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Florence AC, Stefančić A, Sheitman A, Fidaleo K, Bello I, Dixon L, Drake RE, Nossel I, Cabassa LJ, Montague E, Pagdon S, Lyn J, Patel SR. Client and family experiences with telehealth-delivered early psychosis services. Early Interv Psychiatry 2024. [PMID: 38945691 DOI: 10.1111/eip.13550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 03/02/2024] [Accepted: 05/08/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE The COVID-19 pandemic prompted a significant shift to delivering early psychosis services using telehealth. Little is known about the experience of using telehealth in early psychosis services. This quality improvement qualitative project investigated the experiences of program participants and family members with telehealth services in OnTrackNY, an early intervention program for psychosis in New York State during the COVID-19 pandemic. METHODS The project team conducted individual interviews and focus groups. Data analyses used a matrix approach. RESULTS Nineteen OnTrackNY program participants and nine family members participated in five focus groups and nine individual interviews. Data were organized into five themes (a) accessibility: most individuals had a device and internet access and challenges were related to connectivity, such as image freezing and sound breaking; (b) convenience/flexibility: benefits included the reduced commute and costs; (c) levels of comfort/privacy with telehealth: program participants felt less judged and less anxiety leading up to in-person appointments while also expressing privacy concerns; (d) sense of connectedness: in-person social connections were deemed important and not replaceable by telehealth; and (e) suggestions: program participants expressed a preference for in-person group activities and suggested hybrid options, highlighting the importance of in-person visits to establish rapport at the beginning of treatment before transitioning to telehealth. CONCLUSIONS Telehealth services were generally well accepted. Suggestions for future service delivery include offering a combination of telehealth and in-person services based on program participants' preferences and prioritizing in-person services during the early phase of treatment.
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Affiliation(s)
- Ana Carolina Florence
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Ana Stefančić
- Department of Psychiatry, Columbia University, New York, New York, USA
- Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York, USA
| | | | - Kaleigh Fidaleo
- New York State Psychiatric Institute, New York, New York, USA
| | - Iruma Bello
- New York State Psychiatric Institute, New York, New York, USA
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Lisa Dixon
- New York State Psychiatric Institute, New York, New York, USA
- Department of Psychiatry, Columbia University, New York, New York, USA
| | - Robert Eldon Drake
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Ilana Nossel
- New York State Psychiatric Institute, New York, New York, USA
- Columbia University Irving Medical Center, New York, New York, USA
| | - Leopoldo J Cabassa
- George Warren Brown School of Social Work, Washington University in St. Louis, St Louis, Missouri, USA
| | | | | | | | - Sapana R Patel
- New York State Psychiatric Institute, New York, New York, USA
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
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Van Denend T, Mathiowetz V, Preissner K, Bethoux F, Finlayson M, Packer T, Ghahari S, Plow M. Adapting the Multiple Sclerosis Functional Composite for Telehealth Administration Using Videoconference Delivery: Methodological Considerations and Interrater Reliability. Arch Rehabil Res Clin Transl 2024; 6:100337. [PMID: 39006110 PMCID: PMC11240042 DOI: 10.1016/j.arrct.2024.100337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024] Open
Abstract
Objective To describe the adaptations made and to examine interrater reliability and feasibility of administering a telehealth version of the Multiple Sclerosis Functional Composite (tele-MSFC). Design The Multiple Sclerosis Functional Composite (MSFC) is a commonly used, in-person clinical outcome assessment. It is composed of the timed 25-Foot Walk Test (T25FWT), Nine-Hole Peg Test (NHPT), and Paced Auditory Serial Addition Test (PASAT). The MSFC was adapted for videoconference administration as part of a larger clinical trial. One of the adaptations included administering a timed 12.5-Foot Walk Test (T12.5FWT) for participants who did not have adequate space in their homes for the T25FWT. Participants, examiners, and raters completed surveys online about their satisfaction and experience with tele-MSFC. Setting Participants underwent the tele-MSFC in their homes using a laptop or smartphone while examiners scored the tele-MSFC in real-time at a remote location. Participants Community-dwelling adults (n=61) with mild-to-moderate multiple sclerosis (MS) symptoms. Interventions Not applicable. Main Outcome Measure Tele-MSFC. Results Intraclass correlation coefficients (ICC) assessed interrater reliability between the examiner and 2 independent raters who later scored a recording of the tele-MSFC. Interrater reliability was excellent (ICC>0.90) for all tests, including the T12.5FWT. Participants were highly satisfied with tele-MSFC. However, challenges included adequate space for T25FWT, technical difficulties, and safety and privacy considerations of individuals with moderate impairments who were requested to have their caregivers present during testing. Conclusion The tele-MSFC is reliable and feasible to administer with adaptations for community-dwelling adults with mild to moderate MS symptoms. Further validation of T12.5FWT is needed.
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Affiliation(s)
- Toni Van Denend
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL
| | - Virgil Mathiowetz
- Program in Occupational Therapy, University of Minnesota, Minneapolis, MN
| | - Katharine Preissner
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL
| | - Francois Bethoux
- Department of Physical Medicine and Rehabilitation, Neurological Institute, The Cleveland Clinic Foundation, Cleveland, OH
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Tanya Packer
- School of Occupational Therapy and School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Nursing, Umea University, Umea, Sweden
| | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Matthew Plow
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
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Rushton CM, Kelly PJ, Thomas T, Beck AK, Townsend C, Baker AL, Manning V, Argent A, Deane FP, Hides L, Hitsman B, Velleman R, Velleman G, Larance B. SMART Family and Friends: Feasibility and outcomes of a video-conference delivered intervention for families impacted by another's methamphetamine use. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 161:209355. [PMID: 38548059 DOI: 10.1016/j.josat.2024.209355] [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: 04/18/2023] [Revised: 12/20/2023] [Accepted: 03/23/2024] [Indexed: 05/15/2024]
Abstract
INTRODUCTION Families affected by another's substance use, including methamphetamine, experience harms to their mental and physical health. Yet, research has paid little attention to support and service needs of this population. This pilot study examines the feasibility and outcomes of SMART Family and Friends, a video-conference-delivered mutual-support group targeting families affected by another's methamphetamine use. METHODS Recruitment for this study occurred between March-October 2021 via the SMART Recovery Australia website. Participants were English-speaking Australian residents, ≥18 years, affected by another's methamphetamine use, interested in participating in a manualised eight-module group delivered via video-conferencing. Feasibility was evaluated by attendance rates, participant satisfaction, fidelity ratings, and semi-structured interviews. Measures of distress, quality of life, and family functioning assessed outcomes at baseline and one-month post-treatment conclusion. RESULTS Forty-three participants commenced SMART Family and Friends groups. 84 % (n = 36) completed ≥4 modules, 67 % (n = 29) completed ≥6, and 42 % (n = 18) completed all 8 modules. Participant satisfaction (M = 4.32, SD = 0.66, out of 5) and facilitator fidelity (>94 % for all modules) were high. A within-group analysis, without comparison condition demonstrated significant improvements in psychological distress (d = 0.38), family impact (d = 0.64), family strain symptoms (d = 0.48), and total family burden (d = 0.69) post-treatment. Qualitative findings illustrated the benefits and challenges of the video-conference-delivered group, as well as recommendations for improvement. CONCLUSIONS Results provide initial support for the feasibility and positive outcomes of the SMART Family and Friends program. These findings demonstrate the successful provision of a mutual-support group for affected families delivered via video-conferencing, and merit further sufficiently powered randomised-control-trials to evaluate efficacy.
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Affiliation(s)
- Clare M Rushton
- School of Psychology, University of Wollongong, Wollongong, Australia.
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Tamsin Thomas
- School of Psychology, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Alison K Beck
- School of Psychology, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Camilla Townsend
- School of Psychology, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Victoria Manning
- Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | | | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Leanne Hides
- Centre for Youth Substance Abuse Research, Lives Lived Well Group, School of Psychology, University of Queensland, Brisbane, Australia
| | - Brian Hitsman
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Richard Velleman
- Department of Psychology, University of Bath, Bath, UK; Addictions and Related Research Group, Sangath, Goa, India
| | - Gill Velleman
- Addictions and Related Research Group, Sangath, Goa, India
| | - Briony Larance
- School of Psychology, University of Wollongong, Wollongong, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
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Poljo A, Tynes DM, Timper K, Süsstrunk J, Kraljević M, Peterli R, Billeter AT, Müller-Stich BP, Klasen JM. Breaking down barriers to bariatric care: a qualitative study on how telemedicine could transform patient experiences in a Swiss monocentric setting. BMJ Open 2024; 14:e083142. [PMID: 38772586 PMCID: PMC11110597 DOI: 10.1136/bmjopen-2023-083142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/30/2024] [Indexed: 05/23/2024] Open
Abstract
OBJECTIVE Telemedicine is becoming an increasingly feasible option for patients with chronic diseases due to its convenience, cost-effectiveness and ease of access. While there are certain limitations, the benefits can be appreciated by those seeking repetitive care. The perception of telemedicine as an alternative to recurrent, in-person appointments for patients with obesity in structured bariatric programmes is still unclear. This content analysis' primary endpoint was to explore how patients within our bariatric programme perceived telemedicine and virtual consultations as a new way of communication during COVID-19. DESIGN A qualitative study using semistructured interviews and qualitative content analysis method by Elo and Kyngäs following four steps: data familiarisation, coding and categorising with Quirkos software and final interpretation guided by developed categories. SETTING University Hospital, Switzerland. PARTICIPANTS We conducted 33 interviews with 19 patients from a structured bariatric programme. RESULTS Most patients shared positive experiences, acknowledging the convenience and accessibility of virtual appointments. Others voiced concerns, especially regarding telemedicine's limitations. These reservations centred around the lack of physical examinations, difficulties in fostering connections with healthcare providers, as well as barriers stemming from language and technology. The research identified a spectrum of patient preferences in relation to telemedicine versus in-person visits, shaped by the immediacy of their concerns and their availability. CONCLUSION While telemedicine is increasingly accepted by the public and provides accessible and cost-effective options for routine follow-up appointments, there are still obstacles to overcome, such as a lack of physical examination and technological limitations. However, integrating virtual alternatives, like phone or video consultations, into routine bariatric follow-ups could improve continuity and revolutionise bariatric care.
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Affiliation(s)
- Adisa Poljo
- Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St. Claraspital and University Hospital Basel, Basel, Switzerland
| | - Deborah M Tynes
- Clinic of Endocrinology, Diabetes and Metabolism, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Katharina Timper
- Division of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Julian Süsstrunk
- Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St. Claraspital and University Hospital Basel, Basel, Switzerland
| | - Marko Kraljević
- Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St. Claraspital and University Hospital Basel, Basel, Switzerland
| | - Ralph Peterli
- Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St. Claraspital and University Hospital Basel, Basel, Switzerland
| | - Adrian T Billeter
- Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St. Claraspital and University Hospital Basel, Basel, Switzerland
| | - Beat P Müller-Stich
- Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St. Claraspital and University Hospital Basel, Basel, Switzerland
| | - Jennifer M Klasen
- Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St. Claraspital and University Hospital Basel, Basel, Switzerland
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Hooley C, Adams DR, Ng WY, Wendt CLE, Dennis CB. Key actors in behavioral health services availability and accessibility research: a scoping review bibliometric analysis. DISCOVER MENTAL HEALTH 2024; 4:15. [PMID: 38700757 PMCID: PMC11068714 DOI: 10.1007/s44192-024-00068-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/18/2024] [Indexed: 05/06/2024]
Abstract
This bibliometric review aims to identify key actors in the behavioral health services availability/accessibility literature. Coalescing information about these actors could support subsequent research efforts to improve the availability and accessibility of behavioral health services. The authors used a scoping review method and a bibliometric approach. The articles came from Medline, Embase, Web of Science, CINAHL, and PsycINFO. Articles were included if they assessed behavioral health service availability or accessibility quantitatively and were written in English. The final sample included 265 articles. Bibliometric data were extracted, coded, and verified. The authors analyzed the data using univariate and social network analyses. Publishing in this area has become more consistent and has grown since 2002. Psychiatric Services and Graduate Theses were the most frequently used publication venues. The National Institute on Drug Abuse, National Institute of Mental Health, and the Veterans Administration funded the most research. The most frequently used keyword was "health services accessibility." The findings suggest that this literature is growing. There are a few clusters of researchers in this area. Government organizations primarily fund this research. The paper and supplementary materials list the top researchers, publication venues, funding sources, and key terms to promote further behavioral health availability/accessibility research.
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Affiliation(s)
- Cole Hooley
- School of Social Work Brigham Young University, 2190 JFSB, Provo, UT, 84602, USA.
| | - Danielle R Adams
- Center for Mental Health Services Research Brown School of Social Work and Public Health, Washington University in St. Louis, St. Louis, MO, USA
| | - Wai Yan Ng
- School of Social Work Brigham Young University, 2190 JFSB, Provo, UT, 84602, USA
| | - Carrie L E Wendt
- School of Social Work Brigham Young University, 2190 JFSB, Provo, UT, 84602, USA
| | - Cory B Dennis
- School of Social Work Brigham Young University, 2190 JFSB, Provo, UT, 84602, USA
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Kristen A, Moretti MM, Osman F. "It opened a new door for me": A qualitative study of forcibly displaced parents' experiences of an attachment-based parenting program. Clin Child Psychol Psychiatry 2024; 29:700-712. [PMID: 37728567 PMCID: PMC10945979 DOI: 10.1177/13591045231202875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
The aim of the study was to explore forcibly displaced parents' experiences of how an online attachment-based parenting program (eConnect) impacted their relationships with their teens. Data was collected from four focus group discussions with 28 parents who participated in the eConnect program. Data was analyzed using network thematic analysis. A global theme emerged from the analysis: Strengthened Parent-Teen Relationships. Four underpinning organizing themes described the process through which the parent-teen relationship was strengthened: Knowledge Served as the Foundation for Change, Increased Parental Self-Efficacy, Improved Emotional Attunement Facilitates Dyadic Affect Regulation, and Shifted Power Dynamics and Emerging Mutual Parent-Teen Partnership. Findings suggest that eConnect is promising intervention for strengthening parent-teen relationships and supporting forcibly displaced families.
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Affiliation(s)
- Anna Kristen
- Department of Psychology, Simon Fraser University, Canada
| | | | - Fatumo Osman
- School of Health and Welfare, Dalarna University, Sweden
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Chakrabarti S. Digital psychiatry in low-and-middle-income countries: New developments and the way forward. World J Psychiatry 2024; 14:350-361. [PMID: 38617977 PMCID: PMC11008387 DOI: 10.5498/wjp.v14.i3.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/28/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
Low- and middle-income countries (LMICs) bear the greater share of the global mental health burden but are ill-equipped to deal with it because of severe resource constraints leading to a large treatment gap. The remote provision of mental health services by digital means can effectively augment conventional services in LMICs to reduce the treatment gap. Digital psychiatry in LMICs has always lagged behind high-income countries, but there have been encouraging developments in the last decade. There is increasing research on the efficacy of digital psychiatric interventions. However, the evidence is not adequate to conclude that digital psychiatric interventions are invariably effective in LMICs. A striking development has been the rise in mobile and smartphone ownership in LMICs, which has driven the increasing use of mobile technologies to deliver mental health services. An innovative use of mobile technologies has been to optimize task-shifting, which involves delivering mental healthcare services in community settings using non-specialist health professionals. Emerging evidence from LMICs shows that it is possible to use digital tools to train non-specialist workers effectively and ensure that the psychosocial interventions they deliver are efficacious. Despite these promising developments, many barriers such as service costs, underdeveloped infrastructure, lack of trained professionals, and significant disparities in access to digital services impede the progress of digital psychiatry in LMICs. To overcome these barriers, digital psychiatric services in LMICs should address contextual factors influencing the delivery of digital services, ensure collaboration between different stakeholders, and focus on reducing the digital divide.
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Affiliation(s)
- Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, UT, India
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Sperling SA, Acheson SK, Fox-Fuller J, Colvin MK, Harder L, Cullum CM, Randolph JJ, Carter KR, Espe-Pfeifer P, Lacritz LH, Arnett PA, Gillaspy SR. Tele-Neuropsychology: From Science to Policy to Practice. Arch Clin Neuropsychol 2024; 39:227-248. [PMID: 37715508 DOI: 10.1093/arclin/acad066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to accelerate the number of randomized experimental studies of the reliability and validity in-home tele-neuropsychological testing (tele-np-t). METHOD We conducted a critical review of the tele-neuropsychology literature. We discuss this research in the context of the United States' public and private healthcare payer systems, including the Centers for Medicare & Medicaid Services (CMS) and Current Procedural Terminology (CPT) coding system's telehealth lists, and existing disparities in healthcare access. RESULTS The number of tele-np publications has been stagnant since the onset of the COVID-19 pandemic. There are less published experimental studies of tele-neuropsychology (tele-np), and particularly in-home tele-np-t, than other tele-np publications. There is strong foundational evidence of the acceptability, feasibility, and reliability of tele-np-t, but relatively few studies of the reliability and validity of in-home tele-np-t using randomization methodology. CONCLUSIONS More studies of the reliability and validity of in-home tele-np-t using randomization methodology are necessary to support inclusion of tele-np-t codes on the CMS and CPT telehealth lists, and subsequently, the integration and delivery of in-home tele-np-t services across providers and institutions. These actions are needed to maintain equitable reimbursement of in-home tele-np-t services and address the widespread disparities in healthcare access.
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Affiliation(s)
- Scott A Sperling
- Department of Neurology, Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA
| | | | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lana Harder
- Children's Health, Children's Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | | | - Patricia Espe-Pfeifer
- Department of Psychiatry and Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peter A Arnett
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
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Vasiliadis HM, Spagnolo J, Fleury MJ, Gouin JP, Roberge P, Bartram M, Grenier S, Shen-Tu G, Vena JE, Wang J. Factors associated with mental health service use during the pandemic: Initiation and barriers. Int J Soc Psychiatry 2024; 70:59-69. [PMID: 37646244 PMCID: PMC10860360 DOI: 10.1177/00207640231194489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BACKGROUND Scarce are the studies focusing on initiation of new mental health service use (MHSU) and distinguishing individuals who have sought services but have been unsuccessful in accessing these. AIMS Assessing the factors associated with initiating new MHSU as compared to no MHSU due to self-reported no need, no MHSU due to health system and personal barriers and MHSU using resources already in place. METHODS The sample included participants (n = 16,435) in the five established regional cohorts of the Canadian Partnership for Tomorrow's Health (CanPath) who responded to the CanPath COVID-19 health surveys (May-December 2020 and January-June 2021). Multinomial regression analyses were carried out to study MHSU since the pandemic (March 2020) as a function of predisposing, enabling and need factors. Analyses were carried out in the overall sample and restricted to those with moderate and severe symptoms (MSS) of depression and/or anxiety (n = 2,237). RESULTS In individuals with MSS of depression and/or anxiety, 14.4% reported initiating new MHSU, 22.0% had no MHSU due to barriers and personal reasons and 36.7% had no MHSU due to self-reported no need. Age, living alone, lower income, a decrease in income during the pandemic and health professional status were associated with MHSU. Younger adults were more likely to initiate MHSU during the pandemic than older adults who reported not being comfortable to seek mental health care or self-reported no need. Individuals living alone and with lower income were more likely to report not being able to find an appointment for mental health care. CONCLUSIONS Awareness campaigns focusing on older adults that explain the importance of seeking treatment is needed, as well as sensitising health professionals as to the importance of informing and aiding individuals at risk of social isolation and lower socio-economic status as to available mental health resources and facilitating access to care.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, QC, Canada
| | - Jessica Spagnolo
- Département des sciences de la santé communautaire, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche Charles-Le Moyne, Longueuil, QC, Canada
| | - Marie-Josée Fleury
- Douglas Mental Health University Institute, Verdun, QC, Canada
- McGill University, Montreal QC, Canada
| | - Jean-Philippe Gouin
- Department of Psychology, Concordia University, Montreal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Pasquale Roberge
- Département de médecine de famille et de médecine d’urgence, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Mary Bartram
- Mental Health Commission of Canada, Ottawa, ON, Canada
- School of Public Policy & Administration, Carleton University, Ottawa, ON, Canada
| | - Sébastien Grenier
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
- Département de psychologie, Université de Montréal, Montréal, QC, Canada
| | - Grace Shen-Tu
- Alberta’s Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Jennifer E. Vena
- Alberta’s Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - JianLi Wang
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
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Wilczewski H, Ong T, Ivanova J, Soni H, Barrera JF, Cummins MR, Welch BM, Bunnell BE. Telemedicine from Home or the Office: Perceptions of Mental Health Providers. Telemed J E Health 2024; 30:422-429. [PMID: 37466479 PMCID: PMC10877387 DOI: 10.1089/tmj.2023.0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/05/2023] [Accepted: 05/24/2023] [Indexed: 07/20/2023] Open
Abstract
Introduction: The COVID-19 pandemic led to a rapid transition to telemedicine for mental health care and redefined many providers' work environments and practices. The purpose of the study was to investigate the impact of work location on telemental health (TMH) benefits, disruptions, and concerns to further understand the rapid implementation of telemedicine for mental health treatment. Methods: A sample of 175 practicing TMH providers completed an online survey between July and August 2020. Providers answered questions about personal demographics and practice characteristics. Next, they answered questions about benefits, disruptions, and concerns regarding the use of telemedicine in their practice. Chi-square and independent samples t-test were conducted to identify work location differences for personal demographics and clinical practice characteristics. Three multivariate analyses of covariance were conducted to examine overall differences in perceptions of telemedicine benefits, concerns, and disruptions based on work location while covarying for provider race, ethnicity, percentage of caseload seen through telemedicine, practice type, specialty, and primary method of reimbursement. Results: TMH providers who primarily work from an office reported more benefit of reduced costs/overhead (ηp2 = 0.039), less benefit of limiting the spread of the virus (ηp2 = 0.028), and more concern about reimbursement (ηp2 = 0.046) than those who primarily work from home. We observed no difference in disruptions, patient access to care, quality of care, and work-life balance. Discussion: Exploration into work location of TMH providers aids in understanding of clinical workflows and provider wellbeing. Our findings suggest that telemedicine may be easily integrated into different types of clinical workflows and work locations.
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Affiliation(s)
| | - Triton Ong
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
| | - Julia Ivanova
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
| | - Hiral Soni
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
| | - Janelle F. Barrera
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
| | - Mollie R. Cummins
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
- College of Nursing and Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA
| | - Brandon M. Welch
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Brian E. Bunnell
- Doxy.me Research, Doxy.me, Inc., Rochester, New York, USA
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
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11
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O’Neill JC, O’Callaghan ET, Sullivan S, Winsberg M. Novel Telehealth Adaptations for Evidence-Based Outpatient Suicide Treatment: Feasibility and Effectiveness of the Crisis Care Program. Healthcare (Basel) 2023; 11:3158. [PMID: 38132048 PMCID: PMC10743225 DOI: 10.3390/healthcare11243158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
Background: Suicide rates in the United States have escalated dramatically over the past 20 years and remain a leading cause of death. Access to evidenced-based care is limited, and telehealth is well-positioned to offer novel care solutions. The Crisis Care program is a suicide-specific treatment program delivered within a national outpatient telehealth setting using a digitally adapted version of the Collaborative Assessment and Management of Suicidality (CAMS) as the framework of care. This study investigates the feasibility and preliminary effectiveness of Crisis Care as scalable suicide-specific treatment model. Methods: Patient engagement, symptom reduction, and care outcomes were examined among a cohort of patients (n = 130) over 16 weeks. The feasibility of implementation was assessed through patient engagement. Clinical outcomes were measured with PHQ-9, GAD-7, and the CAMS SSF-4 rating scales. Results: Over 85% of enrolled patients were approved for Crisis Care at intake, and 83% went on to complete at least four sessions (the minimum required to graduate). All patient subgroups experienced declines in depressive symptoms, anxiety symptoms, suicidal ideation frequency, and suicide-specific risk factors. Conclusions: Results support the feasibility and preliminary effectiveness of Crisis Care as a suicide-specific care solution that can be delivered within a stepped-care model in an outpatient telehealth setting.
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Affiliation(s)
- J. Conor O’Neill
- Brightside Health, 2471a Peralta Street, Oakland, CA 94607, USA (M.W.)
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12
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Alarcón Garavito GA, Burgess R, Dedios Sanguinetti MC, Peters LER, Vera San Juan N. Mental health services implementation in Colombia-A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001565. [PMID: 38055705 DOI: 10.1371/journal.pgph.0001565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 10/02/2023] [Indexed: 12/08/2023]
Abstract
Colombia's mental health services have a complex history shaped by 60 years of armed conflict, a predominantly clinical approach to mental health, and social factors such as inequities and stigma. The 1990 Caracas declaration proposed a shift towards decentralised community mental health services and interventions based on the recovery approach and emphasis on social determinants of mental health in the Americas. Colombia has adopted these approaches in its legal and practical framework in recent years, but implementation has been uneven. This systematic review aims to contribute to mental health services understanding in Colombia by examining the barriers and facilitators to the implementation of mental health services in Colombia. A search was conducted to explore available peer-reviewed studies on Colombian mental health services across five databases (Medline, PubMed, Scopus, Scielo and BVS) on quantitative and qualitative research papers published in the last ten years and without language restrictions. The Consolidated Framework for Implementation Research (CFIR) was used to structure the analysis and identify barriers and facilitators during the implementation of mental health services. We adapted the CFIR to attend to gender, race and age informed by the Socio-Political Economy of Global Mental Health framework, given the importance of these factors to the Colombian health landscape. Finally, narrative synthesis was used to summarise the data. 1 530 records were identified, and 12 articles met all inclusion criteria and were included in the analysis. 8 papers described substance use disorders services, 11 involved multidisciplinary healthcare professionals, and 7 were implemented at a local scale. The primary barriers to implementation were the lack of coordination, high workloads, and low funding. Facilitators included the use of protocols, and the involvement of communities, stakeholders, users, and external champions. Findings suggest the continued importance of community and recovery approaches and efforts to improve coordination between multi-sector actors involved in the mental health spaces (e.g., public, and private organisations, users and their families).
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Affiliation(s)
- Germán Andrés Alarcón Garavito
- Institute for Global Health-University College London, London, United Kingdom
- School of Government-Universidad de los Andes, Bogotá, Colombia
| | - Rochelle Burgess
- Institute for Global Health-University College London, London, United Kingdom
| | | | - Laura E R Peters
- Institute for Risk and Disaster Reduction, University College London, London, United Kingdom
- College of Earth, Ocean, and Atmospheric Sciences, Oregon State University, Corvallis, OR, United States of America
| | - Norha Vera San Juan
- Institute for Global Health-University College London, London, United Kingdom
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13
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Ramachandran M, Brinton C, Wiljer D, Upshur R, Gray CS. The impact of eHealth on relationships and trust in primary care: a review of reviews. BMC PRIMARY CARE 2023; 24:228. [PMID: 37919688 PMCID: PMC10623772 DOI: 10.1186/s12875-023-02176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Given the increasing integration of digital health technologies in team-based primary care, this review aimed at understanding the impact of eHealth on patient-provider and provider-provider relationships. METHODS A review of reviews was conducted on three databases to identify papers published in English from 2008 onwards. The impact of different types of eHealth on relationships and trust and the factors influencing the impact were thematically analyzed. RESULTS A total of 79 reviews were included. Patient-provider relationships were discussed more frequently as compared to provider-provider relationships. Communication systems like telemedicine were the most discussed type of technology. eHealth was found to have both positive and negative impacts on relationships and/or trust. This impact was influenced by a range of patient-related, provider-related, technology-related, and organizational factors, such as patient sociodemographics, provider communication skills, technology design, and organizational technology implementation, respectively. CONCLUSIONS Recommendations are provided for effective and equitable technology selection, application, and training to optimize the impact of eHealth on relationships and trust. The review findings can inform providers' and policymakers' decision-making around the use of eHealth in primary care delivery to facilitate relationship-building.
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Affiliation(s)
- Meena Ramachandran
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada.
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, QC, H3G 1Y5, Canada.
| | - Christopher Brinton
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada
- Michael G. DeGroote School of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - David Wiljer
- Education Technology Innovation, University Health Network, 190 Elizabeth St, Toronto, ON, M5G 2C4, Canada
- Department of Psychiatry, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
- Centre for Addiction and Mental Health, 1000 Queen St W, Toronto, ON, M6J 1H4, Canada
| | - Ross Upshur
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
| | - Carolyn Steele Gray
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
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14
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Antonacci G, Benevento E, Bonavitacola S, Cannavacciuolo L, Foglia E, Fusi G, Garagiola E, Ponsiglione C, Stefanini A. Healthcare professional and manager perceptions on drivers, benefits, and challenges of telemedicine: results from a cross-sectional survey in the Italian NHS. BMC Health Serv Res 2023; 23:1115. [PMID: 37853448 PMCID: PMC10585875 DOI: 10.1186/s12913-023-10100-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 10/01/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The Covid-19 pandemic provided new challenges and opportunities for patients and healthcare providers while accelerating the trend of digital healthcare transformation. This study explores the perspectives of healthcare professionals and managers on (i) drivers to the implementation of telemedicine services and (ii) perceived benefits and challenges related to the use of telemedicine across the Italian National Health Service. METHODS An online cross-sectional survey was distributed to professionals working within 308 healthcare organisations in different Italian regions. Quantitative and qualitative data were collected through a self-administered questionnaire (June-September 2021). Responses were analysed using summary statistics and thematic analysis. RESULTS Key factors driving the adoption of telemedicine have been grouped into (i) organisational drivers (reduce the virus spread-80%; enhance care quality and efficiency-61%), (ii) technological drivers (ease of use-82%; efficacy and reliability-64%; compliance with data governance regulations-64%) and (iii) regulatory drivers (regulations' semplification-84%). Nearly all respondents perceive telemedicine as useful in improving patient care (96%). The main benefits reported by respondents are shorter waiting lists, reduced Emergency Department attendance, decreased patient and clinician travel, and more frequent patient-doctor interactions. However, only 7% of respondents believe that telemedicine services are more effective than traditional care and 66% of the healthcare professionals believe that telemedicine can't completely substitute in-person visits due to challenges with physical examination and patient-doctor relationships. Other reported challenges include poor quality and interoperability of telemedicine platforms and scarce integration of telemedicine with traditional care services. Moreover, healthcare professionals believe that some groups of patients experience difficulties in accessing and using the technologies due to socio-cultural factors, technological and linguistic challenges and the absence of caregivers. CONCLUSIONS Respondents believe that telemedicine can be useful to complement and augment traditional care. However, many challenges still need to be overcome to fully consider telemedicine a standard of care. Strategies that could help address these challenges include additional regulations on data governance and reimbursements, evidence-based guidelines for the use of telemedicine, greater integration of tools and processes, patient-centred training for clinicians, patient-facing material to assist patients in navigating virtual sessions, different language options, and greater involvement of caregivers in the care process.
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Affiliation(s)
- Grazia Antonacci
- Department of Primary Care and Public Health, Imperial College London, National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) Northwest London, London, UK.
- Business School, Centre for Health Economics and Policy Innovation (CHEPI), Imperial College London, London, UK.
| | - Elisabetta Benevento
- Department of Energy, Systems, Territory and Construction Engineering, University of Pisa, Pisa, Italy
| | | | | | - Emanuela Foglia
- Healthcare Datascience LAB, LIUC- Carlo Cattaneo University, Castellanza, VA, Italy
| | - Giulia Fusi
- LIUC- Cattaneo University, Castellanza, VA, Italy
| | - Elisabetta Garagiola
- Healthcare Datascience LAB, LIUC- Carlo Cattaneo University, Castellanza, VA, Italy
| | - Cristina Ponsiglione
- Department of Industrial Engineering, University of Naples Federico II, Naples, Italy
| | - Alessandro Stefanini
- Department of Energy, Systems, Territory and Construction Engineering, University of Pisa, Pisa, Italy
- School of Economics and Business, Kaunas University of Technology, Kaunas, Lithuania
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15
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Nashwan AJ, Gharib S, Alhadidi M, El-Ashry AM, Alamgir A, Al-Hassan M, Khedr MA, Dawood S, Abufarsakh B. Harnessing Artificial Intelligence: Strategies for Mental Health Nurses in Optimizing Psychiatric Patient Care. Issues Ment Health Nurs 2023; 44:1020-1034. [PMID: 37850937 DOI: 10.1080/01612840.2023.2263579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
This narrative review explores the transformative impact of Artificial Intelligence (AI) on mental health nursing, particularly in enhancing psychiatric patient care. AI technologies present new strategies for early detection, risk assessment, and improving treatment adherence in mental health. They also facilitate remote patient monitoring, bridge geographical gaps, and support clinical decision-making. The evolution of virtual mental health assistants and AI-enhanced therapeutic interventions are also discussed. These technological advancements reshape the nurse-patient interactions while ensuring personalized, efficient, and high-quality care. The review also addresses AI's ethical and responsible use in mental health nursing, emphasizing patient privacy, data security, and the balance between human interaction and AI tools. As AI applications in mental health care continue to evolve, this review encourages continued innovation while advocating for responsible implementation, thereby optimally leveraging the potential of AI in mental health nursing.
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Affiliation(s)
- Abdulqadir J Nashwan
- Nursing Department, Hamad Medical Corporation, Doha, Qatar
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Suzan Gharib
- Nursing Department, Al-Khaldi Hospital, Amman, Jordan
| | - Majdi Alhadidi
- Psychiatric & Mental Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | | | | | | | | | - Shaimaa Dawood
- Faculty of Nursing, Alexandria University, Alexandria, Egypt
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Link K, Christians S, Hoffmann W, Grabe HJ, van den Berg N. Telemedicine treatment of patients with mental disorders during and after the first COVID-19 pandemic lockdown in Germany - an observational study on feasibility and patient satisfaction. BMC Psychiatry 2023; 23:654. [PMID: 37670236 PMCID: PMC10478407 DOI: 10.1186/s12888-023-05140-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/25/2023] [Indexed: 09/07/2023] Open
Abstract
INTRODUCTION In response to the COVID-19 pandemic, a general lockdown was enacted across Germany in March 2020. As a consequence, patients with mental health conditions received limited or no treatment in day hospitals and outpatient settings. To ensure continuity of care, the necessary technological preparations were made to enable the implementation of telemedical care via telephone or video conferencing, and this option was then used as much as possible. The aim of this study was to investigate the satisfaction and acceptance with telemedical care in a heterogeneous patient group of psychiatric outpatients in Germany during the first COVID-19 lockdown. METHODS In this observational study, patients in ongoing or newly initiated outpatient psychiatric therapy as well as those who had to be discharged from the day clinic ahead of schedule received telemedical treatment via telephone. Data collection to assess the patients' and therapists' satisfaction with and acceptance of the telemedical care was adjusted to the treatment setting. RESULTS Of 60 recruited patients, 57 could be included in the analysis. 51.6% of the patients and 52.3% of their therapists reported that the discussion of problems and needs worked just as well over the phone as in face-to-face consultations. In the subgroup of patients who were new to therapy due to being discharged from hospital early, acceptance was higher and telemedicine was rated as equally good in 87.5% of contacts. Both patients and therapists felt that telemedicine care during lockdown was an alternative for usual therapy in the outpatient clinic and that the option of telemedicine care should continue for the duration of the coronavirus pandemic. DISCUSSION The results show a clear trend towards satisfaction with and acceptance of telemedicine care in a heterogeneous group of unselected psychiatric patients. Although the number of patients is small, the results indicate that the mostly positive results of telemedicine concepts in research projects can probably be transferred to real healthcare settings. CONCLUSIONS Telemedicine can be employed in healthcare for psychiatric patients either an alternative treatment option to maintain continuity of care or as a potential addition to regular care.
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Affiliation(s)
- Karsten Link
- Institut Für Community Medicine, Universitätsmedizin Greifswald, Ellernholzstraße 1-2, 17475, Greifswald, Germany.
| | - Svenja Christians
- Klinik Und Poliklinik Für Psychiatrie Und Psychotherapie, Universitätsmedizin Greifswald, Ellernholzstraße 1-2, 17475, Greifswald, Germany
| | - Wolfgang Hoffmann
- Institut Für Community Medicine, Universitätsmedizin Greifswald, Ellernholzstraße 1-2, 17475, Greifswald, Germany
| | - Hans Jörgen Grabe
- Klinik Und Poliklinik Für Psychiatrie Und Psychotherapie, Universitätsmedizin Greifswald, Ellernholzstraße 1-2, 17475, Greifswald, Germany
| | - Neeltje van den Berg
- Institut Für Community Medicine, Universitätsmedizin Greifswald, Ellernholzstraße 1-2, 17475, Greifswald, Germany
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17
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Sheridan R, McCaughan D, Hewison A, Roman E, Smith A, Patmore R, Howell D. Experiences and preferences for psychosocial support: a qualitative study exploring the views of patients with chronic haematological cancers. BMJ Open 2023; 13:e070467. [PMID: 37597866 PMCID: PMC10441118 DOI: 10.1136/bmjopen-2022-070467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 08/02/2023] [Indexed: 08/21/2023] Open
Abstract
OBJECTIVES Patients with chronic haematological cancers are often treated on a relapsing-remitting pathway, which may extend for many years. Such diagnoses are associated with uncertainties that often cause anxiety and distress, meaning patients (and families) are susceptible to potentially prolonged emotional difficulties, across the cancer journey. Experiences and preferences regarding psychosocial needs and support over time are relatively unexplored, which this study aimed to address. SETTING AND DESIGN Set within the UK's Haematological Malignancy Research Network (an ongoing population-based cohort that generates evidence to underpin improved clinical practice) a qualitative, exploratory study was conducted, using semistructured interviews. Reflexive thematic analysis was used to assess the interview data via an exploratory, inductive approach, underpinned by the research questions. PARTICIPANTS Thirty-five patients were included with chronic lymphocytic leukaemia, follicular lymphoma, marginal zone lymphoma or myeloma; 10 of whom were interviewed alongside a relative. RESULTS Five themes were identified from the data: (1) accessing support, (2) individual coping behaviour affecting support preferences, (3) divergent and fluctuating thoughts on patient support forums, (4) the role, influence and needs of family and friends and (5) other sources of support and outstanding needs. Findings suggest that patients' individual attitudes towards support varied over time. This also influenced whether support was perceived to be available, and if it was then used. CONCLUSION This study highlighted the variation in preferences towards psychosocial support among patients with chronic haematological cancers. As patients can live for many years with significant emotional difficulties, they may benefit from frequent monitoring of their psychosocial well-being, as well as signposting to holistic support, if this is needed.
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Affiliation(s)
| | | | - Ann Hewison
- Department of Health Sciences, University of York, York, UK
| | - Eve Roman
- Department of Health Sciences, University of York, York, UK
| | | | - Russell Patmore
- Queens Centre for Oncology and Haematology, Castle Hill Hospital, Cottingham, UK
| | - Debra Howell
- Department of Health Sciences, University of York, York, UK
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18
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Kristen A, Salari R, Moretti M, Osman F. Attachment and trauma-informed programme to support forcibly displaced parents of youth in Sweden: feasibility and preliminary outcomes of the eConnect Online programme. BMJ Open 2023; 13:e072368. [PMID: 37550024 PMCID: PMC10407377 DOI: 10.1136/bmjopen-2023-072368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/29/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVES To assess the feasibility, acceptability and the impact of an online parenting programme for forcibly displaced parents of adolescents. DESIGN The study was a single-arm feasibility study using pre-intervention post-intervention and follow-up assessments. SETTING Participants were recruited from municipality-based activities for refugee parents in a small city in the south of Sweden. PARTICIPANTS Participants were forcibly displaced parents (n=23; 47.8% maternal figures) of youth (n=23; 8-17 years old; 26.1% female) from Syria, Afghanistan and Somalia participating in an online parenting programme (eConnect). INTERVENTION eConnect is an attachment-based and trauma-informed parenting intervention and was delivered over the course of 10 weekly sessions. PRIMARY AND SECONDARY OUTCOME MEASURES Feasibility was assessed by programme enrolment, attendance, completion and acceptability of the online platform and cultural fit of the programme. Primary outcome measures were programme impact on youth mental health problems. Secondary outcome measures were programme impact on family functioning and parent-child attachment insecurity. RESULTS The eConnect programme was highly feasible in terms of overall enrolment (100%), attendance (89.6%) and retention rates (100%). The online platform was acceptable, with mixed feedback primarily related to the access and usage of technology. Cultural fit of the programme was acceptable. Youth mental health problems (η 2=0.29) and family functioning significantly improved (η 2=0.18) over the course of the programme. Unexpectedly, parent reports of youth attachment insecurity significantly worsened (η 2=0.16). CONCLUSIONS The findings suggest that the online delivery of Connect was a promising way to reduce barriers to service access and improve mental health problems and family functioning among forcibly displaced parents and their children during COVID-19. Future research is needed to explore the acceptability and impact of this programme post-COVID-19, and to develop culturally tailored and psychometrically sound measures for parent and youth reports of attachment.
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Affiliation(s)
- Anna Kristen
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Raziye Salari
- Child Health and Parenting, Department of Public Health and Caring Sciences, Uppsala Universitet Institutionen for folkhalso- och vardvetenskap, Uppsala, Sweden
| | - Marlene Moretti
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Fatumo Osman
- School of Health and Welfare, Hogskolan Dalarna, Falun, Sweden
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19
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Connolly SL, Charness ME, Gifford AL, Miller CJ. Discipline-level differences in mental health provider perceptions of video and phone telehealth. Psychol Serv 2023:2023-90620-001. [PMID: 37439733 PMCID: PMC10787026 DOI: 10.1037/ser0000791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
COVID-19 led to a rapid increase in telemental health care via video or phone. It is important to examine contributors to the choice of video versus phone, as video may be more effective and preferred by patients. Medical mental health (MH) providers (e.g., psychiatrists) may conduct more phone and less video visits than nonmedical MH providers (e.g., psychologists). This study examined whether medical and nonmedical providers' perceptions of the quality and complexity of phone and video MH care may contribute to differences in use. A 32-item survey of 414 providers (79.5% response rate) assessed perceptions of care quality, factors contributing to modality choice, and telehealth challenges. The types of visits completed by providers in the months prior to the survey were extracted from administrative data. Medical and nonmedical providers generally viewed video care as higher quality and more preferred than phone, although to a lesser extent among medical providers. Nonmedical providers' decision making was more impacted by research regarding the modalities' relative effectiveness. Medical providers more frequently endorsed video challenges, including patient technical difficulties and lack of patient training. Administrative data demonstrated that medical providers conducted fewer video appointments than nonmedical providers. Medical providers may be less aware of research demonstrating that video care is effective and preferred by patients, and the complexity of video visits may be a barrier to use. Streamlining video processes, increasing technical support, and disseminating research that compares the quality of video and phone care may increase video use among medical providers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Samantha L Connolly
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System
| | | | - Allen L Gifford
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System
| | - Christopher J Miller
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System
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20
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Wu QL, Street RL. How communicative environments affect college students' mental health help-seeking during COVID-19: a cross-sectional study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 37399517 DOI: 10.1080/07448481.2023.2224435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 04/14/2023] [Accepted: 06/01/2023] [Indexed: 07/05/2023]
Abstract
Objective: This study explores how interpersonal communication environments (eg family, patient-provider, and online communication environments) affect college students' mental help-seeking during COVID-19. Methods: Based on Social Cognitive Theory, we conducted a cross-sectional survey assessing participants' mental help-seeking attitudes, self-stigma, self-efficacy, and readiness, as well as their communication experiences with their families, healthcare providers, and online environments. Four hundred fifty-six student participants were recruited. Structural equation modeling was used to explore relationships among the assessed variables. Results: About one-third of the participants (N = 137) had signs of mental distress, and most of them (N = 71) did not intend to seek help soon. Patient-centered communication experiences with healthcare providers were associated with reduced help-seeking stigma, whereas online and family communication predicted help-seeking readiness through changes in attitude, self-stigma, and self-efficacy. Conclusions: This study's results help identify risk factors of help-seeking reluctance. It suggests that communicative environments affect help-seeking by influencing individual predictors. This study may inform interventions targeting college students' use of mental health services during health crises like COVID-19.
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Affiliation(s)
- Qiwei Luna Wu
- School of Communication, Cleveland State University, Cleveland, OH, USA
| | - Richard L Street
- Department of Communication and Journalism, Texas A&M University, College Station, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
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21
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Faija CL, Connell J, Gellatly J, Rushton K, Lovell K, Brooks H, Armitage C, Bower P, Bee P. Enhancing the quality of psychological interventions delivered by telephone in mental health services: increasing the likelihood of successful implementation using a theory of change. BMC Psychiatry 2023; 23:405. [PMID: 37280575 DOI: 10.1186/s12888-023-04829-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/29/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND The implementation of new and complex interventions in mental health settings can be challenging. This paper explores the use of a Theory of Change (ToC) for intervention design and evaluation to increase the likelihood of complex interventions being effective, sustainable, and scalable. Our intervention was developed to enhance the quality of psychological interventions delivered by telephone in primary care mental health services. METHODS A ToC represents how our designed quality improvement intervention targeting changes at service, practitioner, and patient levels was expected to improve engagement in, and the quality of, telephone-delivered psychological therapies. The intervention was evaluated following implementation in a feasibility study within three NHS Talking Therapies services through a qualitative research design incorporating semi-structured interviews and a focus group with key stakeholders (patients, practitioners, and service leads) (N = 15). Data were analysed using the Consolidated Framework for Implementation Research (CFIR) and the ToC was examined and modified accordingly following the findings. RESULTS CFIR analysis highlighted a set of challenges encountered during the implementation of our service quality improvement telephone intervention that appeared to have weakened the contribution to the change mechanisms set out by the initial ToC. Findings informed changes to the intervention and refinement of the ToC and are expected to increase the likelihood of successful future implementation in a randomised controlled trial. CONCLUSIONS Four key recommendations that could help to optimise implementation of a complex intervention involving different key stakeholder groups in any setting were identified. These include: 1-developing a good understanding of the intervention and its value among those receiving the intervention; 2-maximising engagement from key stakeholders; 3-ensuring clear planning and communication of implementation goals; and 4-encouraging the use of strategies to monitor implementation progress.
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Affiliation(s)
- Cintia L Faija
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK.
| | - Janice Connell
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Judith Gellatly
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK
| | - Kelly Rushton
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK
| | - Karina Lovell
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Helen Brooks
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK
| | - Christopher Armitage
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - Peter Bower
- Centre for Primary Care and Centre for Health Informatics, NIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Penny Bee
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester, Manchester, M13 9PL, UK
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22
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Selick A, Durbin J, Hamdani Y, Rayner J, Lunsky Y. "Can you hear me now?": a qualitative exploration of communication quality in virtual primary care encounters for patients with intellectual and developmental disabilities. BMC PRIMARY CARE 2023; 24:105. [PMID: 37081380 PMCID: PMC10117251 DOI: 10.1186/s12875-023-02055-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND High quality communication is central to effective primary care. The COVID-19 pandemic led to a dramatic increase in virtual care but little is known about how this may affect communication quality. Adults with intellectual and developmental disabilities (IDD) can experience challenges communicating or communicate in non-traditional ways. This study explored how the use of virtual modalities, including telephone and video, affects communication in primary care interactions for patients with IDD. METHODS This qualitative descriptive study included semi-structured interviews with a multi-stakeholder sample of 38 participants, including 11 adults with IDD, 13 family caregivers, 5 IDD support staff and 9 primary care physicians. Interviews were conducted in Ontario, Canada between March and November 2021 by video-conference or telephone. A mixed inductive and deductive thematic analysis approach was used to code the data and identify themes. Themes were reviewed and refined with members of each stakeholder group. RESULTS Four elements of communication were identified that were affected by virtual care: (1) patient engagement in the virtual appointment; (2) the ability to hear other participants and have the time and space to be heard; (3) the ability to use nonverbal communication strategies; and (4) the ability to form trusting relationships. In some cases, the virtual platform hindered these elements of communication. Video offered some advantages over telephone to support nonverbal communication, and stimulate engagement; though this could be limited by technical challenges. For adults with IDD who find it difficult to attend in-person appointments, virtual care improved communication quality by allowing them to participate from a space where they were comfortable. CONCLUSION Though there are circumstances in which virtual delivery can improve communication for patients with IDD, there are also challenges to achieving high quality patient-provider communication over telephone and video. Improved infrastructure and training for providers, patients and caregivers can help improve communication quality, though in some cases it may never be appropriate. A flexible patient-centred approach is needed that includes in-person, telephone and video options for care.
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Affiliation(s)
- Avra Selick
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Provincial System Support Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Janet Durbin
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Provincial System Support Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yani Hamdani
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Jennifer Rayner
- Centre for Studies in Family Medicine, Western University, London, ON, Canada
- Department of Research and Evaluation, Alliance for Healthier Communities, Toronto, ON, Canada
| | - Yona Lunsky
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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23
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Grunberg VA, Vranceanu AM. Integrating Mind, Body, and Technology: Building Virtual Psychosocial Programs for Medical Populations. HEALTH POLICY AND TECHNOLOGY 2023; 12:100700. [PMID: 36937652 PMCID: PMC10022579 DOI: 10.1016/j.hlpt.2022.100700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Victoria A. Grunberg
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
- Division of Newborn Medicine, MassGeneral for Children, Boston, MA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Boston, MA
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24
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Ivey G, Denmeade L. Trainee psychologists’ experiences of learning and conducting psychodynamic therapy via telepsychology. PSYCHOANALYTIC PSYCHOTHERAPY 2023. [DOI: 10.1080/02668734.2022.2158210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Gavin Ivey
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Lesley Denmeade
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
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25
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Witteveen A, Young S, Cuijpers P, Ayuso-Mateos J, Barbui C, Bertolini F, Cabello M, Cadorin C, Downes N, Franzoi D, Gasior M, John A, Melchior M, McDaid D, Palantza C, Purgato M, Van der Waerden J, Wang S, Sijbrandij M. Remote mental health care interventions during the COVID-19 pandemic: An umbrella review. Behav Res Ther 2022; 159:104226. [PMID: 36410111 PMCID: PMC9661449 DOI: 10.1016/j.brat.2022.104226] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 10/13/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
Mitigating the COVID-19 related disruptions in mental health care services is crucial in a time of increased mental health disorders. Numerous reviews have been conducted on the process of implementing technology-based mental health care during the pandemic. The research question of this umbrella review was to examine what the impact of COVID-19 was on access and delivery of mental health services and how mental health services have changed during the pandemic. A systematic search for systematic reviews and meta-analyses was conducted up to August 12, 2022, and 38 systematic reviews were identified. Main disruptions during COVID-19 were reduced access to outpatient mental health care and reduced admissions and earlier discharge from inpatient care. In response, synchronous telemental health tools such as videoconferencing were used to provide remote care similar to pre-COVID care, and to a lesser extent asynchronous virtual mental health tools such as apps. Implementation of synchronous tools were facilitated by time-efficiency and flexibility during the pandemic but there was a lack of accessibility for specific vulnerable populations. Main barriers among practitioners and patients to use digital mental health tools were poor technological literacy, particularly when preexisting inequalities existed, and beliefs about reduced therapeutic alliance particularly in case of severe mental disorders. Absence of organizational support for technological implementation of digital mental health interventions due to inadequate IT infrastructure, lack of funding, as well as lack of privacy and safety, challenged implementation during COVID-19. Reviews were of low to moderate quality, covered heterogeneously designed primary studies and lacked findings of implementation in low- and middle-income countries. These gaps in the evidence were particularly prevalent in studies conducted early in the pandemic. This umbrella review shows that during the COVID-19 pandemic, practitioners and mental health care institutions mainly used synchronous telemental health tools, and to a lesser degree asynchronous tools to enable continued access to mental health care for patients. Numerous barriers to these tools were identified, and call for further improvements. In addition, more high quality research into comparative effectiveness and working mechanisms may improve scalability of mental health care in general and in future infectious disease outbreaks.
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Affiliation(s)
- A.B. Witteveen
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands,Corresponding author
| | - S. Young
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - P. Cuijpers
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - J.L. Ayuso-Mateos
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain,Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - C. Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - F. Bertolini
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - M. Cabello
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - C. Cadorin
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - N. Downes
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - D. Franzoi
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Gasior
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - A. John
- Health Data Science, Swansea University Medical School, Swansea, UK
| | - M. Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - D. McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - C. Palantza
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - J. Van der Waerden
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - S. Wang
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
| | - M. Sijbrandij
- Clinical, Neuro and Developmental Psychology, and WHO Collaborating Center for Research and Dissemination of Psychological Interventions, Amsterdam Public Health Institute, VU University, Amsterdam, the Netherlands
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26
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Every-Palmer S, Grant ML, Thabrew H. Young people don't tend to ask for help more than once: Child and adolescent psychiatrists' views on ailing mental health services for young New Zealanders. Australas Psychiatry 2022; 30:684-688. [PMID: 35918633 DOI: 10.1177/10398562221115624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To explore the views of New Zealand doctors working in child and adolescent psychiatry regarding the state of public mental health services. METHODS All practicing child and adolescent psychiatrists/advanced trainees were electronically surveyed in August 2021. Quantitative and qualitative analysis of feedback was undertaken. RESULTS Almost 100 specialists responded, an 80% response rate. High levels of dissatisfaction with current services and future service plans were identified. Content analysis identified an overarching theme that child and adolescent services were under great pressure, with subthemes of increased demand, a stretched workforce and social issues driving complex presentations. Recommendations were made for addressing workforce, service design and wider issues. CONCLUSIONS Multiple measures are needed to improve currently ailing child mental health services, including urgently expanding the number of psychiatrists and other clinical staff.
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Affiliation(s)
- Susanna Every-Palmer
- Department of Psychological Medicine, 8494University of Otago, Wellington, New Zealand.,Tu Te Akaaka Roa, New Zealand National Committee, 170472Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Marion L Grant
- Tu Te Akaaka Roa, New Zealand National Committee, 170472Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia
| | - Hiran Thabrew
- Tu Te Akaaka Roa, New Zealand National Committee, 170472Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia; and.,Centre for Infant, Child and Adolescent Mental Health, The University of Auckland, New Zealand
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27
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Galvin E, Desselle S, Gavin B, Quigley E, Flear M, Kilbride K, McNicholas F, Cullinan S, Hayden J. Patient and provider perspectives of the implementation of remote consultations for community-dwelling people with mental health conditions: A systematic mixed studies review. J Psychiatr Res 2022; 156:668-678. [PMID: 36399859 PMCID: PMC9637462 DOI: 10.1016/j.jpsychires.2022.10.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/17/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022]
Abstract
Remote, or tele-, consultations became a necessary form of mental healthcare provision during the COVID-19 pandemic. As the prevalence of mental health problems rises, they may have a role in future mental health services. We aimed to review the literature on patient and provider perspectives on factors influencing the implementation of remote consultations for community-dwelling people with mental health conditions. We searched five electronic databases (PubMed, EMBASE, Web of Science, CINAHL, and PsycINFO) for empirical research up to July 13th, 2022. Only studies of synchronous, interactive remote consultations conducted via video, phone, or live-messaging between patients and providers were included. Two reviewers independently assessed the quality of included studies using the Mixed Methods Appraisal Tool. We integrated qualitative and quantitative data from 39 studies into a single mixed-methods synthesis. We mapped reported factors to the domains of the Consolidated Framework for Implementation Research (CFIR). Acceptability was generally high among participants, despite concerns about the quality of care and the perceived impeded therapeutic relationship. A prominent facilitator was the increased accessibility and convenience of remote consultations, while lack of appropriate infrastructure and low patient comfort and competence were among the most prevalent barriers. This review highlights the importance of patient preferences and provider buy-in to the future of remote consultations.
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Affiliation(s)
- Emer Galvin
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | | | - Blánaid Gavin
- School of Medicine, University College Dublin, Dublin, Ireland.
| | - Etain Quigley
- National University of Ireland, Maynooth, Maynooth, Ireland.
| | - Mark Flear
- Queen's University Belfast, Belfast, United Kingdom.
| | | | | | - Shane Cullinan
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - John Hayden
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
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28
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Palmer CS, Brown Levey SM, Kostiuk M, Zisner AR, Tolle LW, Richey RM, Callan S. Virtual Care for Behavioral Health Conditions. Prim Care 2022; 49:641-657. [PMID: 36357068 PMCID: PMC9581698 DOI: 10.1016/j.pop.2022.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Christina S. Palmer
- Department of Family Medicine, University of Colorado School of Medicine,Corresponding author
| | | | | | - Aimee R. Zisner
- Department of Family Medicine, University of Colorado School of Medicine
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29
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Shaker AA, Austin SF, Sørensen JA, Storebø OJ, Simonsen E. Psychiatric treatment conducted via telemedicine versus in-person consultations in mood, anxiety and personality disorders: a protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e060690. [PMID: 36171023 PMCID: PMC9528631 DOI: 10.1136/bmjopen-2021-060690] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Major advancements in technology have led to considerations how telemedicine (TM) and other technology platforms can be meaningfully integrated in treatment for psychiatric disorders. The COVID-19 pandemic has placed a further focus on use of TM in psychiatry. Despite the widespread use of TM, little is known about its effect compared with traditional in-person (IP) consultation. The objective of this systematic review is to examine if individual psychiatric outpatient interventions for adults using TM are comparable to IP in terms of (1) psychopathology outcomes, (2) levels of patient satisfaction, (3) working alliance and (4) dropout from treatment. METHODS AND ANALYSIS This review will only include randomised controlled trials for adult participants with mood disorders, anxiety or personality disorders. The primary outcome is psychopathology, and secondary outcomes include patient satisfaction, treatment alliance and dropout rate. Systematic searches were conducted in MEDLINE, APA PsycINFO, Embase, Web of Science and CINAHL. The inverse-variance method will be used to conduct the meta-analysis. Effect sizes will be calculated as standardised mean difference (Hedges' g) for the primary outcome, mean difference for patient satisfaction and working alliance, and risk ratio for the dropout rate. Effect sizes will be supplemented with 95% CI. We will calculate the I² statistic to quantify heterogeneity and Chi-square statistic (χ²) to test for heterogeneity for the primary outcome. Potential clinical and methodological heterogeneity moderators will be assessed in subgroup and sensitivity analysis. The risk of bias will be assessed by Cochrane Risk of Bias Tool V.2, and confidence in cumulative evidence will be assessed by Grading of Recommendations Assessment, Development and Evaluation. ETHICS AND DISSEMINATION No ethical approval is required for this systematic review protocol. Data sets will be deposited in the Zenodo repository. The findings of this study will be published in a peer-review scientific journal. PROSPERO REGISTRATION NUMBER CRD42021256357.
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Affiliation(s)
- Ali Abbas Shaker
- Psychiatric Research Unit, Psychiatric Services Region Zealand, Slagelse, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Stephen F Austin
- Psychiatric Research Unit, Psychiatric Services Region Zealand, Slagelse, Denmark
- Department of Psychology, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | | | - Ole Jakob Storebø
- Psychiatric Research Unit, Psychiatric Services Region Zealand, Slagelse, Denmark
- Department of Psychology, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Erik Simonsen
- Psychiatric Research Unit, Psychiatric Services Region Zealand, Slagelse, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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30
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Cascini F, Altamura G, Failla G, Gentili A, Puleo V, Melnyk A, Causio F, Ricciardi W. Approaches to priority identification in digital health in ten countries of the Global Digital Health Partnership. Front Digit Health 2022; 4:968953. [PMID: 36339514 PMCID: PMC9632991 DOI: 10.3389/fdgth.2022.968953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/22/2022] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND To promote shared digital health best practices in a global context, as agreed within the Global Digital Health Partnership (GDHP), one of the most important topics to evaluate is the ability to detect what participating countries believe to be priorities suitable to improve their healthcare systems. No previously published scientific papers investigated these aspects as a cross-country comparison. OBJECTIVE The aim of this paper is to present results concerning the priorities identification section of the Evidence and Evaluation survey addressed to GDHP members in 2021, comparing countries' initiatives and perspectives for the future of digital health based on internationally agreed developments. METHODS This survey followed a cross-sectional study approach. An online survey was addressed to the stakeholders of 29 major countries. RESULTS Ten out of 29 countries answered the survey. The mean global score of 3.54 out of 5, calculated on the whole data set, demonstrates how the global attention to a digital evolution in health is shared by most of the evaluated countries. CONCLUSION The resulting insights on the differences between digital health priority identification among different GDHP countries serves as a starting point to coordinate further progress on digital health worldwide and foster evidence-based collaboration.
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Affiliation(s)
| | - Gerardo Altamura
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
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31
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Ceniti AK, Abdelmoemin WR, Ho K, Kang Y, Placenza F, Laframboise R, Bhat V, Foster JA, Frey BN, Lam RW, Milev R, Rotzinger S, Soares CN, Uher R, Kennedy SH. "One Degree of Separation": A Mixed-Methods Evaluation of Canadian Mental Health Care User and Provider Experiences With Remote Care During COVID-19. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:712-722. [PMID: 34986035 PMCID: PMC9445628 DOI: 10.1177/07067437211070656] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The COVID-19 pandemic has contributed to a shift from in-person to remote mental health care. While remote care methods have long existed, their widespread use is unprecedented. There is little research about mental health care user and provider experiences with this transition, and no published studies to date have compared satisfaction between these groups. METHODS Canadian mental health care users (n = 332) and providers (n = 107) completed an online self-report survey from October 2020 to February 2021 hosted by the Canadian Biomarker Integration Network in Depression. Using a mixed-methods approach, participants were asked about their use of remote care, including satisfaction, barriers to use, helpful and unhelpful factors, and suggestions for improvement. RESULTS Overall, 59% to 63% of health care users and 59% of health care providers were satisfied with remote care. Users reported the greatest satisfaction with the convenience of remote care, while providers were most satisfied with the speed of provision of care; all groups were least satisfied with therapeutic rapport. Health care providers were less satisfied with the user-friendliness of remote care (P < 0.001) than users, while health care users were less satisfied than providers with continuity of care (P < 0.001). The use of a video-based platform was associated with remote care satisfaction among health care users (P < 0.02), and qualitative responses support the importance of visual cues in maintaining therapeutic rapport remotely. The majority of users (55%) and providers (87%) reported a likelihood of using remote care after the pandemic. CONCLUSIONS Remote mental health care is generally accepted by both users and providers, and the majority would consider using remote care following the pandemic. Suggestions for improvement include greater use of video, increased attention to body language and eye contact, consistency with in-person care, as well as increased provider training and administrative support.
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Affiliation(s)
- Amanda K Ceniti
- Arthur Sommer Rotenberg Suicide & Depression Studies Program, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada.,Institute of Medical Science, 7938University of Toronto, Toronto, Canada
| | - Wegdan R Abdelmoemin
- Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada
| | - Keith Ho
- Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Mental Health, 7989University Health Network, Toronto, Canada
| | - Yudi Kang
- Centre for Mental Health, 7989University Health Network, Toronto, Canada
| | - Franca Placenza
- Centre for Mental Health, 7989University Health Network, Toronto, Canada
| | - Rachel Laframboise
- Centre for Mental Health, 7989University Health Network, Toronto, Canada
| | - Venkat Bhat
- Arthur Sommer Rotenberg Suicide & Depression Studies Program, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada.,Institute of Medical Science, 7938University of Toronto, Toronto, Canada.,Centre for Mental Health, 7989University Health Network, Toronto, Canada.,Department of Psychiatry, 7938University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, 10071St. Michael's Hospital, Toronto, Canada
| | - Jane A Foster
- Centre for Mental Health, 7989University Health Network, Toronto, Canada.,Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Canada.,Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Raymond W Lam
- Department of Psychiatry, 8166University of British Columbia, Vancouver, Canada
| | - Roumen Milev
- Departments of Psychiatry and Psychology, 4257Queen's University, Kingston, Canada.,Providence Care, Kingston, ON, Canada
| | - Susan Rotzinger
- Arthur Sommer Rotenberg Suicide & Depression Studies Program, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Mental Health, 7989University Health Network, Toronto, Canada.,Department of Psychiatry, 7938University of Toronto, Toronto, Canada
| | - Claudio N Soares
- Departments of Psychiatry and Psychology, 4257Queen's University, Kingston, Canada.,Providence Care, Kingston, ON, Canada
| | - Rudolf Uher
- Department of Psychiatry, 3688Dalhousie University, Halifax, Canada
| | - Sidney H Kennedy
- Arthur Sommer Rotenberg Suicide & Depression Studies Program, 10071St. Michael's Hospital, Toronto, Canada.,Centre for Depression and Suicide Studies, 10071St. Michael's Hospital, Toronto, Canada.,Institute of Medical Science, 7938University of Toronto, Toronto, Canada.,Centre for Mental Health, 7989University Health Network, Toronto, Canada.,Department of Psychiatry, 7938University of Toronto, Toronto, Canada.,Li Ka Shing Knowledge Institute, 10071St. Michael's Hospital, Toronto, Canada
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Connolly SL, Sullivan JL, Lindsay JA, Shimada SL, Heyworth L, Weaver KR, Miller CJ. Factors influencing uptake of telemental health via videoconferencing at high and low adoption sites within the Department of Veterans Affairs during COVID-19: a qualitative study. Implement Sci Commun 2022; 3:66. [PMID: 35725642 PMCID: PMC9207848 DOI: 10.1186/s43058-022-00318-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic dramatically increased the use of telemental health via videoconferencing (TMH-V). While TMH-V has been found to be effective and satisfactory to both patients and providers, little is known regarding factors that influence site-level uptake. We examined facilitators and barriers to TMH-V uptake at higher and lower adoption sites within the US Department of Veterans Affairs (VA). METHODS We conducted twenty-four semi-structured qualitative interviews at four northeastern VA medical centers (two with higher TMH-V adoption and two with lower adoption). Six interviews were conducted per site (one member of mental health leadership, one facility telehealth coordinator/technician, and four mental health providers per site). We performed directed content analysis, guided by the Consolidated Framework for Implementation Research (CFIR), followed by a matrix rating process to rank the degree of influence of each of the 19 included CFIR constructs at the four sites. Positive overall influences, negative overall influences, and differentiators were then identified based on patterns in ratings across sites. RESULTS Five CFIR constructs had positive overall influences across sites: Relative advantage, Patient needs and resources, Relative priority, Knowledge and beliefs, and Self-efficacy. Complexity had a negative overall influence across sites. Four constructs significantly differentiated between higher and lower adoption sites with regards to TMH-V use: Quality, Compatibility, Leadership engagement, and Champions. CONCLUSIONS Several positive overall influences on TMH-V uptake were identified across sites; respondents acknowledged multiple advantages of TMH-V (e.g., convenience), and providers' attitudes towards TMH-V improved as they gained experience. In contrast, complexity was a negative overall influence; TMH-V platforms and processes must be simple and user friendly to promote use. The emergence of Quality, Leadership engagement, and Champions as differentiators speaks to the importance of educating frontline staff and leadership at lower adoption sites about the evidence base demonstrating that TMH-V is high-quality care. Compatibility also emerged as a differentiator; if TMH-V is not easily integrated into provider workflows, uptake will falter. Future work should draw from these findings to develop implementation strategies aiming to increase TMH-V uptake at lower adoption sites, thereby increasing access to high-quality mental health care.
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Affiliation(s)
- Samantha L Connolly
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA, USA. .,Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Jennifer L Sullivan
- Center of Innovation in Long Term Services and Supports, VA Providence Healthcare System, Providence, RI, USA.,Brown University School of Public Health, Providence, RI, USA
| | - Jan A Lindsay
- Michael E. DeBakey VA Medical Center, HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA.,Baylor College of Medicine, Houston, TX, USA.,South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA
| | - Stephanie L Shimada
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA.,Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA.,Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Leonie Heyworth
- Veterans Health Administration Office of Connected Care/Telehealth, Washington, D.C, USA.,Department of Health Sciences, University of California San Diego, San Diego, CA, USA
| | - Kendra R Weaver
- Clinical Operations, Veterans Health Administration Office of Mental Health and Suicide Prevention, Washington, D.C, USA
| | - Christopher J Miller
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Adams L, Adamo N, Hollocks MJ, Valmaggia L, Brewster A, Watson J, Krisson M, Simonoff E. Examining clinicians' concerns delivering telemental health interventions directly to autistic individuals during COVID-19. RESEARCH IN AUTISM SPECTRUM DISORDERS 2022; 94:101956. [PMID: 35369648 PMCID: PMC8963796 DOI: 10.1016/j.rasd.2022.101956] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/16/2022] [Accepted: 03/20/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND The COVID-19 pandemic necessitated the adoption of telemental health (TMH). Pre-pandemic, clinicians had voiced many TMH concerns, but these had not been investigated with respect to autism spectrum disorder (ASD) even with it being known that there are distinct ASD-associated challenges for in-person mental health interventions. METHOD A convenience sample of (n = 55) clinicians completed an online survey regarding their perspectives of adopting TMH interventions in ASD, with closed- and open-answered questions. Quantitative and qualitative data were analysed descriptively/inferentially and via Content Analysis, respectively. RESULTS Multiple clinicians endorsed each TMH challenges/barrier previously identified as concerns in the non-ASD literature. However, overall levels of concern over challenges/barriers were low, and challenges were more likely to be predicted than experienced and considered to be case/presentation specific. Challenges that were considered ASD-specific included the exacerbation of those associated with in-person delivery in ASD, alongside difficulties with trust and appropriate remote social behaviour. On average, clinicians indicated a preference for 50% TMH interventions post-pandemic. Clinicians' perceived technological competence and extent of professional experience with ASD were not significantly associated with levels of concern, nor number of experienced challenges, with TMH interventions in ASD. CONCLUSION In support of the existing TMH literature, challenges/barriers were more likely to be predicted than experienced and were considered to be case/presentation-specific, though this may be more variable in ASD owing to the well-established marked heterogeneity in this population. Remote provision of interventions exacerbated in-person ASD-associated challenges, as predicted, but clinician-level factors appeared not to impact TMH perceptions.
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Affiliation(s)
- Lucy Adams
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
- Service for Complex Autism and Associated Neurodevelopmental Disorders, Maudsley Hospital, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
| | - Nicoletta Adamo
- Service for Complex Autism and Associated Neurodevelopmental Disorders, Maudsley Hospital, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Matthew J Hollocks
- Service for Complex Autism and Associated Neurodevelopmental Disorders, Maudsley Hospital, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Lucia Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Aylana Brewster
- Service for Complex Autism and Associated Neurodevelopmental Disorders, Maudsley Hospital, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
| | - Jennifer Watson
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Maisie Krisson
- Service for Complex Autism and Associated Neurodevelopmental Disorders, Maudsley Hospital, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
| | - Emily Simonoff
- Service for Complex Autism and Associated Neurodevelopmental Disorders, Maudsley Hospital, Michael Rutter Centre, De Crespigny Park, London SE5 8AZ, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
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Butt Z, Kirsten L, Beatty L, Kelly B, Dhillon H, Shaw JM. Barriers and enablers to implementing telehealth consultations in psycho-oncology. Psychooncology 2022; 31:1365-1373. [PMID: 35460322 PMCID: PMC9545227 DOI: 10.1002/pon.5939] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/21/2022] [Accepted: 04/05/2022] [Indexed: 11/09/2022]
Abstract
Objective In response to the COVID‐19 pandemic, use of telehealth to deliver care was recommended across the Australian health system. This study aims to explore the barriers and enablers to delivery of psycho‐oncology services via telehealth and attitudes to use of telehealth in psycho‐oncology. Methods Twenty‐one psycho‐oncology clinicians participated in semi‐structured telephone interviews. Transcribed interviews were thematically analysed using the framework method. Results Three key themes were identified which described the overall experience of delivering psycho‐oncology services via telehealth: (1) Context Matters‐for whom is telehealth effective, when is it less effective; (2) Therapy content and telehealth implementation; (3) Recommendations for Sustainability. Conclusions These insights into the barriers and enablers to delivering psycho‐oncology services via telehealth inform future research and clinical practice. While there is support for the continued use of telehealth in psycho‐oncology, there are significant improvements needed to ensure effective implementation and continued benefit.
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Affiliation(s)
- Zoe Butt
- The University of Sydney, School of Psychology, Psycho-Oncology Co-operative Research Group (PoCoG), Sydney, New South Wales, Australia
| | - Laura Kirsten
- Nepean Cancer Care Centre, Penrith, New South Wales, Australia
| | - Lisa Beatty
- Flinders University, College of Education, Psychology and Social Work, Adelaide, South Australia, Australia
| | - Brian Kelly
- University of Newcastle, School of Medicine and Public Health, Newcastle, New South Wales, Australia
| | - Haryana Dhillon
- The University of Sydney, School of Psychology, Psycho-Oncology Co-operative Research Group (PoCoG), Sydney, New South Wales, Australia
| | - Joanne M Shaw
- The University of Sydney, School of Psychology, Psycho-Oncology Co-operative Research Group (PoCoG), Sydney, New South Wales, Australia
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England KM, Forseth B, Bangash M, Bhagat R, Murray M, Bakula DM, Davis AM. The Impact of the COVID-19 Pandemic on Healthy Lifestyles in Rural Families. JOURNAL OF HEALTHY EATING AND ACTIVE LIVING 2022; 2:23-31. [PMID: 36199811 PMCID: PMC9531899 DOI: 10.51250/jheal.v2i1.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of the current study is to understand how the early portion of COVID-19 pandemic impacted the health behaviors of rural families participating in a healthy lifestyles intervention. Caregivers of rural children participating in a healthy lifestyles intervention were invited to participate in a structured interview regarding how the COVID-19 pandemic affected their family and family health behaviors. Interviews were transcribed and the research team conducted a rigorous inductive thematic analysis. Structured qualitative interviews with caregivers (n=30) resulted in 5 saturated themes: (a) caregivers reported new or exacerbated mental health concerns and stress among family members, largely due to social isolation and external stressors, (b) caregivers reported feeling out of control of positive health behaviors for themselves and their children, (c) families reported variability in how they handled reductions in schedule demands, ranging from filling time with positive activities to negative behaviors such as snacking, (d) families continuously re-adjusted their approach to parenting, routines, and health behaviors due to internal and external factors, (e) families ate foods that were accessible and convenient, which impacted the health of the family diet. Despite being asked primarily about lifestyle behavior changes, families reported concerns around mental health. Implications are that professionals working with rural children and families, even those without mental health training, may be called upon to help address these concerns especially in these underserved, rural families.
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Affiliation(s)
- Keisha M. England
- Department of Pediatrics, University of Kansas Medical Center,
U.S.A
| | - Bethany Forseth
- Department of Pediatrics, University of Kansas Medical Center,
U.S.A
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, Missouri,
U.S.A
| | - Maheen Bangash
- Department of Pediatrics, University of Kansas Medical Center,
U.S.A
| | - Rohit Bhagat
- Department of Pediatrics, University of Kansas Medical Center,
U.S.A
| | - Megan Murray
- Department of Pediatrics, University of Kansas Medical Center,
U.S.A
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, Missouri,
U.S.A
| | | | - Ann M. Davis
- Department of Pediatrics, University of Kansas Medical Center,
U.S.A
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, Missouri,
U.S.A
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36
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Collegiate Student-Athlete Psychological Distress and Counseling Utilization During COVID-19. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2022. [DOI: 10.1123/jcsp.2021-0091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The onset of COVID-19 and cancellation of collegiate sports may have exacerbated student-athletes’ psychological distress. Within a national sample of collegiate athletes (N = 5,755; 66.7% women), we determined how gender and race related to rates of depression, stress, and counseling use at the beginning of the pandemic (April/May 2020). Overall, 26.5% (n = 1,526) and 10.6% (n = 612) endorsed clinical levels of depression and stress, respectively; 25.1% (n = 1,443) and 69.7% (n = 4,014) reported subclinical levels. Few athletes (2.3%–17.1%) reported counseling use before or after the onset of COVID-19; those who did reported higher levels of depression and stress than those who never sought services. The female athletes reported higher rates of depression, stress, and counseling use than the male athletes. There were no race effects. Athletic departments must address their student-athletes’ psychological distress by facilitating a higher use of mental health services.
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Rohrmann T, Praus P, Proctor T, Benedyk A, Tost H, Hennig O, Meyer-Lindenberg A, Wahl AS. Patients with affective disorders profit most from telemedical treatment: Evidence from a naturalistic patient cohort during the COVID-19 pandemic. Front Psychiatry 2022; 13:971896. [PMID: 36532188 PMCID: PMC9751940 DOI: 10.3389/fpsyt.2022.971896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/04/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND During the COVID-19 pandemic telemedicine became essential in maintaining diagnostic procedures and treatment in psychiatry. However, it is still an open question if telemedicine is a feasible treatment option for all groups of psychiatric patients alike. This prospective monocentric observational trial was conducted to assess the general applicability of telemedical treatment in a naturalistic psychiatric outpatient cohort and to identify groups of disorders and clusters of psychopathology that respond particularly well to telemedical treatment considering sociodemographic characteristics and patients' perspectives. METHODS Patients were recruited April 2020-April 2021 and asked to fill out the WHO-5 and the SCL-90R at baseline, after 4-6 and 8-12 weeks and a feedback-survey. Additionally, medical records, psychopathology, psychosocial functioning, and socio-demographic data were analyzed. Primary outcomes were well-being, psychopathology and functioning during treatment. Secondly, diagnostic groups and psychopathology linked to a superior treatment-response were determined with respect to patients' subjective experiences. RESULTS Out of 1.385 patients, 254-mostly with hyperkinetic (35.3%) and depressive disorders (24.6%)-took part. Well-being and SCL-90R total scores improved substantially (both p < 0.001). CGI and GAF scores were worse in depressed subjects (both p < 0.05). Improvement was mainly seen in depressed patients; chronic disorders experienced a decline in well-being. Sociodemographic characteristics could not explain this difference. Particularly female (r = 0.413) patients found telepsychiatry equivalent to conventional treatment. The more virtual sessions participants attended the more likely they were to find telepsychiatry equal to conventional treatment (r = 0.231). CONCLUSION Telemedicine is an effective treatment for patients with depression under naturalistic conditions. Telemedical consultations are a simple and reliable way of monitoring symptom severity and directing treatment choices during the treatment of depressive disorders. Patients with depression benefited more from telemedical treatment compared to participants with chronic non-episodic psychiatric disorders. Future research needs to concentrate on improving telemedical treatment options suited for the latter conditions. Psychiatric telemedicine yielded overall high degrees of satisfaction among users.
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Affiliation(s)
- Tobias Rohrmann
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Peter Praus
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Tanja Proctor
- Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Anastasia Benedyk
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Heike Tost
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Oliver Hennig
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | | | - Anna-Sophia Wahl
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.,Brain Research Institute, University of Zurich, Zurich, Switzerland.,Department of Neuroanatomy, Institute of Anatomy, Ludwigs-Maximilians-University, Munich, Germany
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38
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Qian F, Hastings JF, Ahmed R. Overcoming telemental health disparities during the COVID-19 pandemic. Int J Qual Health Care 2021; 33:6372514. [PMID: 34541600 PMCID: PMC8499973 DOI: 10.1093/intqhc/mzab127] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/16/2021] [Accepted: 09/19/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Feng Qian
- Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany-State University of New York
| | - Julia F Hastings
- Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany-State University of New York.,Department of Health Policy, Management, and Behavior, School of Social Welfare, University at Albany-State University of New York
| | - Rukhsana Ahmed
- Department of Communication, University at Albany-State University of New York, 1400 Washington Avenue, Albany, NY 12222, USA
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