Division of Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Department of Undergraduate Education- Medical Sciences, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Brain Inj. 2022 Mar 21;36(4):536-543. doi: 10.1080/02699052.2022.2034956. Epub 2022 Feb 3.
To examine professional stakeholders' perspectives of barriers to behavioral health care (BHC) follow-up and telepsychology after pediatric traumatic brain injury (TBI).
Twenty-nine professionals participated in a focus group (FG) or key informant interview (KII) between January and March 2020. Professionals answered questions about facilitators and barriers to BHC follow-up and telepsychology. Given widespread telepsychology implementation since COVID-19, a follow-up survey assessing telehealth perceptions since the pandemic was sent out in December 2020. Nineteen professionals completed the survey.
Professionals identified individual (e.g., family factors, insurance coverage/finances, transportation/distance, availability, planning follow-up care) and system-level (e.g., lack of access to BHC providers) barriers to BHC post-injury. Possible solutions, like collaborative follow-up care, were also identified. Generally, clinical professionals have favorable impressions of telepsychology and utilized services as a delivery modality for clinical care. Though telepsychology could reduce barriers to care, professionals also expressed concerns (e.g., technology issues, security/safety) and challenges (e.g., funding, accessibility, training/licensure for clinicians) with implementing telepsychology.
Barriers identified highlight the need for context-specific solutions to increase BHC access, with telepsychology generally recognized as a beneficial modality for BHC. Future work should continue to focus on understanding barriers to BHC and potential solutions after pediatric TBI.
探讨行为健康护理(BHC)随访和儿童创伤性脑损伤(TBI)后远程心理治疗的专业利益相关者对障碍的看法。
29 名专业人员于 2020 年 1 月至 3 月期间参加了焦点小组(FG)或关键知情人访谈(KII)。专业人员回答了关于 BHC 随访和远程心理治疗的促进因素和障碍的问题。鉴于 COVID-19 以来远程心理治疗的广泛实施,我们在 2020 年 12 月发送了一项关于大流行后远程医疗认知的后续调查。19 名专业人员完成了调查。
专业人员确定了个人(例如,家庭因素、保险覆盖范围/财务状况、交通/距离、可用性、规划随访护理)和系统级(例如,缺乏 BHC 提供者的机会)受伤后 BHC 的障碍。还确定了可能的解决方案,例如协作性随访护理。一般来说,临床专业人员对远程心理治疗的印象良好,并将其用作临床护理的交付模式。尽管远程心理治疗可以减少护理障碍,但专业人员也表达了对实施远程心理治疗的担忧(例如,技术问题、安全/保障)和挑战(例如,资金、可及性、临床医生的培训/许可)。
确定的障碍突出表明需要有针对性的解决方案来增加 BHC 的可及性,远程心理治疗通常被认为是 BHC 的有益模式。未来的工作应继续关注理解儿童 TBI 后 BHC 的障碍和潜在解决方案。