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关爱最脆弱的群体:COVID-19 大流行期间管理有精神特殊需求儿童适应不良行为的模式。

Caring for the Most Vulnerable: A Model for Managing Maladaptive Behavior in Children with Mental Special Needs During the COVID-19 Pandemic.

机构信息

Autism, Mental Special Needs and Rare Disease Department in Turkish Ministry of Health, General Directorate of Health Services, Ankara, Turkey.

Child and Adolescent Psychiatry Department, Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey.

出版信息

Telemed J E Health. 2021 Sep;27(9):1068-1073. doi: 10.1089/tmj.2020.0380. Epub 2020 Nov 23.

DOI:10.1089/tmj.2020.0380
PMID:33232640
Abstract

This article presents the results of a comprehensive national model developed for managing maladaptive behaviors (MBs) in children with mental special needs (CMSNs) during the coronavirus disease 2019 (COVID-19) pandemic that combines telehealth-based Applied Behavioral Analyses, psychiatric interventions, and support from local psychosocial teams. This study aims to determine the effectiveness of a system that combined telehealth applications with local psychosocial support teams, allowing services from video calls to emergency interventions. The system combines the telehealth applications with the services from local psychosocial intervention teams. In addition to system records covering sociodemographic variables and initial complaints, a telephone survey questioning the effectiveness and satisfaction of the system was used as the main outcome. In total, 347 individuals used the system with mothers constituting the majority of applicants (88.7%,  = 332). The overall satisfaction of the system was 8.8/10. In terms of effectiveness, 63.3% ( = 237) of caregivers reported an improvement in the reason of application. Counselors decided on a need for follow-up visits for 36.6% ( = 137) of applications. A referral to a psychiatrist was asked for 40 patients (10.6%). To our best knowledge, this is the first study presenting a model for managing MBs of CMSNs during the COVID-19 outbreak. In general, therefore, it seems that there is a need for unique systems to handle behavioral problems of CMSNs. The findings of this study suggest that it is possible to establish an integrative multistep multidisciplinary telehealth-based approach in a short while.

摘要

这篇文章介绍了一种针对患有精神特殊需求的儿童的不良行为(MBs)的综合性国家管理模型的结果,该模型结合了基于远程医疗的应用行为分析、精神干预以及当地心理社会团队的支持。本研究旨在确定一种将远程医疗应用与当地心理社会支持团队相结合的系统的有效性,使服务从视频通话到紧急干预。该系统将远程医疗应用与当地心理社会干预团队的服务相结合。除了涵盖社会人口统计学变量和初始投诉的系统记录外,还使用了电话调查来询问系统的有效性和满意度作为主要结果。共有 347 人使用该系统,母亲是申请人的大多数(88.7%, = 332)。系统的总体满意度为 8.8/10。就有效性而言,63.3%( = 237)的照顾者报告申请的原因有所改善。咨询师决定对 36.6%( = 137)的申请进行随访。有 40 名患者(10.6%)需要转介给精神科医生。据我们所知,这是第一项在 COVID-19 爆发期间针对 CMSN 的 MBs 管理模型的研究。因此,总体而言,似乎需要独特的系统来处理 CMSN 的行为问题。本研究的结果表明,在短时间内建立一种整合的多步骤多学科基于远程医疗的方法是可行的。

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