Kip Hanneke, Bouman Yvonne H A, Kelders Saskia M, van Gemert-Pijnen Lisette J E W C
Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.
Department of Research, Stichting Transfore, Deventer, Netherlands.
Front Psychiatry. 2018 Feb 21;9:42. doi: 10.3389/fpsyt.2018.00042. eCollection 2018.
Treatment of offenders in forensic mental health is complex. Often, these in- or outpatients have low treatment motivation, suffer from multiple disorders, and have poor literacy skills. eHealth may be able to improve treatment outcomes because of its potential to increase motivation and engagement, and it can overcome the predominant one-size-fits-all approach by being tailored to individual patients.
To examine its potential, this systematic review studies the way that eHealth has been used and studied in forensic mental health and identifies accompanying advantages and disadvantages for both patients and treatment, including effectiveness.
A systematic search in Scopus, PsycINFO, and Web of Science was performed up until December 2017. Studies were included if they focused on technological interventions to improve the treatment of forensic psychiatric patients.
The search resulted in 50 studies in which eHealth was used for treatment purposes. Multiple types of studies and technologies were identified, such as virtual reality, web-based interventions, and videoconferencing. The results confirmed the benefits of technology, for example, the acquisition of unique information about offenders, effectiveness, and tailoring to specific characteristics, but indicated that these are not fully taken advantage of.
To overcome the barriers and obtain the benefits, eHealth has to have a good fit with patients and the forensic psychiatric context. It has to be seamlessly integrated in existing care and should not be added as an isolated element. To bridge the gap between the current situation and eHealth's potential, further research on development, implementation, and evaluation should be conducted.
法医精神卫生领域中对罪犯的治疗十分复杂。这些门诊或住院患者往往治疗动机低，患有多种疾病，读写能力差。电子健康（eHealth）因其有提高动机和参与度的潜力，或许能够改善治疗效果，并且它可以针对个体患者进行定制，从而克服普遍存在的一刀切方法。
为检验其潜力，本系统评价研究了电子健康在法医精神卫生领域的使用和研究方式，并确定了对患者和治疗（包括有效性）而言相应的优缺点。
截至2017年12月，在Scopus、PsycINFO和科学网进行了系统检索。纳入的研究需聚焦于改善法医精神病患者治疗的技术干预措施。
检索得到50项将电子健康用于治疗目的的研究。确定了多种类型的研究和技术，如虚拟现实、基于网络的干预措施和视频会议。结果证实了技术的益处，例如获取关于罪犯的独特信息、有效性以及针对特定特征进行定制，但表明这些优势尚未得到充分利用。
为克服障碍并获得益处，电子健康必须与患者及法医精神病学背景良好契合。它必须无缝融入现有护理中，而不应作为一个孤立的元素添加。为弥合当前状况与电子健康潜力之间的差距，应进一步开展关于开发、实施和评估的研究。
