Applicability of telemedicine for assessing patients with schizophrenia: Acceptance and reliability
Applicability of telemedicine for assessing patients with schizophrenia: Acceptance and reliability
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DOI：
10.4088/jcp.v58n0104
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发表时间：
1997-01-01
影响因子：
5.3
通讯作者：
Baer, L
中科院分区：
文献类型：
--
作者：
Zarate, CA;Weinstock, L;Baer, L
背景资料：远程医疗有望为服务不足的人群提供专家精神病咨询，但尚未对精神分裂症或任何其他严重精神障碍进行定量研究。本研究旨在评估电视会议设备在精神分裂症患者评估中的可靠性和可接受性。方法：我们在三种情况下评估简明精神病评定量表（BPRS）、阳性症状评估量表（SAPS）和阴性症状评估量表（SANS）的可靠性：（1）亲自出席，（2）通过低带宽（每秒128千比特）的视频会议，（3）通过高带宽（384千比特）的视频会议。所有45例患者均符合DSM-IV精神分裂症标准。所有的患者和两个面试官的评价对以前的生活精神interviews.Results：BPRS和SAPS的总得分的研究采访的各个方面进行了评估，同样可靠的三个媒体。SANS总分在低带宽下评估的可靠性较低，精神分裂症的几种特定阴性症状严重依赖于非语言线索。两组患者都很好地接受了视频访谈，尽管高带宽组的患者更喜欢视频访谈而不是现场访谈。通过视频会议技术可靠地评估了精神分裂症的总体严重程度和阳性症状的总体严重程度，较高的带宽导致对阴性症状的更可靠的评估，并且优于低带宽，尽管在这两种情况下，患者和评估者对视频的接受度都很好，但视频咨询似乎是评估偏远地区精神分裂症患者的可靠方法，这些患者很少有机会获得专家咨询。
Background: Telemedicine holds promise for providing expert psychiatric consultation to underserved populations, but has not been quantitatively studied in schizophrenia or any other major mental disorder. This study was conducted to assess the reliability and acceptance of videoconferencing equipment in the assessment of patients with schizophrenia.Method: We assessed reliability of the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), and Scale for the Assessment of Negative Symptoms (SANS) under three conditions: (1) in person, (2) by videoconferencing at low (128 kilobits per second [kbs]) bandwidth, (3) by videoconferencing at high (384 kbs) bandwidth. All 45 patients met DSM-IV criteria for schizophrenia. All patients and the two interviewers rated various aspects of the study interviews against previous live psychiatric interviews.Results: Total scores on both the BPRS and SAPS were assessed equally reliably by the three media. Total score on the SANS was less reliably assessed at the low bandwidth, as were several specific negative symptoms of schizophrenia that depend heavily on nonverbal cues. Video interviews were well accepted by patients in both groups, although patients in the high bandwidth group were more likely to prefer the video interview to a live interview.Conclusion: Global severity of schizophrenia and overall severity of positive symptoms were reliably assessed by videoconferencing technology, Higher bandwidth resulted in more reliable assessment of negative symptoms and was preferred over low bandwidth, although patients' and raters' acceptance of video was good in both conditions, Videoconsultation appears to be a reliable method of assessing schizophrenic patients in remote locations who have limited access to expert consultation.