Meurk Carla, Leung Janni, Hall Wayne, Head Brian W, Whiteford Harvey
School of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Herston, Australia.
J Med Internet Res. 2016 Jan 13;18(1):e10. doi: 10.2196/jmir.4827.
Growing evidence attests to the efficacy of e-mental health services. There is less evidence on how to facilitate the safe, effective, and sustainable implementation of these services.
We conducted a systematic review on e-mental health service use for depressive and anxiety disorders to inform policy development and identify policy-relevant gaps in the evidence base.
Following the PRISMA protocol, we identified research (1) conducted in Australia, (2) on e-mental health services, (3) for depressive or anxiety disorders, and (4) on e-mental health usage, such as barriers and facilitators to use. Databases searched included Cochrane, PubMed, PsycINFO, CINAHL, Embase, ProQuest Social Science, and Google Scholar. Sources were assessed according to area and level of policy relevance.
The search yielded 1081 studies; 30 studies were included for analysis. Most reported on self-selected samples and samples of online help-seekers. Studies indicate that e-mental health services are predominantly used by females, and those who are more educated and socioeconomically advantaged. Ethnicity was infrequently reported on. Studies examining consumer preferences found a preference for face-to-face therapy over e-therapies, but not an aversion to e-therapy. Content relevant to governance was predominantly related to the organizational dimensions of e-mental health services, followed by implications for community education. Financing and payment for e-services and governance of the information communication technology were least commonly discussed.
Little research focuses explicitly on policy development and implementation planning; most research provides an e-services perspective. Research is needed to provide community and policy-maker perspectives. General population studies of prospective treatment seekers that include ethnicity and socioeconomic status and quantify relative preferences for all treatment modalities are necessary.
越来越多的证据证明电子心理健康服务的有效性。但关于如何促进这些服务的安全、有效和可持续实施的证据较少。
我们对用于治疗抑郁和焦虑症的电子心理健康服务进行了系统综述，以为政策制定提供信息，并确定证据基础中与政策相关的差距。
按照PRISMA协议，我们确定了以下研究：（1）在澳大利亚进行的；（2）关于电子心理健康服务的；（3）针对抑郁或焦虑症的；（4）关于电子心理健康使用情况的，如使用的障碍和促进因素。检索的数据库包括Cochrane、PubMed、PsycINFO、CINAHL、Embase、ProQuest社会科学数据库和谷歌学术。根据政策相关性的领域和水平对来源进行评估。
检索共得到1081项研究；纳入30项研究进行分析。大多数研究报告的是自我选择的样本和在线求助者的样本。研究表明，电子心理健康服务的主要使用者是女性，以及受教育程度较高和社会经济地位较优越的人群。关于种族的报道很少。研究消费者偏好的研究发现，与电子治疗相比，消费者更喜欢面对面治疗，但并非厌恶电子治疗。与治理相关的内容主要与电子心理健康服务的组织层面有关，其次是对社区教育的影响。关于电子服务的融资和支付以及信息通信技术治理的讨论最少。
很少有研究明确关注政策制定和实施规划；大多数研究提供的是电子服务视角。需要开展研究以提供社区和政策制定者的视角。有必要对潜在治疗寻求者进行包括种族和社会经济地位在内的总体人群研究，并量化对所有治疗方式的相对偏好。
