Dunn Natalie, Walton Carla J, Matsunaga Eric, Williams Carolyn, Dimeff Linda A
Portland DBT Institute, Portland, Oregon, USA.
Hunter New England Mental Health Service, Newcastle, New South Wales, Australia.
Telemed J E Health. 2023 Apr;29(4):593-601. doi: 10.1089/tmj.2022.0205. Epub 2022 Aug 18.
This study aimed to evaluate the acceptability of Dialectical Behavior Therapy (DBT) delivered through telehealth to complex, suicidal patients during the COVID-19 pandemic. We surveyed 163 adult participants enrolled in outpatient services at a private, free-standing DBT clinic certified by the DBT-Linehan Board of Certification for its fidelity to the treatment. Treatment satisfaction was assessed, as well as ease of telehealth over time, differences in satisfaction between patients who had previously experienced face-to-face treatment and those who had only experienced telehealth, patients' beliefs regarding the impact of telehealth on their progress, and preference for face-to-face versus telehealth services. Additionally, participants' reasons for liking and disliking telehealth were reported. The average overall satisfaction rating was 82.26 (±18.71) on a 100-point scale. Factors identified as being relevant to satisfaction included increased access to care, saving time and money, and increased comfort participating in therapy from home. Factors identified as relevant to dissatisfaction included feeling less connected to therapists and other patients. The majority of participants reported that telehealth positively impacted or did not impact treatment progress. Satisfaction was significantly related to participants' perception of telehealth's impact on progress in treatment. Demographic variables were also included in the analyses, but were unrelated to satisfaction. Findings indicate that, from the point of view of consumer satisfaction, telehealth appears satisfactory for delivery of DBT and may play an increased role in behavioral health care postpandemic.
本研究旨在评估在2019冠状病毒病大流行期间,通过远程医疗向复杂的自杀患者提供辩证行为疗法(DBT)的可接受性。我们对163名成年参与者进行了调查,这些参与者在一家经DBT-Linehan认证委员会认证的私立独立DBT诊所接受门诊服务,该诊所对治疗的忠诚度较高。我们评估了治疗满意度、随着时间推移远程医疗的便利性、以前接受过面对面治疗的患者与仅接受过远程医疗的患者在满意度上的差异、患者对远程医疗对其治疗进展影响的看法,以及对面对面服务与远程医疗服务的偏好。此外,还报告了参与者喜欢和不喜欢远程医疗的原因。在100分制中,平均总体满意度评分为82.26(±18.71)。被确定与满意度相关的因素包括获得医疗服务的机会增加、节省时间和金钱,以及在家中参与治疗时舒适度提高。被确定与不满相关的因素包括感觉与治疗师和其他患者的联系减少。大多数参与者报告说,远程医疗对治疗进展有积极影响或没有影响。满意度与参与者对远程医疗对治疗进展影响的看法显著相关。分析中还包括了人口统计学变量,但这些变量与满意度无关。研究结果表明,从消费者满意度的角度来看,远程医疗对于提供DBT似乎是令人满意的,并且在疫情后可能在行为医疗保健中发挥更大的作用。