.1%). Appetite for wearable devices was similar at 59.9%. Conclusions: Whilst awareness of virtual healthcare was low, appetite exists amongst Australian parents to use technology to support their child's health care. Health-care models, which incorporate asynchronous communication or symptom monitoring through apps, are likely to be acceptable and offer an accessible and sustainable alternative to traditional face-to-face health care.
MeSH term(s)	Australia ; Child ; Communication ; Delivery of Health Care ; Female ; Humans ; Male ; Parents ; Surveys and Questionnaires
Language	English
Publishing date	2022-04-16
Publishing country	Australia
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1024476-1
ISSN	1440-1754 ; 1034-4810
ISSN (online)	1440-1754
ISSN	1034-4810
DOI	10.1111/jpc.15974
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Article ; Online: How safe and effective are paediatric virtual fracture clinics? A systematic review.

Waite, Emma / Ahmed, Zubair

Frontiers in digital health

2023 Volume 5, Page(s) 1261035

Abstract: Introduction: Virtual fracture clinics (VFC) involve a consultant-led multidisciplinary team ... meeting where cases are reviewed before a telephone consultation with the patient. VFCs have ... still concerns over safety in the paediatric population. Fractures make up a large burden of paediatric ...

Abstract	Introduction: Virtual fracture clinics (VFC) involve a consultant-led multidisciplinary team meeting where cases are reviewed before a telephone consultation with the patient. VFCs have the advantages of reducing waiting times, outpatient appointments and time off school compared to face-to-face (F2F) fracture clinics. There has been a surge in VFC use since the COVID-19 pandemic but there are still concerns over safety in the paediatric population. Fractures make up a large burden of paediatric injuries, therefore research is required on the safety and efficacy of paediatric VFCs. This systematic review will look at the safety and effectiveness of paediatric VFCs, as well as determine the cost-effectiveness and parent preferences. Methods: As per the PRISMA guidelines two independent reviewers searched the following databases: Medline, Embase and Web of Science. Studies were included if children under 18 years old presented to A&E with a suspected or confirmed simple un-displaced fracture and were referred to a VFC. The primary outcomes assessed were effectiveness and safety, with the secondary outcomes of cost-effectiveness and parent satisfaction. Results: Six studies met the inclusion criteria for this systematic review. There was a high rate of direct discharge from the VFC leading to reduced outpatient appointments. All patients were seen within 72 h of presentation. There were limited incidences of missed fractures and the rates of re-presentation were similar to that of F2F orthopaedic clinics. There were significant cost savings for the hospitals and high parent satisfaction. Discussion: VFCs have shown to be safe and effective at managing most stable, low operative risk paediatric fractures. Safety must be ensured with a telephone helpline and an open return to fracture clinic policy. More research is needed into specific paediatric fracture types to be managed in the VFC. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/#searchadvanced, identifier: CRD42023423795.
Language	English
Publishing date	2023-10-27
Publishing country	Switzerland
Document type	Journal Article ; Review
ISSN	2673-253X
ISSN (online)	2673-253X
DOI	10.3389/fdgth.2023.1261035
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Article: Clinical perception of effectiveness of virtual appointments and comparison with appointment outcomes at a specialist children's hospital.

Akintomide, Eve / Shah, Bindi / Sridharan, Shankar / Visram, Sheena / Sebire, Neil J / Peters, Catherine

Future healthcare journal

2021 Volume 8, Issue 3, Page(s) e660–e665

Abstract: Introduction: A transition from face-to-face to virtual consultations occurred in response ... Ninety-three clinicians responded from 28 subspecialties. Virtual consultations increased from 6% (2019 ... The perception of clinicians is that virtual appointments enabled continuity of paediatric care with improved ...

Abstract	Introduction: A transition from face-to-face to virtual consultations occurred in response to the COVID-19 pandemic. Evaluation of outcome data is essential for future healthcare modelling. Methods: Clinicians at a children's hospital evaluated perceptions of face-to-face video and telephone appointments by questionnaire. Responses were compared with operational outcomes from June 2019 and June 2020. Results: Ninety-three clinicians responded from 28 subspecialties. Virtual consultations increased from 6% (2019) to 67% (2020). No differences were found between appointment types for recording a medical and social history; a significant difference (p<0.001) was seen for the perceived ability to detect clinical signs, organise investigations and make a diagnosis. The proportion of appointments resulting in discharge compared with face-to-face visits was unchanged. The proportion of patients requiring further contact increased from 35% (32% face-to-face and 3% telephone) to 46% (14% face-to-face; 21% telephone and 11% video; chi-squared 426; p<0.0001).The percentage of patients offered an appointment following two 'was not brought' appointments increased from 71% (2019) to 81% (2020) and was most common following telephone appointments (20% face-to-face, 43% telephone and 18% video; chi-squared 474; p<0.0001). Conclusion: The perception of clinicians is that virtual appointments enabled continuity of paediatric care with improved clinical assessment capability and attendance during video consultations compared with telephone consultations.
Language	English
Publishing date	2021-12-06
Publishing country	England
Document type	Journal Article
ZDB-ID	3016427-8
ISSN	2514-6653 ; 2514-6645
ISSN (online)	2514-6653
ISSN	2514-6645
DOI	10.7861/fhj.2021-0044
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Article ; Online: LED virtual windows are valuable in windowless consultation rooms.

Sen, Sumit / Nielsen, Tove / Nielsen, Erik / Pryds, Ole / Cortes, Dina

Danish medical journal

2018 Volume 65, Issue 9

Abstract: ... of Paediatrics has windowless consultation rooms. Work environment surveys revealed that nurses and doctors ... Methods: Four similar windowless consultations rooms located next to each other were used in the study ... This study evaluated the effects of installing light-emitting diode (LED) virtual windows in these rooms ...

Abstract	Introduction: Due to the design of Hvidovre Hospital, the outpatient clinic of the Department of Paediatrics has windowless consultation rooms. Work environment surveys revealed that nurses and doctors working in these windowless rooms considered the lack of natural light a considerable health problem. This study evaluated the effects of installing light-emitting diode (LED) virtual windows in these rooms. Methods: Four similar windowless consultations rooms located next to each other were used in the study. All had older T-5 fluorescent luminaires installed. In two of these rooms, Servodan LED virtual windows depicting various natural scenes were installed. The illuminance and correlated colour temperature (CCT) of each room's lighting was measured, and a work environment questionnaire was filled out by nurses and doctors working in each room. Results: A total of 113 questionnaires were collected and evaluated. LED virtual windows produced an improved perception of lighting conditions, both at the desk (p < 0.001) and in the rooms in general (p < 0.001) and improved the overall positive experience of the rooms (p = 0.02). A tendency towards concentration difficulties was reported less often in the rooms with LED virtual windows, (p = 0.11). Retinal illuminance (p = 0.02) as well as CCT at the desk (p < 0.005) and at the retina (p < 0.01) alike were increased in rooms with LED virtual windows. Conclusions: LED virtual windows improved the lighting experience, the impression of the space, the retinal illuminance and the CCT at the desk and at the retina in the windowless rooms. Funding: none. Trial registration: not relevant.
MeSH term(s)	Female ; Hospital Design and Construction ; Humans ; Light ; Male ; Personnel, Hospital/psychology ; Surveys and Questionnaires ; Workplace
Language	English
Publishing date	2018-09-05
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	2648771-8
ISSN	2245-1919 ; 2245-1919
ISSN (online)	2245-1919
ISSN	2245-1919
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