Authors (including presenting author) :
Ng MP(1), Shiu ATY(2), Mok PH(1), Kam YW(1)
Affiliation :
(1) Diabetes Ambulatory Care Centre, United Christian Hospital (2) Chung Chi College, The Chinese University of Hong Kong
Introduction :
The COVID-19 pandemic has made integrating telehealth services essential, offering a viable option for those unable to visit clinics due to geographic barriers, chronic illnesses, or work commitments. Studies show that telehealth is particularly effective for managing long-term health conditions like diabetes.
Objectives :
This study aimed to examine patients’ perceptions of service satisfaction regarding telehealth diabetes education. This paper reports on patients’ perceptions of the telehealth diabetes education service through a 360-degree evaluation approach, considering structure, process, and outcomes.
Methodology :
A mixed-methods study was employed. For the purpose of this paper, only data collected from patients’ perceptions of the telehealth diabetes education service regarding service structure, process, and outcomes are reported. The questionnaire consisted of 16 items designed to evaluate service satisfaction from patients’ perspectives. Subjects rated their satisfaction on a Likert scale from 1 to 5, where 1 indicates "very strongly agree," 3 is "neutral," and 5 represents "very strongly disagree." Following Donabedian’s Model of evaluation, items 1-4 assess the structure domain, items 5-9 assess the process domain, and items 10-14 assess the outcome domain. Item 15 evaluates overall satisfaction with the telehealth diabetes education service on a scale from 0% to 100%, while item 16 allows respondents to suggest areas for improvement or provide comments.
Result & Outcome :
The 16-item questionnaires were administered to patients (n = 34; 21 males and 13 females; mean age 44 years, SD 12.29), comprising 28 individuals with type 1 diabetes, 5 with type 2 diabetes, and 1 classified as "other." The mean duration of diabetes was 16.18 years (SD 9.39). The reliability statistic, measured by Cronbach’s alpha, was 0.956 for items 1-14. Three major domains were analyzed. In the structure domain, patient satisfaction scores ranged from 1.118 to 1.382, indicating that the telehealth service was convenient and easy to use, both at home and in private settings. Patients also found the duration of the telehealth service adequate and expressed a preference for adopting it as an alternative mode of diabetes nurse clinic. In the process domain, patient satisfaction scores ranged from 1.088 to 1.176, suggesting that the service instructions were easy to follow. The diabetes nurses effectively engaged patients in meaningful discussions and provided tailored diabetes education based on individual needs. Patients appreciated the supportive attitude, extensive diabetes knowledge, and clear explanations offered by the diabetes nurses during the telehealth service. In the outcome domain, satisfaction scores ranged from 1.147 to 1.265, indicating enhancements in diabetes knowledge, self-care management, and self-efficacy, particularly in the area of continuous glucose monitoring interpretation. For item 15, which evaluated overall satisfaction with the telehealth diabetes education service on a scale from 0% to 100%, the mean score was 96 (maximum: 100; minimum: 80). Regarding item 16, which addressed areas for improvement or additional comments, three patients responded. One patient expressed concerns about privacy and issues related to sick leave certificates, as well as poor sound quality during sessions. The other two patients reported satisfaction with the service, with one suggesting that the telehealth service should be extended to doctor clinics three times a year while maintaining annual in-person visits. Additionally, practical issues were raised to enhance the feasibility of telehealth services in doctor clinics, including the arrangement for issuing laboratory blood tests and managing medication prescriptions. Although this is a small study, the findings have significant implications for telehealth diabetes education services. Our results provide strong evidence that patients require alternative modes of diabetes education from nursing professionals.
