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专业利益相关者对儿童创伤性脑损伤后行为保健障碍的看法。

Professional stakeholders' perceptions of barriers to behavioral health care following pediatric traumatic brain injury.

机构信息

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.

出版信息

Brain Inj. 2022 Mar 21;36(4):536-543. doi: 10.1080/02699052.2022.2034956. Epub 2022 Feb 3.

Abstract

OBJECTIVE

To examine professional stakeholders' perspectives of barriers to behavioral health care (BHC) follow-up and telepsychology after pediatric traumatic brain injury (TBI).

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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