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审视视频的价值:一项关于退伍军人事务远程心理健康项目评估中患者对使用视频的偏好的定性研究。

Seeing the Value of Video: A Qualitative Study on Patient Preference for Using Video in a Veteran Affairs Telemental Health Program Evaluation.

作者信息

Chen Patricia V, Helm Ashley, Fletcher Terri, Wassef Miryam, Hogan Julianna, Amspoker Amy, Cloitre Marylène, Lindsay Jan

机构信息

Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas, USA.

Margaret M. and Albert B Alkek Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.

出版信息

Telemed Rep. 2021 May 31;2(1):156-162. doi: 10.1089/tmr.2021.0005. eCollection 2021.

Abstract

As the use of telemental health-mental health care delivered through video or phone-has increased in the era of COVID, it is important to understand patients' preferences and perspectives regarding the use of video for telehealth visits. A new web-based treatment program for veterans uses video visits with mental health experts to supplement its online cognitive behavioral therapy to treat clinically significant symptoms of depression and/or post-traumatic stress disorder. As part of the program evaluation, Veterans were asked, "How important was it for you to be able to physically see your provider through video telehealth?" to understand whether they thought using video was important and why it may or may not be important. The study uses data from the program's exit survey and exit interview. The surveys and interviews were conducted over a 19-month period. Surveys and interviews were conducted over the phone with note taking. Matrix and content analyses were used to analyze the qualitative data-predetermined themes and emergent themes were analyzed and inform findings. Seventy-three veterans completed a survey. Of these, 64 completed an interview. The majority of veterans surveyed (75%) said that it was "very important" to physically see their provider through video telehealth, 23% said that it was at least "somewhat important" or "not at all important." This study highlights three main themes found in the qualitative data: patients discuss (1) advantages of using video, (2) why they dislike video, and (3) technological barriers to using video. Being able to visually see a provider, and be seen by a provider, has distinct benefits for care and relationship building that are difficult to achieve over the phone. This has important implications for the future delivery of telemental health care and deserves consideration as patients and providers decide whether to use phone or video for remotely delivered care.

摘要

在新冠疫情时代,随着远程心理健康服务(即通过视频或电话提供的心理健康护理)的使用增加,了解患者对于在远程医疗就诊中使用视频的偏好和看法变得很重要。一项针对退伍军人的新型网络治疗项目利用与心理健康专家的视频就诊来补充其在线认知行为疗法,以治疗具有临床意义的抑郁症状和/或创伤后应激障碍症状。作为项目评估的一部分,研究人员询问退伍军人:“通过视频远程医疗能够亲眼见到你的医疗服务提供者对你来说有多重要?”,以了解他们是否认为使用视频很重要以及原因。该研究使用了该项目的出院调查和出院访谈数据。调查和访谈在19个月的时间内进行。通过电话进行调查和访谈并做记录。采用矩阵分析和内容分析来分析定性数据——对预定主题和新出现的主题进行分析并为研究结果提供信息。73名退伍军人完成了调查。其中,64人完成了访谈。接受调查的大多数退伍军人(75%)表示,通过视频远程医疗亲眼见到医疗服务提供者“非常重要”,23%的人表示至少“有些重要”或“一点也不重要”。这项研究突出了定性数据中发现的三个主要主题:患者讨论了(1)使用视频的优点,(2)他们不喜欢视频的原因,以及(3)使用视频的技术障碍。能够亲眼看到医疗服务提供者,同时也被医疗服务提供者看到,对于护理和建立医患关系具有明显的好处,而这些好处通过电话很难实现。这对于未来远程心理健康护理的提供具有重要意义,并且在患者和医疗服务提供者决定是使用电话还是视频进行远程护理时值得考虑。

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