e-Mental health care for people living with dementia: A lesson on digital equality from COVID-19.
e-Mental health care for people living with dementia: A lesson on digital equality from COVID-19.
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DOI：
10.1002/dad2.12100
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Wong G
中科院分区：
文献类型：
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作者：
Dai R;Spector A;Wong G
在大流行条件下，迫切需要减轻弱势群体的心理健康后果。1痴呆症患者(PLwD)是处境最不利的人群之一。大多数PLWD是患有慢性病的老年人，死亡风险增加，此外还有与认知障碍相关的感染风险，这导致难以遵循个人卫生指示。2、3“呆在家里”和探视限制措施拯救了生命，但却以PLWD及其照顾者的心理健康为代价：当心理社会干预等“非必要”活动被削减时，孤独、抑郁、认知恶化、焦虑和照顾者负担3等负面后果就是合乎逻辑的结果，人们只能靠自己的设备来应对可能对其心理健康造成的长期损害。这发生在这样的背景下，本来健康的人设法在日常生活中保持一些正常，免受完全的社交孤立。由于信息通信技术(ICT)，能够获得非紧急服务：虚拟会议、实时聊天和在线学习蓬勃发展。理论上，应用信息和通信技术支持“非紧急”护理是可行的；例如，关于视频会议用于痴呆症诊断面谈的可行性的初步证据可以追溯到2007年。5然而，在痴呆症电子心理健康方面的发展并没有看到太大的进展，直到最近新冠肺炎的可怕情况敲响了警钟，迫使我们重新考虑最佳实践的可能性。最近，我们看到痴呆症服务提供商探索通过视频会议或电话的方式提供远程服务。4大流行病可能成为保健电子服务的转折点，6促进电子心理保健服务的实施，这可能被证明是超越当前危机的较长期解决办法。我们目睹了自下而上、由需求驱动的对信通技术支持的服务的请求的大规模激增。在英国，国家健康与护理卓越研究所(NICE)指南建议所有轻度至中度痴呆症患者都可以接受团体认知刺激疗法(CST)，7考虑到其在提高认知和生活质量方面的好处。这项服务主要是通过英国的国家卫生服务(NHS)和全球约30个国家的其他提供者提供的，在大流行期间基本上受到了干扰。世界各地的服务提供商已经发起了非正式
The urgent need to mitigate the mental health consequences for vulnerable groups under pandemic conditions is clear. 1 People living with dementia (PLwD) are among the most disadvantaged. The majority of PLwD are older persons with chronic conditions with increased mortality risk, in addition to risks of infection associated with cognitive impairment, which causes difficulties in following personal hygiene instructions. 2, 3 The" stay-at-home" and visitation restrictions measures save lives, but at a cost to the mental health of PLwD and their carers: when" non-essential" activities such as psychosocial interventions are cut, 4 negative consequences such as loneliness, depression, worsened cognition, agitation, and carer burden 3 are logical outcomes, and people are left to their own devices to handle the likely long-term damage to their mental health.This happens against a background in which otherwise healthy people manage to maintain some normality in everyday life, protected from being completely socially isolated, and being able to access non-urgent services thanks to information communication technology (ICT): virtual meetings, live chats, online learning are flourishing. In theory, the application of ICT to support" non-urgent" care is feasible; for example, initial evidence on the feasibility of videoconferencing for diagnostic interviewing in dementia can be dated back to 2007. 5 Development in e-mental health for dementia has not seen much progress, however, until the recent wake-up call from the dire situation of COVID-19, which forces us to rethink the possibilities of best practice. Recently, we have seen dementia service providers exploring remote services via videoconferencing methods or telephone calls. 4 The pandemic could be the turning point for e-services in health care, 6 catalyzing implementation of e-mental health services, which may prove to be a longerterm solution beyond the current crisis. We are witnessing a massive surge in bottom-up, needs-driven requests for ICT-supported services. In the UK, the National Institute for Health and Care Excellence (NICE) guidelines recommend that all people with mild to moderate dementia have access to group cognitive stimulation therapy (CST), 7 in view of its benefits in enhancing cognition and quality of life. This service, provided mainly through the National Health Service (NHS) in the UK and other providers in approximately 30 countries worldwide, has been largely disrupted during the pandemic. Service providers around the world have initiated informal