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用于个性化危机解决和家庭治疗的数字化服务提供形式

[Digital forms of service delivery for personalized crisis resolution and home treatment].

作者信息

Rauschenberg Christian, Hirjak Dusan, Ganslandt Thomas, Schulte-Strathaus Julia C C, Schick Anita, Meyer-Lindenberg Andreas, Reininghaus Ulrich

机构信息

Abteilung Public Mental Health, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, J5, 68159, Mannheim, Deutschland.

Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Niederlande.

出版信息

Nervenarzt. 2022 Mar;93(3):279-287. doi: 10.1007/s00115-021-01100-5. Epub 2021 Mar 17.

Abstract

BACKGROUND

Ward-equivalent treatment (StäB), a form of crisis resolution and home treatment in Germany, has been introduced in 2018 as a new model of mental health service delivery for people with an indication for inpatient care. The rapid progress in the field of information and communication technology offers entirely new opportunities for innovative digital mental health care, such as telemedicine, eHealth, or mHealth interventions.

OBJECTIVE

This review aims to provide a comprehensive overview of novel digital forms of service delivery that may contribute to a personalized delivery of StäB and improving clinical and social outcomes as well as reducing direct and indirect costs.

METHOD

This work is based on a narrative review.

RESULTS

Four primary digital forms of service delivery have been identified that can be used for personalized delivery of StäB: (1) communication, continuity of care, and flexibility through online chat and video call; (2) monitoring of symptoms and behavior in real-time through ecological momentary assessment (EMA); (3) use of multimodal EMA data to generate and offer personalized feedback on subjective experience and behavioral patterns as well as (4) adaptive ecological momentary interventions (EMI) tailored to the person, moment, and context in daily life.

CONCLUSION

New digital forms of service delivery have considerable potential to increase the effectiveness and cost-effectiveness of crisis resolution, home treatment, and assertive outreach. An important next step is to model and initially evaluate these novel digital forms of service delivery in the context of StäB and carefully investigate their quality from the user perspective, safety, feasibility, initial process and outcome quality as well as barriers and facilitators of implementation.

摘要

背景

病房等效治疗(StäB)是德国危机解决和家庭治疗的一种形式,于2018年推出,作为一种针对有住院治疗指征的人群的新型心理健康服务模式。信息和通信技术领域的快速发展为创新的数字心理健康护理提供了全新的机会,如远程医疗、电子健康或移动健康干预。

目的

本综述旨在全面概述新型数字服务提供形式,这些形式可能有助于个性化提供StäB,改善临床和社会结果,并降低直接和间接成本。

方法

本研究基于叙述性综述。

结果

已确定四种主要的数字服务提供形式,可用于个性化提供StäB:(1)通过在线聊天和视频通话实现沟通、护理连续性和灵活性;(2)通过生态瞬时评估(EMA)实时监测症状和行为;(3)利用多模式EMA数据生成并提供关于主观体验和行为模式的个性化反馈,以及(4)针对日常生活中的个人、时刻和情境量身定制的适应性生态瞬时干预(EMI)。

结论

新的数字服务提供形式具有相当大的潜力,可提高危机解决、家庭治疗和积极外展服务的有效性和成本效益。重要的下一步是在StäB的背景下对这些新型数字服务提供形式进行建模并初步评估,并从用户角度仔细研究它们的质量、安全性、可行性、初始过程和结果质量以及实施的障碍和促进因素。

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