Service user experiences and views regarding telemental health during the COVID-19 pandemic: A co-produced framework analysis.
Service user experiences and views regarding telemental health during the COVID-19 pandemic: A co-produced framework analysis.
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DOI：
10.1371/journal.pone.0257270
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Johnson S
中科院分区：
文献类型：
--
作者：
Vera San Juan N;Shah P;Schlief M;Appleton R;Nyikavaranda P;Birken M;Foye U;Lloyd-Evans B;Morant N;Needle JJ;Simpson A;Lyons N;Rains LS;Dedat Z;Johnson S
在COVID-19大流行期间，远程健康（包括通过视频通话和电话提供护理）的重要性大大增加。然而，在接受和接受方面存在明显的差异，人们担心数字排斥可能会加剧以前在获得优质护理方面的不平等。需要更好地了解服务用户如何体验远程健康，以及是什么决定了他们是否参与并认为可以接受。我们对来自半结构化访谈的数据进行了合作框架分析，访谈样本是在大流行之前已经经历过心理健康问题的人。识别并提取了参与者在大流行期间对远程健康的经验和观点的相关数据。数据收集和分析采用参与式合作方法，具有相关生活经验的研究人员与临床和学术研究人员一起参与数据收集，分析和解释结果的所有阶段。44名参与者对远程医疗保健的体验和偏好是动态的，并且随着时间和环境以及个人之间的变化而变化。参与者的偏好是由联系服务的原因，他们与护理提供者的关系，以及双方对技术的访问和他们的个人偏好形成的。虽然面对面的护理往往是首选，但参与者确定了远程护理的好处，包括使某些人群更容易获得护理，并提高了处方审查等功能预约的效率。与会者强调了与在线环境中的安全和隐私相关的重要挑战，并举例说明了他们所经历的良好远程护理策略，包括安排定期电话服务和制定有关如何访问远程护理工具的指导方针。我们研究的参与者强调了远程医疗的优势，以及可能阻碍心理健康支持和加剧获得服务不平等的重大限制。其中一些限制被认为是可以消除的，例如通过工作人员培训或为工作人员或服务用户提供更好的数字访问。其他人则表示，至少在某些约会中，需要保持传统的面对面接触。显然，护理需要灵活和个性化，以满足用户的情况和偏好。需要进一步研究如何最大限度地减少数字排斥，并支持工作人员有效和协作地使用相关技术。
The prominence of telemental health, including providing care by video call and telephone, has greatly increased during the COVID-19 pandemic. However, there are clear variations in uptake and acceptability, and concerns that digital exclusion may exacerbate previous inequalities in access to good quality care. Greater understanding is needed of how service users experience telemental health, and what determines whether they engage and find it acceptable. We conducted a collaborative framework analysis of data from semi-structured interviews with a sample of people already experiencing mental health problems prior to the pandemic. Data relevant to participants’ experiences and views regarding telemental health during the pandemic were identified and extracted. Data collection and analysis used a participatory, coproduction approach where researchers with relevant lived experience, contributed to all stages of data collection, analysis and interpretation of findings alongside clinical and academic researchers. The experiences and preferences regarding telemental health care of the forty-four participants were dynamic and varied across time and settings, as well as between individuals. Participants’ preferences were shaped by reasons for contacting services, their relationship with care providers, and both parties’ access to technology and their individual preferences. While face-to-face care tended to be the preferred option, participants identified benefits of remote care including making care more accessible for some populations and improved efficiency for functional appointments such as prescription reviews. Participants highlighted important challenges related to safety and privacy in online settings, and gave examples of good remote care strategies they had experienced, including services scheduling regular phone calls and developing guidelines about how to access remote care tools. Participants in our study have highlighted advantages of telemental health care, as well as significant limitations that risk hindering mental health support and exacerbate inequalities in access to services. Some of these limitations are seen as potentially removable, for example through staff training or better digital access for staff or service users. Others indicate a need to maintain traditional face-to-face contact at least for some appointments. There is a clear need for care to be flexible and individualised to service user circumstances and preferences. Further research is needed on ways of minimising digital exclusion and of supporting staff in making effective and collaborative use of relevant technologies.
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