Parent preference: Comparing telephone with face to face consultations during the COVID-19 pandemic

ABSTRACT

Background The Covid-19 pandemic led to a strong government response in attempts to limit spread of this virulent infectious disease. Societal measures included social distancing, hand hygiene with 'stay-at-home' advice, colloquially referred to as 'lockdown'. Medical practice had to respond quickly, respecting these measures whilst trying to offer ongoing patient services. Objectives There has been a proliferation of virtual appointments, offered either via telephone or video call. For a paediatrics department in a major district general hospital, phone consultations were the immediately available option. Our study objective was to implement an online survey questionnaire to explore family perceptions on virtual telephone appointments. Methods 168 families who participated in general paediatric follow up telephone consultations over a two-week period in May were contacted for consent to send them an online survey comparing telephone and face-to-face consultations. This group was targeted because they had at least one face-to-face appointment previously. The online survey consisted of 10 questions to compare different modes of consultations, including satisfaction rating using the Likert scale, and open text responses. Results 40 families (response rate 44%) of 92 who consented, completed the online survey. 4 (10%) parents had a strong preference for face-to-face appointments, with roughly 25% each slightly preferring telephone or face-toface appointments (9 and 12 respectively). 35% (14) did not mind either option. Despite this, if given the choice, 12 (30%) would choose face-to-face appointments in the future as opposed to 5 (12.5%) who would chose the telephone consultation. Parents rated convenience as greater for telephone appointments (33 responses, 85%). Some parents mentioned in feedback slightly better ability to remember information and ask questions. However, there was limited possibility for involving other adults and the child or young person. Positive comments about virtual clinics included not having to pay for parking (6, 15%). Parents gave constructive feedback, saying they could be asked to be ready to provide information, for example child's current weight. Few children were involved, and this needs to be borne in mind, especially as visual ques can be missed over telephone. 3 families (8%) however did report that children were happy not to be involved in the discussions. Conclusions Parents were grateful that some efforts had been made to maintain contact in difficult times, and responses may have been different in normal circumstances. There are some limitations to telephone consultations;mainly not being able to clinically examine or talk to children. Telephone consultations may result in silencing of the child's voice, with possible mental health and safeguarding issues. Some of these issues could be addressed with video calling. Interestingly despite convenience of telephone consultations, more parents indicated a preference for physical face-to-face consultations suggesting that, as the world returns to normal, whilst both options should be made available to them, we may not see significant changes in practice. Going forwards it may be beneficial to ask parents after initial consultation and if appropriate, if they would like a telephone or physical face-to-face appointment in the future.