Using videoconsultations to deliver dietary advice to children with chronic kidney disease: a qualitative study of parent and child perspectives

Abstract

Background Children with chronic kidney disease require specialist renal paediatric dietetic care, regardless of disease severity or geographical location; however, under‐resourcing makes this challenging. Videoconsultation may offer a solution but research exploring its acceptability is limited. The present study explored parent/carer and child perspectives of videoconsultation as an alternative or supplement to existing regional dietetic care. Methods Children and families using a regional paediatric nephrology service were recruited through purposeful sampling techniques. Renal paediatric dietitians used existing hospital software to host videoconsultations with families. Perspectives were subsequently explored in telephone interviews with the children, their parents and separately with the renal dietitians. Data were transcribed verbatim and an inductive framework analysis conducted. Results Twelve families took part in the study, comprising 13 parents and five children (aged 9 months to 14 years). Two renal dietitians were also interviewed. Six themes emerged which were ‘Logistics’, ‘Understanding Information’, ‘Family Engagement’, ‘Establishing Trust’, ‘Willingness to Change’ and ‘Preferences’. Satisfaction with the videoconsultations was high, with no data security fears and only minor privacy concerns. Parents reported that screen‐sharing software enhanced their understanding, generating greater discussion and engagement compared to clinic and telephone contacts. Parents praised efficiencies and improved access to specialist advice, requesting that videoconsultations supplement care. Children preferred videoconsultations outright. Conclusions Dietetic videoconsultations were acceptable to families and perceived to be a feasible, high‐quality complement to regional specialist dietetic care. Enhanced understanding and engagement might improve self‐care in adolescents. The acceptability and feasibility of videoconsultations could address inequitable regional service provision.

Patient perspectives and experiences of remote consultations in people receiving kidney care: A scoping review

“…A total of eight studies published between August 2010 and August 2021 were included in this scoping review. Two studies used a cross‐sectional design (Alshaer et al, 2020; Campbell et al, 2012), two used a mixed‐methods design (Lunney et al, 2021; Qiu et al, 2021), and four used a qualitative design (Huuskes et al, 2021, Lunney et al, 2020; Trace et al, 2020; Varsi et al, 2021). The studies were conducted in the United Kingdom, Canada, Australia, and Norway.…”

“…Qiu et al (2021) reported that 45% of adolescents preferred remote consultations and 55% preferred in‐person visits. Trace et al (2020) reported an overall high satisfaction with video consultations and participants expressed that even where in‐person care is available, remote consultations should supplement in‐person care. Trace et al (2020) and Qiu et al (2021) both reported that participants preferred video consultations to telephone, especially if they had not met the practitioner in‐person before.…”

“…Trace et al (2020) reported an overall high satisfaction with video consultations and participants expressed that even where in‐person care is available, remote consultations should supplement in‐person care. Trace et al (2020) and Qiu et al (2021) both reported that participants preferred video consultations to telephone, especially if they had not met the practitioner in‐person before. In summary, remote consultations appear to offer an overall effective alternative to in‐person consultations, without compromising patients' health‐care experience.…”

“…Two studies reported that participants perceived increased involvement with their healthcare as an added benefit of remote consultations. Trace and colleagues (2020) found that younger children enjoyed the novelty of using the computer and older children enjoyed the familiarity of screen‐based conversations. Furthermore, Trace et al (2020) identified that the ability to screen‐share during video consultations increased understanding of medical information and family engagement.…”

“…Trace and colleagues (2020) found that younger children enjoyed the novelty of using the computer and older children enjoyed the familiarity of screen‐based conversations. Furthermore, Trace et al (2020) identified that the ability to screen‐share during video consultations increased understanding of medical information and family engagement. Parents noted that there is no time to process the information in a face‐to‐face clinic.…”