Novack Kaylee, Dufour Rachel, Picard Louis, Taddeo Danielle, Nadeau Pierre-Olivier, Katzman Debra K, Booij Linda, Chadi Nicholas
Department of Psychiatry and Addictology, Université de Montréal, Montréal, Canada.
Department of Psychology, Concordia University, Montreal, Canada.
Ann Gen Psychiatry. 2023 Apr 26;22(1):16. doi: 10.1186/s12991-023-00443-4.
As a result of the public health measures put in place during the COVID-19 pandemic in Canada, many health services, including those for the treatment of eating disorders, were provided at a distance. This study aims to describe the adaptations made in specialized pediatric eating disorder programs in Canada and the impact of these adaptations on health professionals' experience of providing care.
A mixed-methods design was used to survey healthcare professionals working in specialized pediatric eating disorder programs about adaptations to treatment made during the pandemic and the impact of these adaptations on their experience of providing care. Data were collected between October 2021 and March 2022 using a cross-sectional survey comprising 25 questions and via semi-structured interviews. Quantitative data were summarized using descriptive statistics and qualitative data were interpreted using qualitative content analysis.
Eighteen healthcare professionals in Canada completed the online survey, of whom six also participated in the semi-structured interviews. The cross-sectional survey confirmed that, unlike in pre-pandemic times, the majority of participants provided medical care (15/18) and mental health care (17/18) at a distance during the pandemic, with most participants using telephone (17/18) and videoconferencing (17/18). Most (16/18) health professionals indicated that virtual care would continue to be used as a tool in pediatric ED treatment after the pandemic. Participants used a combination of virtual and in-person care, with most reporting weighing patients both in clinic (16/18) and virtually (15/18). Qualitative content analysis generated five themes: (1) responding to increased demand with insufficient resources; (2) adapting to changes in care due to the COVID-19 pandemic; (3) dealing with uncertainty and apprehension; (4) virtual care as an acceptable and useful clinical tool, and (5) optimal conditions and future expectations. Most interview participants (5/6) had globally positive views of virtual care.
Providing virtual multidisciplinary treatment for children and adolescents with eating disorders seemed feasible and acceptable to professionals during the pandemic. Moving forward, focusing on health professionals' perspectives and providing appropriate training in virtual interventions is essential given their central role in successful implementation and continued use of virtual and hybrid care models.
由于加拿大在新冠疫情期间实施了公共卫生措施，许多医疗服务，包括饮食失调治疗服务，都是远程提供的。本研究旨在描述加拿大专门的儿科饮食失调项目所做的调整，以及这些调整对医护人员提供护理体验的影响。
采用混合方法设计，对在专门的儿科饮食失调项目工作的医护人员进行调查，了解疫情期间治疗的调整情况以及这些调整对他们提供护理体验的影响。2021年10月至2022年3月期间，通过一项包含25个问题的横断面调查以及半结构化访谈收集数据。定量数据采用描述性统计进行汇总，定性数据采用定性内容分析进行解读。
加拿大18名医护人员完成了在线调查，其中6人还参与了半结构化访谈。横断面调查证实，与疫情前不同，大多数参与者在疫情期间通过远程提供医疗护理（15/18）和心理健康护理（17/18），大多数参与者使用电话（17/18）和视频会议（17/18）。大多数（16/18）医护人员表示，疫情后虚拟护理仍将作为儿科饮食失调治疗的一种工具继续使用。参与者采用虚拟护理和面对面护理相结合的方式，大多数报告称在诊所（16/18）和通过虚拟方式（15/18）对患者进行称重。定性内容分析产生了五个主题：（1）以不足的资源应对增加的需求；（2）适应新冠疫情导致的护理变化；（3）应对不确定性和担忧；（4）虚拟护理是一种可接受且有用的临床工具，以及（5）最佳条件和未来期望。大多数访谈参与者（5/6）对虚拟护理持总体积极看法。
在疫情期间，为患有饮食失调的儿童和青少年提供虚拟多学科治疗对专业人员来说似乎是可行且可接受的。展望未来，鉴于医护人员在成功实施和持续使用虚拟及混合护理模式中的核心作用，关注他们的观点并提供虚拟干预方面的适当培训至关重要。
