Ingram School of Nursing, McGill University, Montréal, Québec, Canada.
Centre Intégré Universitaire de Santé et Services Sociaux de l'Ouest-de-L'Île-de-Montréal, Montréal, Québec, Canada.
BMC Health Serv Res. 2021 Jan 23;21(1):85. doi: 10.1186/s12913-021-06072-5.
Due to regional, professional, and resource limitations, access to mental health care for Canada's Indigenous peoples can be difficult. Telemental health (TMH) offers the opportunity to provide care across vast distances and has been proven to be as effective as face-to-face services. To our knowledge, there has been no qualitative study exploring the experiences of TMH staff serving the Indigenous peoples in Northern Quebec, Canada; which is the purpose of this study.
Using a qualitative descriptive design, the entire staff of a TMH clinic was recruited, comprising of four psychiatrists and four support staff. Individual semi-structured interviews were conducted through videoconferencing, and results were thematically analyzed.
To address the mental health gap in Northern communities, all psychiatrists believe in the necessity of in-person care and note the synergistic effect of combining in-person care and TMH services. This approach to care allows psychiatrists to maintain both an insider and outsider identity. However, if a patient's condition requires hospitalization, then the TMH staff face a new set of information sharing and communication challenges with the inpatient staff. TMH staff believe that the provision of culturally sensitive care to Northern patients at the inpatient unit is progressing; however, more work needs to be done. Despite the strong collegial atmosphere within the clinic and collective efforts to provide quality TMH services, all participants express a sense of frustration with the paper-based and scattered documentation system.
The TMH team works in cohesion to offer TMH services to Indigenous peoples; yet, automatization is needed to improve the workflow efficiency within the clinic and collaboration with the Northern clinics. More research is needed on the functioning of TMH teams and the separate but important roles of each team member.
由于地区、专业和资源的限制，加拿大原住民获得心理健康护理可能存在困难。远程心理健康（TMH）提供了跨越广阔距离提供护理的机会，并且已被证明与面对面服务一样有效。据我们所知，目前还没有定性研究探讨在加拿大魁北克北部为原住民提供 TMH 服务的工作人员的经验；这就是本研究的目的。
使用定性描述性设计，招募了一家 TMH 诊所的全体工作人员，包括四名精神病医生和四名支持人员。通过视频会议进行了单独的半结构化访谈，并对结果进行了主题分析。
为了解决北部社区的心理健康差距问题，所有精神病医生都认为面对面护理是必要的，并指出将面对面护理和 TMH 服务结合起来的协同作用。这种护理方法使精神病医生能够保持内部人员和外部人员的身份。但是，如果患者的病情需要住院治疗，那么 TMH 工作人员将面临与住院工作人员共享信息和沟通方面的新挑战。TMH 工作人员认为，在住院病房为北部患者提供文化敏感护理正在取得进展；但是，还需要做更多的工作。尽管诊所内的氛围很强，并且为提供高质量的 TMH 服务做出了集体努力，但所有参与者都对基于纸张的分散文档系统表示感到沮丧。
TMH 团队齐心协力为原住民提供 TMH 服务；然而，需要自动化来提高诊所内的工作流程效率，并加强与北部诊所的合作。需要进一步研究 TMH 团队的运作以及每个团队成员的单独但重要的角色。
