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Sheriff R, Hong JSW, Henshall C, D'Agostino A, Tomassi S, Stein HC, Cerveri G, Cibra C, Bonora S, Giordano B, Smith T, Phiri P, Asher C, Elliot K, Zangani C, Ede R, Saad F, Smith KA, Cipriani A. Evaluation of telepsychiatry during the COVID-19 pandemic across service users, carers and clinicians: an international mixed-methods study. BMJ MENTAL HEALTH 2023; 26:e300646. [PMID: 37567731 PMCID: PMC10577786 DOI: 10.1136/bmjment-2022-300646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/14/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND Worldwide uptake of telepsychiatry accelerated during the COVID-19 pandemic. OBJECTIVE To conduct an evaluation of the opinions, preferences and attitudes to telepsychiatry from service users, carers and clinicians in order to understand how telepsychiatry can be best used in the peri/post-COVID-19 era. METHODS This mixed-methods, multicentre, international study of telepsychiatry was set in two sites in England and two in Italy. Survey questionnaires and focus group topic guides were co-produced for each participant group (service users, carers and clinicians). FINDINGS In the UK, 906 service users, 117 carers and 483 clinicians, and in Italy, 164 service users, 56 carers and 72 clinicians completed the surveys. In all, 17 service users/carers and 14 clinicians participated in focus groups. Overall, telepsychiatry was seen as convenient in follow-ups with a specific purpose such as medication reviews; however, it was perceived as less effective for establishing a therapeutic relationship or for assessing acutely disturbed mental states. In contrast to clinicians, most service users and carers indicated that telepsychiatry had not improved during the COVID-19 pandemic. Most service users and carers reported that the choice of appointment modality was most often determined by the service or clinician. CONCLUSION AND RELEVANCE There were circumstances in which telepsychiatry was seen as more suitable than others and clear differences in clinician, carer and service user perspectives on telepsychiatry. CLINICAL IMPLICATIONS All stakeholders should be actively engaged in determining a hybrid model of care according to clinical features and service user and carer preferences. Clinicians should be engaged in training programmes on telepsychiatry.
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Affiliation(s)
- Rebecca Sheriff
- Department of Psychiatry, Oxford University, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - James S W Hong
- Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Precision Psychiatry Lab, Oxford Health Biomedical Research Centre, Oxford, UK
| | - Catherine Henshall
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
- Oxford Institute of Nursing, Midwifery and Allied Health Research (OxINMAHR), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Armando D'Agostino
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Simona Tomassi
- Psychiatric Unit 1, Azienda ULSS 9 Scaligera, Verona, Italy
| | | | | | - Chiara Cibra
- Department of Psychiatry and Addiction, ASST Lodi, Lodi, Italy
| | - Stefano Bonora
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Barbara Giordano
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Tanya Smith
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Peter Phiri
- Research & Innovation Department, Southern Health NHS Foundation Trust, Southampton, UK
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Carolyn Asher
- Research & Innovation Department, Southern Health NHS Foundation Trust, Southampton, UK
| | - Kathryn Elliot
- Research & Innovation Department, Southern Health NHS Foundation Trust, Southampton, UK
| | - Caroline Zangani
- Department of Psychiatry, Oxford University, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Precision Psychiatry Lab, Oxford Health Biomedical Research Centre, Oxford, UK
| | - Roger Ede
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Fathi Saad
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Katharine Alison Smith
- Department of Psychiatry, Oxford University, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Precision Psychiatry Lab, Oxford Health Biomedical Research Centre, Oxford, UK
| | - Andrea Cipriani
- Department of Psychiatry, Oxford University, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
- Oxford Precision Psychiatry Lab, Oxford Health Biomedical Research Centre, Oxford, UK
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de Las Cuevas C, Gutiérrez-Rojas L, Alvarez-Mon MA, Andreu-Bernabeu Á, Capitán L, Gómez JC, Grande I, Hidalgo-Mazzei D, Mateos R, Moreno-Gea P, De Vicente-Muñoz T, Ferre F. Evaluating the Effect of a Telepsychiatry Educational Program on the Awareness, Knowledge, Attitude, and Skills of Telepsychiatry Among Spanish Psychiatrists during COVID-19 Pandemic. Telemed J E Health 2023; 29:102-108. [PMID: 35549720 DOI: 10.1089/tmj.2022.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Introduction: The COVID-19 pandemic has renewed the interest in telepsychiatry as a way to help psychiatrists care for their patients, but mental health providers' unfamiliarity and concerns may impede implementation of such services. This study aimed to determine the effect of an online educational intervention on awareness, knowledge, attitude, and skills (AKAS) of telepsychiatry among psychiatrists. Methods: The study used a pre-post-test design to compare AKAS of telepsychiatry among psychiatrists participating in an online course of practical telepsychiatry. The telemedicine AKAS questionnaire adapted to telepsychiatry was applied before and after the educational intervention, during the months of October to December 2020. Results: Responses from 213 participants were analyzed before the educational intervention and from 152 after it. The knowledge showed by Spanish psychiatrists before the educational intervention was good in 61% of participants, fair in 37%, and inadequate in 2%. With respect to attitudes toward telepsychiatry, 62% self-reported a high attitude, 33% moderate, and 5% low. With regard self-reported skills, 57% of the participating psychiatrists were highly skilled or experts, 22% moderately skilled, and 9% unskilled in handling telepsychiatry equipment. Despite the high baseline values, the educational intervention significantly improved psychiatrists' awareness, knowledge and attitudes toward telepsychiatry although not their skills. Conclusions: Online course of practical telepsychiatry was effective although future editions need to improve its focus on skills. This educational intervention represents an effort to promote the implementation of telepsychiatry as a health care alternative.
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Affiliation(s)
- Carlos de Las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry and Instituto Universitario de Neurociencia (IUNE), University of La Laguna, Canary Islands, Spain
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry, Hospital Universitario San Cecilio, Granada, Spain.,Department of Psychiatry, University of Granada, Granada, Spain
| | - Miguel A Alvarez-Mon
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Álvaro Andreu-Bernabeu
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, School of Medicine, Hospital General Universitario Gregorio Marañón, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Luis Capitán
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Juan Carlos Gómez
- Global Head of Medical Science, Shionogi & Co, London, United Kingdom
| | - Iria Grande
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Diego Hidalgo-Mazzei
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - Raimundo Mateos
- Psychogeriatric Unit, Department of Psychiatry, University of Santiago de Compostela, CHUS University Hospital, Santiago de Compostela, Spain
| | | | | | - Francisco Ferre
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Baart N, Hoving JL, Donker-Cools BHPM. Physicians' perspectives and future vision on disability assessments by phone during the COVID-19 pandemic: a cross-sectional survey. BMC Health Serv Res 2022; 22:687. [PMID: 35606761 PMCID: PMC9125537 DOI: 10.1186/s12913-022-08068-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 04/26/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Physicians, who perform disability assessments for the Dutch Social Security Institute, were urged to conduct phone consultations from their homes to prevent the spread of COVID-19. The purpose of the study was to evaluate the perspectives of physicians regarding phone consultations during the COVID-19 pandemic. Additionally, to explore physicians' views on a more widespread future use of phone consultations in the context of work disability assessments. METHODS An electronic survey conducted from June to August 2020 included 41 statements categorized into themes previously identified in both the literature on physicians' phone consultations and emerging from daily practice. All 1081 physicians working at the Dutch Social Security Institute were invited by e-mail to participate in the survey. Participants indicated on a 5-point Likert scale whether they strongly disagreed, disagreed, neither agreed nor disagreed, agreed or strongly agreed with the statements. The collected data were analysed using descriptive statistics. RESULTS In general, physicians had become accustomed to perform phone consultations. Negative experiences included difficulties in getting an impression of patients and assessing patients' functional limitations. About half of physicians found that phone consultations took more effort, 61% asked more questions due to no direct patient observations. According to 67%, it is mostly necessary to perform an in-person consultation to adequately assess functional limitations of a patient with persistent medically unexplained physical symptoms. A great majority did not prefer telephone consultations to in-person consultations. However, more than half of physicians perceive a greater preference for phone consultations in the future than previously. 56% thought that replacement of in-person consultations with phone consultations in the future might lead to more complaints. CONCLUSIONS Perspectives and future views varied among physicians performing disability assessments by phone. A majority of physicians experienced difficulties with different aspects of the assessment. Despite these difficulties, most physicians support to continue the wider use of phone consultations. To improve remote disability assessments it is required to gain more insights into conditions under which a phone assessment can be as diligent as an in-person assessment.
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Affiliation(s)
- Nadia Baart
- Social Security Institute, Social Medical Affairs division, PO Box 58285, 1040 HG Amsterdam, the Netherlands
| | - Jan Lucas Hoving
- Coronel Institute of Occupational Health, Department of Public and Occupational Health, Amsterdam UMC and Research Center for Insurance Medicine, PO Box 22700, 1100 DE Amsterdam, the Netherlands
| | - Birgit Helena Petra Maria Donker-Cools
- Social Security Institute, Social Medical Affairs division, PO Box 58285, 1040 HG Amsterdam, the Netherlands
- Coronel Institute of Occupational Health, Department of Public and Occupational Health, Amsterdam UMC and Research Center for Insurance Medicine, PO Box 22700, 1100 DE Amsterdam, the Netherlands
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Orsolini L, Bellagamba S, Marchetti V, Menculini G, Tempia Valenta S, Salvi V, Volpe U. A Preliminary Italian Cross-Sectional Study on the Level of Digital Psychiatry Training, Knowledge, Beliefs and Experiences among Medical Students, Psychiatry Trainees and Professionals. Healthcare (Basel) 2022; 10:healthcare10020390. [PMID: 35207004 PMCID: PMC8871870 DOI: 10.3390/healthcare10020390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic led to the implementation of digital psychiatry (DP), resulting in the need for a new skilled healthcare workforce. The purpose of this study was to investigate the level of training, knowledge, beliefs, and experiences of young mental health professionals and medical students in DP. An ad hoc cross-sectional survey was administered and descriptive analyses, Student’s t and ANOVA tests were conducted, together with an exploratory factor analysis, bivariate correlations and linear regression. Most of the sample (N = 239) declared that DP was never discussed within their academic training (89.1%), mainly revealing an overall lack of knowledge on the issue. Nevertheless, subjects mostly declared that DP represents a valuable therapeutic tool in mental health (80%) and that their training should include this topic (54.4%). Moreover, most subjects declared that digital interventions are less effective than face-to-face ones (73.2%), despite the emerging evidence that being trained in DP is significantly associated with the belief that digital and in-person interventions are comparable in their effectiveness (p ≤ 0.05). Strong positive correlations were found between the knowledge score (KS) and perceived significance index (PSI) (r = 0.148, p < 0.001), and KS and Digital Psychiatry Opinion (DPO) index (r = 0.193, p < 0.001). PSI scores statistically significantly predicted KS total scores (F(1, 237) = 5.283, R2 = 0.022, p = 0.022). KS scores statistically significantly predicted DPO total scores (F(1, 237) = 9.136, R2 = 0.037, p = 0.003). During the current pandemic, DP represented an ideal response to the forced physical distancing by ensuring the advantage of greater access to care. However, this kind of intervention is still uncommon, and mental health professionals still prove to be skeptical. The lack of formal training on DP during the academic years could be a limiting factor.
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Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, 60126 Ancona, Italy; (L.O.); (S.B.); (S.T.V.); (V.S.)
| | - Silvia Bellagamba
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, 60126 Ancona, Italy; (L.O.); (S.B.); (S.T.V.); (V.S.)
| | - Virginia Marchetti
- School of Medicine and Surgery, Polytechnic University of Marche, 60126 Ancona, Italy;
| | - Giulia Menculini
- Department of Psychiatry, University of Perugia, 06100 Perugia, Italy;
| | - Silvia Tempia Valenta
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, 60126 Ancona, Italy; (L.O.); (S.B.); (S.T.V.); (V.S.)
| | - Virginio Salvi
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, 60126 Ancona, Italy; (L.O.); (S.B.); (S.T.V.); (V.S.)
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, 60126 Ancona, Italy; (L.O.); (S.B.); (S.T.V.); (V.S.)
- Correspondence:
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