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儿童和青少年远程精神病学:利用情况与满意度

Child and adolescent telepsychiatry: utilization and satisfaction.

作者信息

Myers Kathleen M, Valentine Jeanette M, Melzer Sanford M

机构信息

Childrens Hospital and Regional Medical Center (CHRMC), University of Washington School of Medicine, Seattle, WA, USA.

出版信息

Telemed J E Health. 2008 Mar;14(2):131-7. doi: 10.1089/tmj.2007.0035.

Abstract

Access to psychiatric care for children and adolescents is limited outside of urban areas. Telepsychiatry provides one mechanism to bring needed services to youth. This investigation examines whether telepsychiatry could be successful in providing needed services. Using interactive video teleconferencing at 384 kilobits per second, psychiatrists based at a regional childrens hospital provided consultation and management services to patients at 4 sites across Washington State located 75150 miles from the childrens hospital. Twelve-month review of billing records provided utilization data. Surveys of parents satisfaction over 12 months examined whether parents would accept and be satisfied with the care rendered to their children. Over the study year, 387 telepsychiatry visits were provided to 172 youth 221 years old with a mean of 2.25 visits per patient. The demographic and diagnostic profile of this sample was consistent with usual outpatient mental health samples. Parents endorsed high satisfaction with their childrens telepsychiatric care, with an indication of increasing satisfaction upon return appointments. Parents demonstrated some differential satisfaction, tending to higher satisfaction with their school-aged childrens care and lower satisfaction with their adolescents care. Telepsychiatry offered through a regional childrens hospital was well utilized and parents were highly satisfied with their childrens care. The stage is now set for integrating telepsychiatry into a system of care that meets youths overall needs and for controlled studies demonstrating the efficacy of telepsychiatry with youth.

摘要

在城市以外的地区,儿童和青少年获得精神科护理的机会有限。远程精神病学提供了一种为年轻人提供所需服务的机制。本研究调查了远程精神病学是否能够成功提供所需服务。位于一家地区儿童医院的精神科医生使用每秒384千比特的交互式视频电话会议,为华盛顿州4个距离儿童医院75至150英里的地点的患者提供咨询和管理服务。对计费记录进行的为期12个月的审查提供了使用数据。对家长在12个月内的满意度调查,考察了家长是否会接受并对给予其子女的护理感到满意。在研究年度内,为172名2至21岁的青少年提供了387次远程精神病学诊疗,每名患者平均诊疗2.25次。该样本的人口统计学和诊断特征与普通门诊心理健康样本一致。家长对其子女的远程精神病学护理给予了高度评价,复诊时满意度呈上升趋势。家长表现出一定的差异满意度,对学龄儿童护理的满意度往往较高,对青少年护理的满意度较低。通过地区儿童医院提供的远程精神病学得到了充分利用,家长对其子女的护理非常满意。现在已经为将远程精神病学纳入满足年轻人整体需求的护理系统以及开展证明远程精神病学对年轻人有效性的对照研究做好了准备。

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