Telemedicine satisfaction in children with neurological impairment: the role of disease severity, nutritional status, and travel burden

Vollständiger Abstract

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Background Telemedicine is increasingly used in the follow-up of children with neurological impairment to improve access to specialized care and reduce the burden associated with frequent hospital visits. However, data on caregiver satisfaction and the factors influencing perceived quality of telemedicine services in this population remain limited. Therefore, this study aimed to assess caregiver satisfaction with telemedicine consultations delivered as part of a hybrid model combining routine in-person follow-up and video consultations, and to explore its association with nutritional status and other clinical and logistical factors in children with neurological impairment. Methods We performed a preliminary analysis of an ongoing observational cross-sectional study including children and adolescents with chronic neurological impairment followed at a tertiary pediatric center through a hybrid model of care combining routine face-to-face follow-up and telemedicine consultations. Caregiver satisfaction with telemedicine was assessed using a structured questionnaire administered after the visit. Clinical, nutritional, and logistical variables were collected, including diagnosis, gastrostomy, BMI z -score, quality of life, distance from the hospital, and estimated travel costs. Associations were explored through univariate analyses. Results During the study period, 154 patients were evaluated, of whom 65 participated in telemedicine visits and completed the satisfaction questionnaire. Overall, caregiver satisfaction with telemedicine was high, with 93.8% of caregivers reporting high or excellent satisfaction. No significant associations were found between caregiver satisfaction and demographic, clinical, nutritional, or logistical variables, with the exception of a weak inverse association with the PedsQL total score. Conclusion Telemedicine represents an effective and well-accepted model of care for children with complex neurological conditions. Caregiver satisfaction was consistently high and did not appear to be influenced by clinical, nutritional, or logistical factors. These findings support the role of telemedicine as a complementary component of a hybrid, family-centered model of care for the long-term management of children with complex neurological conditions, including those requiring multidisciplinary and nutritional follow-up.