通过持续远程辅导重新定义获得精神卫生保健的途径:与初级保健医生即时协作视频咨询的报告。

IF 2 Q3 PSYCHIATRY
Chandana Sabbella, Hetashri Shah, Prakyath Ravindranath Hegde, Rahul Patley, Sivakami Sundari Subramanian, Manjunatha Narayana, Naveen Kumar Channaveerachari, Suresh Bada Math
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引用次数: 0

摘要

背景:指导初级保健医生(PCDs)提高他们的能力,并有助于将精神病学护理纳入初级保健,特别是在资源有限的情况下。本研究评估了即时协作视频咨询(i-CVCs)的社会人口学、诊断和治疗分析,以及远程精神科医生对pcd的诊断(领域智能和无序智能)和治疗一致性。方法:这是一项横断面研究,是数字驱动的能力建设计划的一部分,该计划通过远程精神科医生的i- cvc向pcd提供远程指导。对2022年11月至2024年7月期间进行的382例i-CVCs进行了诊断和治疗分析。采用Cohen’s kappa (n = 358)评估远程精神病医生与PCDs之间的一致性。结果:在远程精神科医生的领域诊断分布中,以常见精神障碍(CMDs)为主(47.7%),以抑郁症为主(22.5%)。分析显示PCDs和远程精神科医生在主要领域的诊断一致性非常好:SUD (κ = 0.96), SMD (κ = 0.81)和CMD (κ = 0.75),均p < 0.001。酒精障碍的紊乱性一致性最高(κ = 0.96)。治疗一致性也显示所有主要类型的精神药物(κ = 0.5至0.6;p < .001),包括抗抑郁药、抗精神病药、苯二氮卓类药物和尼古丁替代疗法的治疗一致性中等。寻求i-CVC支持主要是为了确认诊断/治疗并澄清剂量策略。结论:i-CVCs促进了实时学习,提高了在现场初级保健诊所管理精神疾病的信心,展示了一种可扩展的方法来解决治疗差距。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Redefining Access to Mental Health Care Through Sustained Tele-mentoring: A Report of the Instant Collaborative Video Consultations with Primary Care Doctors.

Background: Mentoring primary care doctors (PCDs) improves their competency and aids in integrating psychiatric care into primary care, especially in resource-constrained settings. This study evaluates the socio-demographic, diagnostic, and treatment profiling of instant collaborative video consultations (i-CVCs) and the diagnostic (domain-wise and disorder-wise) and treatment concordance of PCDs with tele-psychiatrists.

Methods: This was a cross-sectional study that was a part of a digitally driven capacity-building program that provided tele-mentoring to PCDs via i-CVCs with tele-psychiatrists. A total of 382 i-CVCs conducted between November 2022 and July 2024 were analyzed for diagnostic and treatment profiling. Concordance between PCDs and tele-psychiatrists was assessed using Cohen's kappa (n = 358).

Results: Among the domain-wise diagnostic distribution by the tele-psychiatrist, the majority were classified as common mental disorders (CMDs) (47.7%), and among the disorder-wise distribution, the majority was depressive disorder (22.5%). The analysis revealed very good to good diagnostic agreement between PCDs and tele-psychiatrists across major domains: SUD (κ = 0.96), SMD (κ = 0.81), and CMD (κ = 0.75), all with p < .001. Disorder-wise concordance was highest for alcohol disorders (κ = 0.96). Treatment concordance also showed moderate agreement for all the major classes of psychotropic medications (κ = 0.5 to 0.6; p < .001), including antidepressants, antipsychotics, benzodiazepines, and nicotine replacement therapy. i-CVC support was primarily sought for diagnostic/treatment confirmation and clarification on dosage strategies.

Conclusions: i-CVCs facilitate real-time learning and improve confidence in managing psychiatric disorders within live primary care clinics, demonstrating a scalable approach to address the treatment gap.

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来源期刊
CiteScore
4.80
自引率
7.10%
发文量
116
审稿时长
12 weeks
期刊介绍: The Indian Journal of Psychological Medicine (ISSN 0253-7176) was started in 1978 as the official publication of the Indian Psychiatric Society South Zonal Branch. The journal allows free access (Open Access) and is published Bimonthly. The Journal includes but is not limited to review articles, original research, opinions, and letters. The Editor and publisher accept no legal responsibility for any opinions, omissions or errors by the authors, nor do they approve of any product advertised within the journal.
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