Avaliação da experiência do uso do telemonitoramento síncrono em um serviço de hemodiálise domiciliar durante a pandemia pelo COVID-19

Abstract

Assisted home hemodialysis is a therapeutic modality for patients diagnosed with chronic kidney disease who need substitute dialysis therapy and, at the same time, have health restrictions that prevent them from attending a dialysis satellite unit or performing their own treatment. Home hemodialysis patients need constant attention from their caregivers and regular consultations with their doctors due to the fragility of their physical condition. The assisted home hemodialysis program, of a private company in the city of Rio de Janeiro, develops the monitoring of its patients through a monthly face-to-face medical visit and supplementary care according to the severity and demand of each patient. The hemodialysis procedure performed at the residence is monitored by a nurse who records the treatment and its complications digitally, in an electronic medical record. Telemedicine, through telemonitoring, can contribute to increase the continued relationship between the doctor, the nurse and the patient, especially in the context of the pandemic by the Coronavirus COVID-19 when social distance is recommended by the World Health Organization and adopted in Brazil and in Brazil. world. This observational, cross-sectional study, with qualitative and quantitative methodology, has the general objective of analyzing the impact of the use of medical telemonitoring, from the perspective of nurses and patients who participate in person in home hemodialysis in the pandemic period by SARS-COV-2 through evaluation of the patient's experience. During the research, we perform remote monitoring using the ZOOM videoconference program, weekly, promoting contact between the doctor, his patient, and the nurse. All telemedicine activities were recorded, respecting data confidentiality. 17 patients were included with the prerequisite of having at least 3 months from the start of home hemodialysis and 12 nurses who carry out bedside treatment. Patients and nurses who did not agree to participate in the research or did not have access to the internet at the residence were excluded. Data were collected and analyzed after a 6-month follow-up by telemonitoring. We observed in our study that patients and nurses had a positive experience in relation to telemonitoring, extolling welcoming and a greater sense of security. Despite the satisfaction and the recommendation of the service to other patients, the vast majority would not replace the doctor's face-to-face visit with a remote consultation