Download PDF
CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(08): 755-760
DOI: 10.1055/s-0042-1748971
Original Article
Urogynecology

Patient Acceptance of Telemedicine in Urogynecology Consultations – A Cross-Sectional Study Performed at a Brazilian Public Institution

Aceitação de telemedicina em consultas de uroginecologia: Estudo transversal em uma instituição pública brasileira
Débora Vianna D'Almeida Lucas Macharet 
1   Postgraduate Program in Women's Health of Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
,
Leonardo Nogueira Mendes 
2   Division of Urology, Hospital das Clínicas of Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
,
Walter Carlos Santos de Oliveira 
3   Division of Urology, Hospital das Clínicas of Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
,
Gláucia Miranda Varella Pereira 
4   Physiotherapist, State University of Campinas, Campinas, SP, Brazil
,
Marilene Vale de Castro Monteiro 
5   Department of Gynecology and Obstetrics, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
› Author Affiliations Funding The coauthor GMVP receives a scholarship Grant (number 2019/26723–5) from Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).
› Further Information
   Permissions and Reprints

Abstract

Objective To evaluate the acceptance of telemedicine and determine its associated factors in an urogynecology outpatient clinic of a public hospital in Brazil.

Methods The present was a cross-sectional study performed between June and November 2020. The included patients had their elective appointments postponed due to the coronavirus disease 2019 (COVID-19) pandemic. The variables considered regarding the acceptance of telemedicine were: urogynecologic diagnosis, age, level of schooling, place of residence, access to the internet, type of device used, frequency of internet use, and use of social media platforms. The categorical variables were described by their absolute and relative frequencies. The association among variables was evaluated through the Fisher exact test, and univariate and multivariate analyses, considering the acceptance of telemedicine as the dependent variable.

Results A total of 225 patients were listed, and 182 agreed to participate. The mean age was 59 years old, 81.3% of the patients had access to the internet, and 87.3% of them accepted telemedicine. There were statistically significant associations regarding the acceptance of telemedicine and high levels of schooling (p < 0.01), internet access (p < 0.01), daily use of the internet (p < 0.01), access through personal mobile phone (p < 0.01), and access through the participant's own residence (p < 0.01). In the univariate and multivariate analyses, only high levels of schooling were associated with the acceptance of telemedicine (Adjusted odds ratio: 4.82; 95% confidence interval = 1.59–14.65).

Conclusion Most of the urogynecology patients of a public hospital in a developing country accepted telemedicine. Internet access and level of schooling were the factors associated with the acceptance of telemedicine in urogynecology.

Resumo

Objetivo Avaliar aceitação da telemedicina e determinar seus fatores associados em uma clínica de uroginecologia de um hospital público brasileiro.

Métodos Trata-se de estudo transversal realizado entre junho e novembro de 2020. Foram recrutadas pacientes que tiveram seus atendimentos eletivos adiados devido à pandemia de doença do coronavírus 2019 (coronavirus disease 2019, COVID-19, em inglês). As variáveis consideradas para a aceitação da telemedicina foram: diagnóstico uroginecológico, idade, escolaridade, local de residência, acesso à internet, tipo de dispositivo, frequência do uso da internet, e uso de plataformas de redes sociais. As variáveis categóricas foras descritas na forma de suas frequências absoluta e relativa. A associação entre essas variáveis foi avaliada por meio do teste exato de Fisher e análises uni e multivariada, e a aceitação da telemedicina foi considerada a variável dependente.

Resultados Um total de 225 pacientes foram listadas, e 182 concordaram em participar. A idade média das participantes foi de 59 anos; 81,3% delas tinham acesso à internet, e 87,3% aceitaram a telemedicina. Observaram-se associações estatisticamente significativas entre a aceitação e maior escolaridade (p < 0,01), acesso à internet (p < 0,01), uso diário da internet (p < 0,01), acesso por celular próprio (p < 0,01), e acesso da própria residência (p < 0,01). Nas análises uni e multivariada, somente alto nível de escolaridade esteve associado à aceitação da telemedicina (razão de probabilidades ajustada: 4,82; intervalo de confiança de 95% = 1,59–14,65).

Conclusão A maioria das pacientes atendidas em um hospital público de um país em desenvolvimento concordaram com a telemedicina. Acesso à internet e nível de escolaridade foram fatores associados à aceitação da telemedicina nessa população.

Palavras-chave

telemedicina - estudos de viabilidade - preferência do paciente - internet - ginecologia

Keywords

telemedicine - feasibility studies - patient preference - internet - gynecology

Contributions

Macharet DVDL: project development, data collection, data analysis, manuscript writing. Mendes LN: project development, data collection, data analysis, manuscript editing. Oliveira WCS: data collection, data analysis. Pereira GMV: project development, data analysis, manuscript editing. Monteiro MVC: project development, data analysis, manuscript editing.




Publication History

Received: 23 June 2021

Accepted: 15 January 2022

Article published online:
27 June 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 World Health Organization.. Telemedicine: opportunities and developments in member states: report on the second Global survey on eHealth. Geneva:: WHO;; 2010
    Search in Google Scholar
  • 2 Rogers RG, Swift S. The world is upside down; how coronavirus changes the way we care for our patients. Int Urogynecol J Pelvic Floor Dysfunct 2020; 31 (05) 853-854
    CrossrefPubMedSearch in Google Scholar
  • 3 Grimes CL, Balk EM, Crisp CC, Murphy M, Halder GE. et al. A guide for urogynecologic patient care utilizing telemedicine during the COVID-19 pandemic: review of existing evidence. Int Urogynecol J Pelvic Floor Dysfunct 2020; 31 (06) 1063-1089
    CrossrefPubMedSearch in Google Scholar
  • 4 Serna-Gallegos T, Ninivaggio CS. A lasting impression: telemedicine in urogynecology during the coronavirus disease 2019 pandemic. Curr Opin Obstet Gynecol 2020; 32 (06) 456-460
    CrossrefPubMedSearch in Google Scholar
  • 5 Escura Sancho S, Ros Cerro C, Anglès-Acedo S, Bataller Sánchez E, Espuña-Pons M. Cómo la pandemia por COVID-19 ha cambiado la forma de atender a las pacientes en una unidad de uroginecología. Clin Invest Ginecol Obstet 2020; 47 (03) 111-117
    CrossrefPubMedSearch in Google Scholar
  • 6 Thompson JC, Cichowski SB, Rogers RG, Qeadan F, Zambrano J, Wenzl C. et al. Outpatient visits versus telephone interviews for postoperative care: a randomized controlled trial. Int Urogynecol J Pelvic Floor Dysfunct 2019; 30 (10) 1639-1646
    CrossrefPubMedSearch in Google Scholar
  • 7 Palma PCR, Brito LGO, Ghigo J. Impact of COVID-19 in female urology. Int Braz J Urol 2020; 46 (Suppl. 01) 93-97
    CrossrefPubMedSearch in Google Scholar
  • 8 Lei No. 13.989, de 15 de abril de 2020.. Dispõe sobre o uso da telemedicina durante a crise causada pelo coronavírus (SARS-CoV-2). Diário Oficial da União. 2020 Aug 20;Sect. 1:1.
    PubMed
  • 9 Fioratti I, Reis FJ, Fernandes LG, Saragiotto BT. The COVID-19 pandemic and the regulations of remote attendance in Brazil: new opportunities for people dealing with chronic pain. Br J Pain 2020; 3 (02) 193-194
    CrossrefPubMedSearch in Google Scholar
  • 10 Paim J, Travassos C, Almeida C, Bahia L, Macinko J. The Brazilian health system: history, advances, and challenges. Lancet 2011; 377 (9779): 1778-1797
    CrossrefPubMedSearch in Google Scholar
  • 11 Instituto Brasileiro de Geografia e Estatística.. Cidades e Estados: população estimada [Internet]. 2020 [cited 21 Dec 2020]. Available from: https://www.ibge.gov.br.2020/cidades-e-estados
    PubMedSearch in Google Scholar
  • 12 We Are Social Inc.. Digital 2020 Global Digital Overview [Internet]. 2020 [cited 20 Dec 2020]. Avalilable from: https://wearesocial.com/digital-2020
    PubMedSearch in Google Scholar
  • 13 Kim Y, Acker R, Ortega M, Valentine KD, Ayati E, VonBargen E. 09 Synchronous telemedicine model in urogynecology: are women willing to continue telemedicine in the post COVID-19 pandemic era?. Am J Obstet Gynecol 2021; 224 (6, Supplement) S747-S748
    CrossrefPubMedSearch in Google Scholar
  • 14 Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecare 2018; 24 (01) 4-12
    CrossrefPubMedSearch in Google Scholar
  • 15 WHO Global Observatory for eHealth.. Global diffusion of eHealth: making universal health coverage achievable: report of the third global survey on eHealth. Geneva:: WHO;; 2016
    Search in Google Scholar
  • 16 Bernard S, Boucher S, McLean L, Moffet H. Mobile technologies for the conservative self-management of urinary incontinence: a systematic scoping review. Int Urogynecol J Pelvic Floor Dysfunct 2020; 31 (06) 1163-1174
    CrossrefPubMedSearch in Google Scholar
  • 17 Castaneda P, Ellimoottil C. Current use of telehealth in urology: a review. World J Urol 2020; 38 (10) 2377-2384
    CrossrefPubMedSearch in Google Scholar
  • 18 Instituto Brasileiro de Geografia e Estatística.. Educação [Internet]. 2020 [cited 21 Dec 2020]. Avalilable from: https://cidades.ibge.gov.br/brasil/panorama
    PubMedSearch in Google Scholar
  • 19 Free C, Phillips G, Watson L, Galli L, Felix L, Edwards P. et al. The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med 2013; 10 (01) e1001363
    CrossrefPubMedSearch in Google Scholar
  • 20 Karageorgos G, Andreadis I, Psychas K, Mourkousis G, Kiourti A, Lazzi G. et al. The promise of mobile technologies for the health care system in the developing world: a systematic review. IEEE Rev Biomed Eng 2019; 12: 100-122
    CrossrefPubMedSearch in Google Scholar
  • 21 Mazloomdoost D, Kanter G, Chan RC, Deveaneau N, Wyman AM, Von Bargen EC, Chan RC. et al. Social networking and Internet use among pelvic floor patients: a multicenter survey. Am J Obstet Gynecol 2016; 215 (05) 654.e1-654.e10
    CrossrefPubMedSearch in Google Scholar
  • 22 Alas A, Sajadi KP, Goldman HB, Anger JT. The rapidly increasing usefulness of social media in urogynecology. Female Pelvic Med Reconstr Surg 2013; 19 (04) 210-213
    CrossrefPubMedSearch in Google Scholar