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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">WhatsApp&#174; is the leading instant messaging application&#46; There is also a separate application &#40;WhatsApp&#174; Business&#41; that provides tools to automate&#44; sort and quickly respond to messages&#46; It offers end-to-end encryption&#44; which guarantees the appropriate level of privacy required for the exchange of medical information&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> There is a growing interest in research on this form of communication within the framework of the doctor&#47;patient relationship&#44; but only a few studies have been published in the literature&#44; none of them in the field of paediatrics&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#44;3</span></a> The aim of our study was to assess the patterns of use of this application by families&#44; and to establish their level of satisfaction with it&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We conducted a descriptive qualitative study in a series of families recruited by consecutive sampling that visited a private clinic staffed by 3 paediatricians between May and October 2018&#46; The legal guardians of the patients signed an informed consent form handed out by the clerical staff of the clinic&#44; which adhered to current regulation on personal data protection&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> The WhatsApp&#174; Business application was installed on a mobile device that was exclusively dedicated to this purpose and exclusively owned by the clinic&#46; We set up a schedule for messaging for each physician based on their availability&#44; with preferential use of the desktop version of the software &#40;WhatsApp&#174; Web&#41;&#44; with automated delivery of prewritten messages to expedite the response process&#46; We collected general information on messaging&#58; total number of messages sent out&#44; delivered&#44; read and received&#46; We also collected data on the pattern of use of the service by families&#58; day and time&#44; need of in-person visit&#44; response time and most frequent reasons for consultation&#46; At the end of the study period&#44; we sent families a 12-item questionnaire to rate their experiences &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; We sent the questionnaire &#40;Google&#174; Forms&#41; through the MailChimp&#174; email campaign platform&#46; We analysed the data with the Google&#174; Spreadsheets platform&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">In the period under study&#44; the clinic received 2160 in-person visits &#40;1982 routine checkups&#44; 178 initial visits&#41;&#46; The clinic also received 352 consultations made directly through WhatsApp&#174; &#40;1692 received messages and 1227 sent out&#41; from 180 families &#40;1&#46;95 consultations per family&#41;&#46; Most were received on weekdays &#40;88&#46;3&#37;&#41; and in the morning &#40;53&#46;7&#37;&#41;&#46; Of these total&#44; 29&#46;5&#37; required an in-person follow-up visit&#46; We responded to 81&#46;3&#37; of the messages received within 1 hour&#46; The most frequent reasons for consultation were administrative issues &#40;22&#46;5&#37;&#41;&#44; infectious diseases &#40;19&#46;5&#37;&#41; and questions about treatment &#40;16&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; We received responses to the satisfaction survey from 149 families &#40;82&#46;7&#37;&#41;&#44; and found that overall&#44; they agreed or strongly agreed that WhatsApp&#174; facilitated access to the paediatrician &#40;95&#46;2&#37;&#41;&#44; that more medical providers should use WhatsApp&#174; &#40;98&#46;2&#37;&#41;&#44; that they would miss being able to send WhatsApp messages&#174; if this option was removed &#40;68&#46;3&#37;&#41; and that they found consultations through WhatsApp&#174; useful &#40;95&#46;9&#37;&#41;&#46; Half of the families &#40;52&#46;8&#37;&#41; expressed concerns about security&#46; In addition&#44; 81&#46;2&#37; considered that the concerns expressed through WhatsApp&#174; were addressed and were satisfied with the response they received &#40;82&#46;5&#37;&#41;&#44; which relieved fears and anxiety &#40;83&#46;1&#37;&#41;&#46; The families did not feel that this platform made them grow apart from their paediatrician &#40;87&#46;6&#37;&#41;&#46; Of all families&#44; 58&#46;7&#37; reported using this means of contact less than once a month&#44; and 39&#46;4&#37; reported having submitted pictures or videos&#46; WhatsApp&#174; was the method preferred by most to contact the paediatrician &#40;70&#46;4&#37;&#41;&#44; followed by phone calls &#40;35&#46;9&#37;&#41; and email &#40;14&#46;8&#37;&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Messaging offers 2 main advantages over conventional phone calls&#58; asynchrony and ubiquity&#46; This has significant benefits compared to traditional communications through the telephone&#44; which involved delays and interruptions&#46; The fact that most consultations could be resolved directly through this system could significantly contribute to decongest and streamline health care delivery&#46; Families declared that the use of WhatsApp&#174; increased the quality of communication with the paediatrician&#46; As for the limitations of our study&#44; the fact that it was conducted in a single private clinic restricts the generalisation of its results&#44; as the system would have to be introduced in different geographical areas and populations of varying socioeconomic status&#46; Another limitation is that the questionnaire used in the satisfaction survey was not a validated instrument&#44; although the response rate was substantial&#46; It would also be interesting to replicate this study in the months that the clinic receives the most visits&#46; The results of our study cannot be generalised&#44; but the patterns of use by the families and their subsequent comments demonstrate that this is a tool that improves communication with patients&#46; In our role as paediatricians&#44; we can be leaders in the use of information and communication technologies &#40;ICTs&#41;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">5&#44;6</span></a> and are among the medical specialists that are best positioned to transform health care in this regard&#46;</p></span>"
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Scientific Letter
Suitability and validation of WhatsApp™ as a method of communicating with family
Predisposición y validación del uso de WhatsApp® como método de comunicación con familias
Alfonso Amado Puentes
Corresponding author
, Noa Villar Rodríguez, Sara Pereiro Fernández, Laura García Alonso
Amado Clínica Pediátrica, Pontevedra, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">WhatsApp&#174; is the leading instant messaging application&#46; There is also a separate application &#40;WhatsApp&#174; Business&#41; that provides tools to automate&#44; sort and quickly respond to messages&#46; It offers end-to-end encryption&#44; which guarantees the appropriate level of privacy required for the exchange of medical information&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> There is a growing interest in research on this form of communication within the framework of the doctor&#47;patient relationship&#44; but only a few studies have been published in the literature&#44; none of them in the field of paediatrics&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#44;3</span></a> The aim of our study was to assess the patterns of use of this application by families&#44; and to establish their level of satisfaction with it&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We conducted a descriptive qualitative study in a series of families recruited by consecutive sampling that visited a private clinic staffed by 3 paediatricians between May and October 2018&#46; The legal guardians of the patients signed an informed consent form handed out by the clerical staff of the clinic&#44; which adhered to current regulation on personal data protection&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> The WhatsApp&#174; Business application was installed on a mobile device that was exclusively dedicated to this purpose and exclusively owned by the clinic&#46; We set up a schedule for messaging for each physician based on their availability&#44; with preferential use of the desktop version of the software &#40;WhatsApp&#174; Web&#41;&#44; with automated delivery of prewritten messages to expedite the response process&#46; We collected general information on messaging&#58; total number of messages sent out&#44; delivered&#44; read and received&#46; We also collected data on the pattern of use of the service by families&#58; day and time&#44; need of in-person visit&#44; response time and most frequent reasons for consultation&#46; At the end of the study period&#44; we sent families a 12-item questionnaire to rate their experiences &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; We sent the questionnaire &#40;Google&#174; Forms&#41; through the MailChimp&#174; email campaign platform&#46; We analysed the data with the Google&#174; Spreadsheets platform&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">In the period under study&#44; the clinic received 2160 in-person visits &#40;1982 routine checkups&#44; 178 initial visits&#41;&#46; The clinic also received 352 consultations made directly through WhatsApp&#174; &#40;1692 received messages and 1227 sent out&#41; from 180 families &#40;1&#46;95 consultations per family&#41;&#46; Most were received on weekdays &#40;88&#46;3&#37;&#41; and in the morning &#40;53&#46;7&#37;&#41;&#46; Of these total&#44; 29&#46;5&#37; required an in-person follow-up visit&#46; We responded to 81&#46;3&#37; of the messages received within 1 hour&#46; The most frequent reasons for consultation were administrative issues &#40;22&#46;5&#37;&#41;&#44; infectious diseases &#40;19&#46;5&#37;&#41; and questions about treatment &#40;16&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; We received responses to the satisfaction survey from 149 families &#40;82&#46;7&#37;&#41;&#44; and found that overall&#44; they agreed or strongly agreed that WhatsApp&#174; facilitated access to the paediatrician &#40;95&#46;2&#37;&#41;&#44; that more medical providers should use WhatsApp&#174; &#40;98&#46;2&#37;&#41;&#44; that they would miss being able to send WhatsApp messages&#174; if this option was removed &#40;68&#46;3&#37;&#41; and that they found consultations through WhatsApp&#174; useful &#40;95&#46;9&#37;&#41;&#46; Half of the families &#40;52&#46;8&#37;&#41; expressed concerns about security&#46; In addition&#44; 81&#46;2&#37; considered that the concerns expressed through WhatsApp&#174; were addressed and were satisfied with the response they received &#40;82&#46;5&#37;&#41;&#44; which relieved fears and anxiety &#40;83&#46;1&#37;&#41;&#46; The families did not feel that this platform made them grow apart from their paediatrician &#40;87&#46;6&#37;&#41;&#46; Of all families&#44; 58&#46;7&#37; reported using this means of contact less than once a month&#44; and 39&#46;4&#37; reported having submitted pictures or videos&#46; WhatsApp&#174; was the method preferred by most to contact the paediatrician &#40;70&#46;4&#37;&#41;&#44; followed by phone calls &#40;35&#46;9&#37;&#41; and email &#40;14&#46;8&#37;&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Messaging offers 2 main advantages over conventional phone calls&#58; asynchrony and ubiquity&#46; This has significant benefits compared to traditional communications through the telephone&#44; which involved delays and interruptions&#46; The fact that most consultations could be resolved directly through this system could significantly contribute to decongest and streamline health care delivery&#46; Families declared that the use of WhatsApp&#174; increased the quality of communication with the paediatrician&#46; As for the limitations of our study&#44; the fact that it was conducted in a single private clinic restricts the generalisation of its results&#44; as the system would have to be introduced in different geographical areas and populations of varying socioeconomic status&#46; Another limitation is that the questionnaire used in the satisfaction survey was not a validated instrument&#44; although the response rate was substantial&#46; It would also be interesting to replicate this study in the months that the clinic receives the most visits&#46; The results of our study cannot be generalised&#44; but the patterns of use by the families and their subsequent comments demonstrate that this is a tool that improves communication with patients&#46; In our role as paediatricians&#44; we can be leaders in the use of information and communication technologies &#40;ICTs&#41;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">5&#44;6</span></a> and are among the medical specialists that are best positioned to transform health care in this regard&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Amado Puentes A&#44; Villar Rodr&#237;guez N&#44; Pereiro Fern&#225;ndez S&#44; Garc&#237;a Alonso L&#46; Predisposici&#243;n y validaci&#243;n del uso de WhatsApp&#174; como m&#233;todo de comunicaci&#243;n con familias&#46; An Pediatr &#40;Barc&#41;&#46; 2020&#59;92&#58;300&#8211;2&#46;</p>"
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Article information
ISSN: 23412879
Original language: English
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