Doctor-Patient Relationship in Synchronous/Real-time Video-Consultations and In-Person Visits: An Investigation of the Perceptions of Young People with Type 1 Diabetes and Their Parents During the COVID-19 Pandemic

Abstract

Background Given that the widely acknowledged influence of the doctor-patient relationship on objective health parameters and treatment adherence in chronic illnesses, this study sought to explore how patients perceived the patient-doctor relationship across virtual and in-person contexts. Methods Parents’ and patients’ perceptions of doctor-patient relationship were evaluated in 610 children and adolescents (12.17 ± 4.19 years, 50.9% girls) with type 1 diabetes who visited via video-conferencing or in person during the COVID-19 pandemic. Results No differences were found between video consultations and in-person visits in terms of care satisfaction (p > .05), doctor-patient relationship—for the dimensions agreement on tasks (p = .506) and bond (p = .828)—as perceived by parents and physician empathy as perceived by patients (p = .096). Parents rated patient-doctor agreement on explicit goals of treatment higher in video consultation than in person (p = .009, d = .211). Agreement on goals (β = − .180, p = .016) and bond with doctor (β = − .160, p = .034) were negatively and significantly associated with HbA1c values, but only in participants who visited in person. Conclusions Parents’ care satisfaction and perceptions of doctor-patient relationship, along with patients’ perceptions of physician empathy, did not substantially differ between visits carried out in person or via video consultations. Given the high risk of psychological problems described in young people with diabetes, video consultation can be considered a useful opportunity to maintain access to a healthcare provider in a challenging time, such as the COVID-19 pandemic.

Satisfaction with pediatric telehealth according to the opinions of children and adolescents during the COVID-19 pandemic: A literature review

“…Studies were conducted in Italy ( 19 , 20 , 29 ), the United States. ( 18 , 25 , 27 ), Australia ( 21 , 26 ), and Canada ( 23 , 31 ) ( Table 1 ).…”

“…Among the 14 studies, there were 2 interventions ( 20 , 22 ) ( Table 2 ). Five were prospective cohort investigations where investigators classified individuals as participating in telehealth services and then followed them over time to assess their satisfaction ( 19 , 24 , 27 , 29 , 30 ). Two studies used retrospective analyses where answers to satisfaction surveys among individuals participating in telehealth at certain time periods in the past were assessed ( 21 , 26 ).…”

“…The Supplementary file S2 Figure illustrates the flow of selecting articles. The number of final studies included in this review was 14 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). An example of a study that was excluded during the full-text review was the study of Elbin et al, 2022 (33) on the satisfaction with telehealth among adolescents prior to the pandemic.…”

“…In one study, for participants, who already had a relationship with a health professional, teleconsultation was perceived as a chance to circumvent the more stressful setting of healthcare entities (31). In the study of Troncone et al (29), the mean Jefferson Scale of Perceptions of Physician Empathy (JSPPPE) score was 28.92 for video consultations and 27.82 for the in-person visits demonstrating slightly higher satisfaction with the video visit which was not statistically significant (p = 0.096) (30). Factors associated with higher satisfaction with telehealth included: longer distance from the health center (19), older age (26), and lower anxiety when using telehealth (26).…”

The impact of COVID-19 on the doctor-patient relationship in China

“…It can be used to communicate with doctors by showing infected or diseased areas. Video consultation will also be beneficial to young people suffering from type I diabetes who are experiencing disease and emotional stress during the COVID-19 pandemic ( 25 ). A second measure taken by the government is to include telemedicine services within the scope of medical insurance reimbursement, and to increase the amount of reimbursement under medical insurance ( 26 ).…”