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一项关于通过远程医疗获取孕产妇心理健康和物质使用障碍治疗服务及满意度的试点研究。

A Pilot Study Examining Access to and Satisfaction with Maternal Mental Health and Substance Use Disorder Treatment via Telemedicine.

作者信息

Guille Constance, Johnson Emily, Douglas Edie, Aujla Rubin, Boyars Lisa, Kruis Ryan, Beeks Rebecca, King Kathryn, Ford Dee, Sterba Katherine

机构信息

Department of Psychiatry and Behavioral Sciences and Charleston, South Carolina, USA.

Department of Obstetrics and Gynecology; Charleston, South Carolina, USA.

出版信息

Telemed Rep. 2022 Jan 11;3(1):24-29. doi: 10.1089/tmr.2021.0041. eCollection 2022.

Abstract

Mental health (MH) and substance use disorders (SUDs) are common during pregnancy and the postpartum year, and have a significant impact on maternal and child health. Most women do not receive treatment for these conditions due to barriers to care. Increasing access to these services via telemedicine is one potential solution to overcoming barriers, but it is unknown if this type of service is acceptable to women. The purpose of this study is to evaluate patient satisfaction with, and accessibility to, a maternal MH and SUD telemedicine service delivered to obstetric practices. The Telemedicine Satisfaction Questionnaire and the Questionnaire for Assessing Patient Satisfaction with Video Consultation were collected via online surveys. Responses were scored on a 5-point Likert scale, ranging from strongly disagree (1) to strongly agree (5). Paired -tests were used to compare round trip travel time and distance between participants home and specialty clinic at an academic medical center versus their local obstetrics clinic where they received telemedicine services. A total of 91.42% (32/35) of women agreed to take part in the study, and 43.75% (14/32) of women were living in a rural community. Patients reported high levels of satisfaction with the following: overall quality of care (mean [] 4.66 [standard deviation, SD, 0.67]); similarity to face-to-face are ( 4.69 [SD 0.63]); and access to care ( 4.47 [SD 0.81]). Compared with in-person care at an academic medical center, women receiving care via telemedicine spent significantly less time (67.44 minutes vs. 256.31 minutes,  < 0.001) and distance (50.33 miles vs. 236.06 miles,  < 0.001) traveling round trip. Women receiving MH and SUD treatment via telemedicine within their obstetrician's office report high levels of satisfaction and increased access to care with this modality of treatment delivery. Telemedicine may provide one solution to removing barriers to care and mitigating the maternal and child risks associated with of untreated MH and SUDs.

摘要

心理健康(MH)和物质使用障碍(SUDs)在孕期及产后一年内很常见,且对母婴健康有重大影响。由于护理障碍,大多数女性并未针对这些情况接受治疗。通过远程医疗增加这些服务的可及性是克服障碍的一个潜在解决方案,但这种服务类型是否为女性所接受尚不清楚。本研究的目的是评估患者对提供给产科机构的孕产妇心理健康和物质使用障碍远程医疗服务的满意度及可及性。通过在线调查收集了《远程医疗满意度问卷》和《视频咨询患者满意度评估问卷》。回答按5分李克特量表计分,从强烈不同意(1分)到强烈同意(5分)。使用配对t检验比较参与者往返学术医疗中心的专科诊所与他们接受远程医疗服务的当地产科诊所的行程时间和距离。共有91.42%(32/35)的女性同意参与研究,43.75%(14/32)的女性生活在农村社区。患者对以下方面满意度较高:总体护理质量(均值[ ]4.66[标准差,SD,0.67]);与面对面诊疗的相似性(4.69[SD 0.63]);以及获得护理的便利性(4.47[SD 0.81])。与在学术医疗中心接受面对面护理相比,通过远程医疗接受护理的女性往返行程花费的时间(67.44分钟对256.31分钟,P<0.001)和距离(50.33英里对236.06英里,P<0.001)显著更少。在产科医生办公室通过远程医疗接受心理健康和物质使用障碍治疗的女性报告对这种治疗方式满意度高且获得护理的便利性增加。远程医疗可能是消除护理障碍以及减轻与未治疗的心理健康和物质使用障碍相关的母婴风险的一种解决方案。

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