Caregiver Perspectives on Telemedicine for Postdischarge Care for Children With Medical Complexity: A Qualitative Study

Published:January 18, 2023DOI:


      The objectives of this study were to describe the perspectives of caregivers of children with medical complexity on telemedicine video visits (TMVV) for posthospitalization care and determine whether TMVV may be a viable alternative to in-person follow-up.


      Our qualitative descriptive study included semistructured telephone interviews with 12 caregivers. Data analysis was conducted using an adapted Colaizzi's descriptive phenomenological method for thematic construction.


      Results were organized into four themes describing caregivers' experiences with TMVV: (1) promoted caregiver self-efficacy and sense of independence; (2) TMVV as convenient, cost-effective, comprehensive, and acceptable; (3) supported caregiver decision-making and problem-solving; and (4) fostered delivery of family-centered care.


      Although in-person visits are necessary for some circumstances, TMVV can serve as a convenient and acceptable alternative for posthospitalization follow-up in children with medical complexity. Overall, caregivers in this study were satisfied with the quality of care and individualized experience of TMVV.


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        • Abebe E.
        • Scanlon M.C.
        • Lee K.J.
        • Chui M.A.
        What do family caregivers do when managing medications for their children with medical complexity?.
        Applied Ergonomics. 2020; 87103108
        • Bandini J.
        • Rollison J.
        • Feistel K.
        • Whitaker L.
        • Bialas A.
        • Etchegaray J.
        Home care aide safety concerns and job challenges during the COVID-19 pandemic.
        New Solutions. 2021; 31: 20-29
        • Bergman D.A.
        • Keller D.
        • Kuo D.Z.
        • Lerner C.
        • Mansour M.
        • Stille C.
        • Richardson T.
        • Rodean J.
        • Hudak M.
        Costs and use for children with medical complexity in a care management program.
        Pediatrics. 2020; 145e20192401
        • Breneol S.
        • Belliveau J.
        • Cassidy C.
        • Curran J.A.
        Strategies to support transitions from hospital to home for children with medical complexity: A scoping review.
        International Journal of Nursing Studies. 2017; 72: 91-104
        • Cohen E.
        • Kuo D.Z.
        • Agrawal R.
        • Berry J.G.
        • Bhagat S.K.M.
        • Simon T.D.
        • Srivastava R.
        Children with medical complexity: An emerging population for clinical and research initiatives.
        Pediatrics. 2011; 127: 529-538
        • Colaizzi P.F.
        Psychological research as the phenomenologist views it.
        in: Valle R.S. King & M. Existential-phenomenological alternatives for psychology. Oxford University Press, 1978: 6
        • Marcin J.P.
        • Rimsza M.E.
        • Moskowitz W.B
        • Committee on Pediatric Workforce.
        The Use of Telemedicine to Address Access and Physician Workforce Shortages.
        Pediatrics. 2015; 136: 202-209
        • Curfman A.
        • McSwain S.D.
        • Chuo J.
        • Yeager-McSwain B.
        • Schinasi D.A.
        • Marcin J.
        • Herendeen N.
        • Chung S.L.
        • Rheuban K.
        • Olson C.A.
        Pediatric telehealth in the COVID-19 pandemic era and beyond.
        Pediatrics. 2021; 148e2020047795
        • Desai A.D.
        • Durkin L.K.
        • Jacob-Files E.A.
        • Mangione-Smith R.
        Caregiver perceptions of hospital to home transitions according to medical complexity: A qualitative study.
        Academic Pediatrics. 2016; 16: 136-144
        • Dick P.T.
        • Bennie J.
        • Barden W.
        • Daniels C.
        • Young N.L.
        • Team Telehome Care
        Preference for pediatric telehome care support following hospitalization: A report on preference and satisfaction.
        Telemedicine Journal and e-Health. 2004; 10 (S-45–S-53)
        • Edelstein H.
        • Schippke J.
        • Sheffe S.
        • Kingsnorth S.
        Children with medical complexity: A scoping review of interventions to support caregiver stress.
        Child: Care, Health and Development. 2017; 43: 323-333
        • Foster C.C.
        • Agrawal R.K.
        • Davis M.M.
        Home health care for children with medical complexity: Workforce gaps, policy, and future directions. 38. Health Affairs, 2019: 987-993
        • Grey M.
        • Schulman-Green D.
        • Knafl K.
        • Reynolds N.R.
        A revised Self- and Family Management Framework.
        Nursing Outlook. 2015; 63: 162-170
        • Haase J.E.
        Components of courage in chronically ill adolescents: A phenomenological study.
        ANS. Advances in Nursing Science. 1987; 9: 64-80
        • Hu C.
        • Kung S.
        • Rummans T.A.
        • Clark M.M.
        • Lapid M.I.
        Reducing caregiver stress with internet-based interventions: A systematic review of open-label and randomized controlled trials.
        Journal of the American Medical Informatics Association. 2015; 22: e194-e209
        • Katzow M.W.
        • Steinway C.
        • Jan S.
        Telemedicine and health disparities during COVID-19.
        Pediatrics. 2020; 146e20201586
        • Kuo D.Z.
        • Melguizo-Castro M.
        • Goudie A.
        • Nick T.G.
        • Robbins J.M.
        • Casey P.H.
        Variation in child health care utilization by medical complexity.
        Maternal and Child Health Journal. 2015; 19: 40-48
        • Looman W.S.
        • Antolick M.
        • Cady R.G.
        • Lunos S.A.
        • Garwick A.E.
        • Finkelstein S.M.
        Effects of a telehealth care coordination intervention on perceptions of health care by caregivers of children with medical complexity: A randomized controlled trial.
        Journal of Pediatric Health Care. 2015; 29: 352-363
        • Malterud K.
        • Siersma V.D.
        • Guassora A.D.
        Sample size in qualitative interview studies: Guided by information power.
        Qualitative Health Research. 2016; 26: 1753-1760
        • McKissick H.D.
        • Cady R.G.
        • Looman W.S.
        • Finkelstein S.M.
        The impact of telehealth and care coordination on the number and type of clinical visits for children with medical complexity.
        Journal of Pediatric Health Care. 2017; 31: 452-458
        • Ming D.Y.
        • Jackson G.L.
        • Sperling J.
        • Gray M.
        • Wyman Roth N.
        • Spears T.
        • Parente V.
        • Bosworth H.
        Mobile complex care plans to enhance parental engagement for children with medical complexity.
        Clinical Pediatrics. 2019; 58: 34-41
        • Ming D.Y.
        • Li T.
        • Ross M.H.
        • Frush J.
        • He J.
        • Goldstein B.A.
        • Jarrett V.
        • Krohl N.
        • Docherty S.L.
        • Turley C.B.
        • Bosworth H.B.
        Feasibility of post-hospitalization telemedicine video visits for children with medical complexity.
        Journal of Pediatric Health Care. 2022; 36: e22-e35
        • Mosquera R.A.
        • Avritscher E.B.C.
        • Pedroza C.
        • Lee K.H.
        • Ramanathan S.
        • Harris T.S.
        • Eapen J.C.
        • Yadav A.
        • Caldas-Vasquez M.
        • Poe M.
        • Martinez Castillo D.J.
        • Harting M.T.
        • Ottosen M.J.
        • Gonzalez T.
        • Tyson J.E.
        Telemedicine for children with medical complexity: A randomized clinical trial.
        Pediatrics. 2021; 148e2021050400
        • Murphy N.A.
        • Alvey J.
        • Valentine K.J.
        • Mann K.
        • Wilkes J.
        • Clark E.B.
        Children with medical complexity: The 10-year experience of a Single Center.
        Hospital Pediatrics. 2020; 10: 702-708
        • Notario P.M.
        • Gentile E.
        • Amidon M.
        • Angst D.
        • Lefaiver C.
        • Webster K.
        Home-based telemedicine for children with medical complexity.
        Telemedicine Journal and e-health: The Official Journal of the American Telemedicine Association. 2019; 25: 1123-1132
        • Nouri S.
        • Khoong E.C.
        • Lyles C.R.
        • Karliner L.
        Addressing equity in telemedicine for chronic disease management during the Covid-19 pandemic.
        NEJM Catalyst Innovations in Care Delivery. 2020; : 1
        • Omery A.
        Phenomenology: A method for nursing research.
        ANS. Advances in Nursing Science. 1983; 5: 49-63
        • Pordes E.
        • Gordon J.
        • Sanders L.M.
        • Cohen E.
        Models of care delivery for children with medical complexity.
        Pediatrics. 2018; 141: S212-S223
        • Portnoy J.
        • Waller M.
        • Elliott T.
        Telemedicine in the era of COVID-19.
        Journal of Allergy and Clinical Immunology: In Practice. 2020; 8: 1489-1491
        • Ross M.H.
        • Parnell L.S.
        • Spears T.G.
        • Ming D.Y.
        Telemedicine video visits for children with medical complexity in a structured clinical complex care program.
        Global Pediatric Health. 2020; 7 (2333794X20952196)
        • Saunders B.
        • Sim J.
        • Kingstone T.
        • Baker S.
        • Waterfield J.
        • Bartlam B.
        • Burroughs H.
        • Jinks C.
        Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality and Quantity. 2018; 52: 1893-1907
        • Vasileiou K.
        • Barnett J.
        • Thorpe S.
        • Young T.
        Characterising and justifying sample size sufficiency in interview-based studies: Systematic analysis of qualitative health research over a 15-year period.
        BMC Medical Research Methodology. 2018; 18: 148
        • Yu J.A.
        • Henderson C.
        • Cook S.
        • Ray K.
        Family caregivers of children with medical complexity: Health-related quality of life and experiences of care coordination.
        Academic Pediatrics. 2020; 20: 1116-1123