Morgiève Margot, Sebbane Déborah, De Rosario Bianca, Demassiet Vincent, Kabbaj Soraya, Briffault Xavier, Roelandt Jean-Luc
World Health Organization Collaborating Centre for Research and Training in Mental Health, Établissement Public de Santé Mentale Lille Metropole, Lille-Hellemmes, France.
Université Lille, Centre Hospitalier Universitaire de Lille, Pôle de psychiatrie, F-59000, Lille, France.
JMIR Ment Health. 2019 Oct 9;6(10):e11665. doi: 10.2196/11665.
For the World Health Organization, electronic health (eHealth) is seen as an effective way to improve therapeutic practices and disease prevention in health. Digital tools lead to major changes in the field of mental medicine, but specific analyses are required to understand and accompany these changes.
Our objective was to highlight the positions of the different stakeholders of the mental health care system on eHealth services and tools, as well as to establish professional and user group profiles of these positions and the uses of these services.
In order to acquire the opinions and expectations of different categories of people, we carried out a qualitative study based on 10 focus groups (n=70, from 3-12 people per group) composed of: general practitioners, psychiatrists, psychologists, social workers, occupational therapists, nurses, caregivers, mental health services users, user representatives, and the general public. The analyses of focus group discussions were performed independently by four investigators through a common analysis grid. The constant comparative method was adopted within this framework.
The interviewees expressed different problems that new technologies engender in the field of mental health. What was previously strictly under the jurisdiction of physicians now tends to be fragmented and distributed over different groups and locations. New technologies reposition care in the field of domestic, rather than therapeutic, activities, and thus the conception of care as an autonomous activity in the subject's life is questioned. The ideal of social autonomy through technology is part of the new logic of health democracy and empowerment, which is linked to a strong, contemporary aspiration to perform. Participants emphasized that there was the potential risk of a decrease in autonomy for the digitally engaged patient, while personal empowerment could become a set of obligations.
This qualitative research highlights the heterogeneity of opinions among the groups and within each group. It suggests that opinions on electronic mental health devices are still far from being stabilized, and that a change management process should be set up to both regulate the development and facilitate the use of these tools.
世界卫生组织认为，电子健康（eHealth）是改善健康领域治疗实践和疾病预防的有效途径。数字工具给精神医学领域带来了重大变革，但需要进行具体分析以理解并顺应这些变化。
我们的目的是突出精神卫生保健系统不同利益相关者对电子健康服务和工具的立场，并建立这些立场以及这些服务使用情况的专业人员和用户群体概况。
为了获取不同人群的意见和期望，我们开展了一项定性研究，该研究基于10个焦点小组（n = 70，每组3至12人），成员包括：全科医生、精神科医生、心理学家、社会工作者、职业治疗师、护士、护理人员、精神卫生服务使用者、用户代表和普通公众。4名研究人员通过一个通用分析网格独立进行焦点小组讨论分析。在此框架内采用了持续比较法。
受访者表达了新技术在精神卫生领域引发的不同问题。以前严格由医生负责的领域现在往往变得分散，分布在不同群体和地点。新技术将护理重新定位到家庭活动领域，而非治疗活动领域，因此护理作为个体生活中一项自主活动的概念受到质疑。通过技术实现社会自主的理想是健康民主和赋权新逻辑的一部分，这与强烈的当代表现愿望相关联。参与者强调，参与数字活动的患者存在自主性降低的潜在风险，而个人赋权可能会变成一系列义务。
这项定性研究突出了各群体之间以及每个群体内部意见的异质性。研究表明，关于电子精神卫生设备的意见仍远未稳定，应建立一个变革管理过程，以规范这些工具的开发并促进其使用。
