Chakravarty Rahul, Chakrabarti Subho, Shah Ruchita
Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
J Family Med Prim Care. 2022 Jun;11(6):2507-2515. doi: 10.4103/jfmpc.jfmpc_1644_21. Epub 2022 Jun 30.
Many developed countries have switched from conventional outpatient psychiatric services to tele mental health-based alternatives because of the COVID-19 pandemic. However, similar transitions might be difficult for countries like India because of a shortage of necessary resources. Therefore, the feasibility and acceptability of converting to a home-based tele mental health (HB-TMH) service during the pandemic were examined in an Indian hospital.
A new and expanded version of an HB-TMH service was operated for all outpatients following the onset of the pandemic. Feasibility outcomes included operational viability, service utilization, service engagement, the need for additional in-person services, and the frequency of adverse events. Patients' and clinicians' satisfaction with different aspects of the service were evaluated using Likert-style questionnaires to ascertain acceptability. The outcomes during the prepandemic and pandemic phases were also compared.
The switch to HB-TMH services took 6 weeks during the pandemic. Patient numbers increased greatly following this transition. Attendance improved, the requirement for in-person services was low, and no serious adverse events were reported. However, patients' satisfaction levels were relatively low during the pandemic. Clinicians were more satisfied than the patients with HB-TMH treatment during the pandemic. Differences between them were less marked but still present before the pandemic. Pre- and postpandemic comparisons revealed that both patients and clinicians were more satisfied with all aspects of HB-TMH care before the pandemic than during it.
Though conversion to HB-TMH services was feasible during the pandemic, such services need to be improved to enhance patient acceptability.
由于新冠疫情，许多发达国家已从传统的门诊精神科服务转向基于远程心理健康的替代服务。然而，像印度这样的国家由于缺乏必要资源，类似的转变可能会很困难。因此，一家印度医院研究了在疫情期间转换为居家远程心理健康（HB-TMH）服务的可行性和可接受性。
疫情爆发后，为所有门诊患者提供了一种新的、扩展版的HB-TMH服务。可行性结果包括运营可行性、服务利用率、服务参与度、额外面对面服务的需求以及不良事件的发生频率。使用李克特式问卷评估患者和临床医生对服务不同方面的满意度，以确定可接受性。还比较了疫情前和疫情期间的结果。
在疫情期间，向HB-TMH服务的转换用了6周时间。这一转变后患者数量大幅增加。出勤率提高，面对面服务的需求较低，且未报告严重不良事件。然而，疫情期间患者的满意度相对较低。疫情期间，临床医生对HB-TMH治疗的满意度高于患者。他们之间的差异在疫情前不太明显但仍然存在。疫情前和疫情后的比较显示，患者和临床医生对HB-TMH护理各方面的满意度在疫情前均高于疫情期间。
尽管在疫情期间转换为HB-TMH服务是可行的，但此类服务需要改进以提高患者的可接受性。
