Hilty Donald M, Groshong Laura W, Coleman Mirean, Maheu Marlene M, Armstrong Christina M, Smout Shelby A, Crawford Allison, Drude Kenneth P, Krupinski Elizabeth A
Department of Psychiatry & Behavioral Sciences, UC Davis, 2230 Stockton Boulevard, Sacramento, CA 95817 USA.
Clinical Social Work Association, Seattle, WA USA.
Clin Soc Work J. 2023 Jun 1:1-35. doi: 10.1007/s10615-023-00865-3.
The shift to communication technologies during the pandemic has had positive and negative effects on clinical social worker practice. Best practices are identified for clinical social workers to maintain emotional well-being, prevent fatigue, and avoid burnout when using technology. A scoping review from 2000 to 21 of 15 databases focused on communication technologies for mental health care within four areas: (1) behavioral, cognitive, emotional, and physical impact; (2) individual, clinic, hospital, and system/organizational levels; (3) well-being, burnout, and stress; and (4) clinician technology perceptions. Out of 4795 potential literature references, full text review of 201 papers revealed 37 were related to technology impact on engagement, therapeutic alliance, fatigue and well-being. Studies assessed behavioral (67.5%), emotional (43.2%), cognitive (57.8%), and physical (10.8%) impact at the individual (78.4%), clinic (54.1%), hospital (37.8%) and system/organizational (45.9%) levels. Participants were clinicians, social workers, psychologists, and other providers. Clinicians can build a therapeutic alliance via video, but this requires additional skill, effort, and monitoring. Use of video and electronic health records were associated with clinician physical and emotional problems due to barriers, effort, cognitive demands, and additional workflow steps. Studies also found high user ratings on data quality, accuracy, and processing, but low satisfaction with clerical tasks, effort required and interruptions. Studies have overlooked the impact of justice, equity, diversity and inclusion related to technology, fatigue and well-being, for the populations served and the clinicians providing care. Clinical social workers and health care systems must evaluate the impact of technology in order to support well-being and prevent workload burden, fatigue, and burnout. Multi-level evaluation and clinical, human factor, training/professional development and administrative best practices are suggested.
疫情期间向通信技术的转变对临床社会工作者的实践产生了积极和消极的影响。文中确定了临床社会工作者在使用技术时保持情绪健康、预防疲劳和避免职业倦怠的最佳实践方法。对2000年至2021年15个数据库进行的一项范围综述聚焦于心理健康护理的通信技术，涉及四个领域：（1）行为、认知、情感和身体影响；（2）个人、诊所、医院以及系统/组织层面；（3）健康、职业倦怠和压力；（4）临床医生对技术的看法。在4795篇潜在文献参考文献中，对201篇论文的全文审查显示，其中37篇与技术对参与度、治疗联盟、疲劳和健康的影响有关。研究评估了在个人（78.4%）、诊所（54.1%）、医院（37.8%）和系统/组织（45.9%）层面上的行为（67.5%）、情感（43.2%）、认知（57.8%）和身体（10.8%）影响。参与者包括临床医生、社会工作者、心理学家和其他提供者。临床医生可以通过视频建立治疗联盟，但这需要额外的技能、努力和监督。由于存在障碍、工作量、认知需求和额外的工作流程步骤，视频和电子健康记录的使用与临床医生的身体和情感问题有关。研究还发现用户对数据质量、准确性和处理的评分较高，但对文书工作任务、所需工作量和干扰的满意度较低。研究忽略了技术、疲劳和健康对所服务人群以及提供护理的临床医生的公平、公正、多样性和包容性影响。临床社会工作者和医疗保健系统必须评估技术的影响，以支持健康并防止工作量负担、疲劳和职业倦怠。建议进行多层次评估，并采用临床、人为因素、培训/专业发展和管理方面的最佳实践方法。
