Experience of primary healthcare workers in using the mobile app-based WHO mhGAP intervention guide in detection and treatment of people with mental disorders: A qualitative study in Nepal

IF 4.1 Q1 PSYCHIATRY
Nagendra P. Luitel , Vibha Neupane , Bishnu Lamichhane , Gobinda Prasad Koirala , Kamal Gautam , Eliza Karki , Sandarba Adhikari , Nicole Votruba , Mark JD. Jordans , Brandon A. Kohrt , Kenneth Carswell , Graham Thornicroft , Heidi Lempp
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Abstract

This study assessed perception and experience of trained primary health care workers in using a mobile app-based version of the WHO mental health gap action programme (mhGAP) Intervention Guide in the assessment and management of people with mental health conditions in primary care in Nepal. A qualitative study was conducted with primary healthcare workers who were trained in using the WHO mhGAP mobile application in Jhapa, a district in eastern Nepal. Semi-structured interviews were carried out with 15 healthcare workers (3 females and 12 males) nine months after the training. Interviews were audio recorded, transcribed and translated into English for the thematic qualitative data analysis. Health care workers (HCWs) found the mobile app helpful to verify and confirm their assessment and diagnosis. The other benefits reported by the participants were: bringing uniformity in diagnosis and management of mental health conditions across primary healthcare facilities; reminding the HCWs specific assessment questions; creating awareness on the importance of psychosocial intervention; improving the interaction between patients and service providers; and the importance of follow-up care. Despite these advantages, lack of clarity about report submission modality; lack of electricity or internet connectivity; and low technology literacy among older HCWs were some of the barriers in using the app. The major recommendation made by the HCWs for the guide included revision of the assessment process and system; inclusion of a chat function with supervisors; minimizing the amount of patients’ data to be collected in the app; and addition of conversion and anxiety disorders to the app. This study concludes that the mobile decision support application could be acceptable and feasible in primary care settings if the suggested modifications are incorporated, in addition to addressing other systemic issues facing the primary care-based delivery of mental health services.

初级卫生保健工作者使用基于移动应用程序的世卫组织mhGAP干预指南检测和治疗精神障碍患者的经验:尼泊尔的一项定性研究
本研究评估了训练有素的初级卫生保健工作者在尼泊尔初级卫生保健中使用基于移动应用程序版本的世卫组织精神卫生差距行动规划(mhGAP)干预指南评估和管理精神卫生状况患者的看法和经验。在尼泊尔东部Jhapa地区,对接受过使用世卫组织mhGAP移动应用程序培训的初级卫生保健工作者进行了定性研究。培训结束9个月后,对15名医护人员(3名女性和12名男性)进行了半结构化访谈。访谈录音、抄写和翻译成英文,以供专题定性数据分析。卫生保健工作者(HCWs)发现移动应用程序有助于核实和确认他们的评估和诊断。参与者报告的其他好处是:在初级卫生保健机构中统一诊断和管理精神健康状况;提醒卫生服务人员具体的评估问题;提高对社会心理干预重要性的认识;改善患者与服务提供者之间的互动;以及后续护理的重要性。尽管有这些优势,但报告提交方式缺乏明确性;缺少电力或互联网连接;老年医护人员的技术素养较低是使用该应用程序的一些障碍。医护人员对该指南提出的主要建议包括修订评估程序和系统;包含与主管聊天的功能;尽量减少在应用程序中收集的患者数据量;本研究的结论是,除了解决基于初级保健的精神卫生服务提供所面临的其他系统性问题外,如果将建议的修改纳入其中,移动决策支持应用程序在初级保健环境中是可以接受和可行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
SSM. Mental health
SSM. Mental health Social Psychology, Health
CiteScore
2.30
自引率
0.00%
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审稿时长
118 days
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