Officer Tara N, Tait Marika, McBride-Henry Karen, Burnet Laura, Werkmeister Benjamin J
School of Nursing, Midwifery, and Health Practice, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand.
School of Health, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand.
JMIR Form Res. 2023 May 26;7:e47008. doi: 10.2196/47008.
The COVID-19 pandemic and consequent lockdowns disrupted mental health service delivery worldwide, accelerating the adoption of telehealth services to provide care continuity. Telehealth-based research largely highlights the value of this service delivery method for a range of mental health conditions. However, only limited research exists exploring client perspectives of mental health services delivered via telehealth during the pandemic.
This study aimed to increase understanding of the perspectives of mental health clients around services provided via telehealth over the 2020 COVID-19 lockdown in Aotearoa New Zealand.
Interpretive description methodology underpinned this qualitative inquiry. Semistructured interviews were conducted with 21 individuals (15 clients and 7 support people; 1 person was both a client and support person) to explore their experiences of outpatient mental health care delivered via telehealth during the COVID-19 pandemic in Aotearoa New Zealand. A thematic analysis approach supported by field notes was used to analyze interview transcripts.
The findings reveal that mental health services delivered via telehealth differed from those provided in person and led some participants to feel they need to manage their own care more actively. Participants highlighted several factors affecting their telehealth journey. These included the importance of maintaining and building relationships with clinicians, the creation of safe spaces within client and clinician home environments, and clinician readiness in facilitating care for clients and their support people. Participants noted weaknesses in the ability of clients and clinicians to discern nonverbal cues during telehealth conversations. Participants also emphasized that telehealth was a viable option for service delivery but that the reason for telehealth consultations and the technicalities of service delivery needed to be addressed.
Successful implementation requires ensuring solid relationship foundations between clients and clinicians. To safeguard minimum standards in delivering telehealth-based care, health professionals must ensure that the intent behind telehealth appointments is clearly articulated and documented for each person. In turn, health systems must ensure that health professionals have access to training and professional guidance to deliver effective telehealth consultations. Future research should aim to identify how therapeutic engagement with mental health services has changed, following a return to usual service delivery processes.
新冠疫情及随之而来的封锁措施扰乱了全球心理健康服务的提供，加速了远程医疗服务的采用以确保护理的连续性。基于远程医疗的研究很大程度上凸显了这种服务提供方式对一系列心理健康状况的价值。然而，仅有有限的研究探讨了疫情期间患者对通过远程医疗提供的心理健康服务的看法。
本研究旨在增进对2020年新西兰奥塔哥地区新冠疫情封锁期间心理健康患者对通过远程医疗提供的服务的看法的理解。
本定性研究采用解释性描述方法。对21人（15名患者和7名陪护人员；1人既是患者又是陪护人员）进行了半结构化访谈，以探讨他们在新西兰奥塔哥地区新冠疫情期间通过远程医疗接受门诊心理健康护理的经历。采用实地笔记辅助的主题分析方法对访谈记录进行分析。
研究结果显示，通过远程医疗提供的心理健康服务与面对面提供的服务有所不同，这使得一些参与者觉得他们需要更积极地管理自己的护理。参与者强调了几个影响他们远程医疗体验的因素。这些因素包括与临床医生维持和建立关系的重要性、在患者和临床医生家中营造安全空间，以及临床医生在为患者及其陪护人员提供护理方面的准备情况。参与者指出，在远程医疗对话中，患者和临床医生辨别非语言线索的能力存在不足。参与者还强调，远程医疗是一种可行的服务提供方式，但需要解决远程医疗咨询的原因和服务提供的技术问题。
成功实施需要确保患者和临床医生之间有坚实的关系基础。为保障基于远程医疗的护理的最低标准，卫生专业人员必须确保为每个人清晰阐明并记录远程医疗预约背后的意图。反过来，卫生系统必须确保卫生专业人员能够获得培训和专业指导，以提供有效的远程医疗咨询。未来的研究应旨在确定恢复常规服务提供流程后，与心理健康服务的治疗性互动发生了怎样的变化。
