In-person or tele-orthopaedic care? A mixed-methods study exploring parents' perspectives on the advantages and challenges of both approaches care for children with cerebral palsy.

backgroundChildren with cerebral palsy (CP) often require ongoing orthopaedic care to address musculoskeletal issues and improve mobility. However, access to specialized services can be challenging due to geographic barriers, patient immobility, transportation difficulties, and long wait times. These challenges place a considerable burden on families, particularly on parents who serve as primary caregivers. This study compared parental perspectives on in-person versus tele-orthopaedic care using a quasi-experimental design, involving interviews with 50 parents to explore the advantages and challenges of both methods.

methodsThis quasi-experimental study employed a mixed-methods approach. Fifty parents of children with cerebral palsy were randomly assigned to intervention (tele-orthopaedics care) or control (in-person care) groups for three months. The control group received in-person orthopaedic services, while the intervention group received tele-orthopaedics care during this period. Quantitative data were collected through structured questionnaires and analyzed using SPSS version 23. In the qualitative phase, semi-structured interviews were conducted with all 50 parents (25 from each group), and qualitative data were analyzed using content analysis in MAXQDA version 18 to extract key themes and sub-themes.

resultsBased on the questionnaire results, the main advantages of in-person visits were "Reduction of medical errors" (4.5 ± 0.6), "More accurate diagnosis" (4.4 ± 0.5), and "Improved and easier interaction between patient and provider" (4.3 ± 0.6). In contrast, the key advantages s of tele-orthopaedicss were "Cost savings" (4.5 ± 0.6) and "Eliminating geographical barriers" (4.4 ± 0.6). Interview findings revealed that the most frequently cited advantages s of in-person visits were "Comprehensive physical examination" (n = 24), "More accurate and effective treatment" (n = 24), and "Direct and more comfortable interaction with the physician" (n = 24). Key challenges included "Difficulty in transferring and moving the child" (n = 24), "Wasting parents' time at the hospital" (n = 22), and "High transportation costs to healthcare centers" (n = 20). Moreover, among the 20 identified advantages, the most frequently mentioned were "Reduced travel costs" (n = 14), "Elimination of geographical distances" (n = 9), and "Reduced sense of isolation and improved communication with the care team" (n = 8). The most common challenges included "Lack of access to high-speed internet" (n = 20), "Limited internet access in remote areas" (n = 19), "Lack of digital literacy in using tele-orthopaedics platforms" (n = 18), and "Lack of physical examination" (n = 18).

conclusionIn-person visits and tele-orthopaedicss each have unique advantages s and limitations, and can complement each other in the healthcare system. While in-person care is vital for complex cases, tele-orthopaedicss helps reduce costs and improve access in remote areas. A hybrid model, supported by better internet infrastructure and digital literacy, can enhance orthopaedic care quality. CLINICAL TRIAL NUMBER: Not applicable.