心理健康服务中持续使用远程医疗的环境因素:混合方法分析。

IF 3.1 Q2 HEALTH CARE SCIENCES & SERVICES
International Journal of Telemedicine and Applications Pub Date : 2024-09-16 eCollection Date: 2024-01-01 DOI:10.1155/2024/8835933
Benjamin Werkmeister, Anne M Haase, Theresa Fleming, Tara N Officer
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引用次数: 0

摘要

背景:在全球范围内,心理健康服务的提供缺口仍然很大。适当使用远程医疗可通过灵活的远程医疗服务提高服务能力。尽管远程医疗在公共资助的精神健康服务中一直缺乏整合,但在 COVID-19 封锁期间,服务迅速转向了电话和视听护理服务。在新西兰奥特亚罗瓦(Aotearoa New Zealand,NZ),当 COVID-19 限制不再需要时,这种做法就被放弃了。本研究探讨了与远程医疗的实施、持续使用或停用有关的环境因素,涉及跨地区的门诊精神健康服务。这项工作有助于了解影响远程医疗使用的系统级因素,从而为后流行环境中的政策和实践提供参考。研究方法这项混合方法研究采用了解释性描述方法。对 33 名心理健康临床医生的半结构式访谈进行了主题分析。通过对人口层面的定量数据(大流行之前和整个大流行期间)进行时间序列分析,对定性研究结果进行重构和评估。研究结果与定性主题进行了综合,以了解促进远程保健使用的环境因素。结果:研究结果表明,接受心理健康服务评估的患者人数增加,而临床医生的人数却在减少,这给临床医生造成了压力。缺乏支持远程医疗的文化,包括有限的意识、领导力和促进实施的拥护者。一些团队提供适合远程保健的服务;其他亚专业团队对远程保健的应用有限。普遍缺乏支持使用远程保健的政策和指南,对不熟悉视听软件的临床医生的技术支持也很有限。结论研究地区对远程医疗的无序采用让我们了解到影响远程医疗应用的更广泛的环境因素。在 COVID-19 之后,远程医疗要想成为一种可行的服务提供模式,就必须进行管理和文化转变,包括制定政策、提供技术支持以及为临床团队提供资源支持。远程保健可通过改善与初级保健的衔接并及时提供专家意见来满足日益增长的服务需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Environmental Factors for Sustained Telehealth Use in Mental Health Services: A Mixed Methods Analysis.

Background: The mental health service delivery gap remains high globally. Appropriate telehealth use may increase capacity through flexible remote care provision. Despite the historical lack of telehealth integration into publicly funded mental health services, during COVID-19 lockdowns, services rapidly switched to telephone and audiovisual care provision. In Aotearoa New Zealand (NZ), this was abandoned when no longer required by COVID-19 restrictions. This study explores environmental factors associated with telehealth implementation and ongoing use or discontinuation across a multiregional outpatient mental health service. This work contributes to understanding system-level factors influencing telehealth use and thus informs policy and practice in postpandemic environments. Methods: This mixed methods study applied an interpretive description methodology. Semistructured interviews with 33 mental health clinicians were thematically analysed. Qualitative findings were reframed and evaluated using time series analyses of population-level quantitative data (prior to and throughout the pandemic). Findings were synthesised with qualitative themes to develop an understanding of environmental factors contributing to telehealth use. Results: Findings highlighted an increase in clients assessed by mental health services and declining clinician numbers, contributing to pressure placed on clinicians. There was a lack of culture supporting telehealth, including limited awareness, leadership, and champions to facilitate implementation. Some teams provided services suited to telehealth; other subspeciality teams had limited applications for telehealth. There was a general lack of policy and guidelines to support telehealth use and limited technical support for clinicians unfamiliar with audiovisual software. Conclusion: Disorganised telehealth adoption in the study regions provides insight into wider environmental drivers affecting telehealth uptake. For telehealth to become a workable service delivery mode following COVID-19, stewardship and culture shifts are required, including policy development, technical support, and resources to support clinical teams. Telehealth may address growing service demand by improving interfaces with primary care and providing timely access to specialist input.

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来源期刊
CiteScore
6.90
自引率
2.30%
发文量
19
审稿时长
12 weeks
期刊介绍: The overall aim of the International Journal of Telemedicine and Applications is to bring together science and applications of medical practice and medical care at a distance as well as their supporting technologies such as, computing, communications, and networking technologies with emphasis on telemedicine techniques and telemedicine applications. It is directed at practicing engineers, academic researchers, as well as doctors, nurses, etc. Telemedicine is an information technology that enables doctors to perform medical consultations, diagnoses, and treatments, as well as medical education, away from patients. For example, doctors can remotely examine patients via remote viewing monitors and sound devices, and/or sampling physiological data using telecommunication. Telemedicine technology is applied to areas of emergency healthcare, videoconsulting, telecardiology, telepathology, teledermatology, teleophthalmology, teleoncology, telepsychiatry, teledentistry, etc. International Journal of Telemedicine and Applications will highlight the continued growth and new challenges in telemedicine, applications, and their supporting technologies, for both application development and basic research. Papers should emphasize original results or case studies relating to the theory and/or applications of telemedicine. Tutorial papers, especially those emphasizing multidisciplinary views of telemedicine, are also welcome. International Journal of Telemedicine and Applications employs a paperless, electronic submission and evaluation system to promote a rapid turnaround in the peer-review process.
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