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围产期远程精神病学护理的促进因素和障碍:一项定性研究。

Facilitators of and barriers to perinatal telepsychiatry care: a qualitative study.

机构信息

Department of Epidemiology, University of Washington, Seattle, Washington, USA.

Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA.

出版信息

BMJ Open. 2023 Oct 6;13(10):e071084. doi: 10.1136/bmjopen-2022-071084.

Abstract

OBJECTIVES

Perinatal mental health disorders such as anxiety, depression and bipolar disorder can negatively impact the health of women and their children without appropriate detection and treatment. Due to increases in mental health symptoms and transmission risks associated with in-person appointments, many clinics transitioned to providing telepsychiatry care during the COVID-19 pandemic. This study sought to identify the facilitators and barriers to receiving perinatal telepsychiatry care from the perspective of patients, clinic staff and psychiatrists.

DESIGN

Qualitative study based on analysis of in depth semistructured interviews.

SETTING

The study was conducted in a virtual specialty mental health clinic in an academic setting.

PARTICIPANTS

Eight patients who had been scheduled for an appointment with the perinatal telepsychiatry clinic between 14 May 2021 and 1 August 2021, seven of whom had attended their scheduled appointment with the clinic and one of whom had not, and five staff members including psychiatrists, navigators and clinic managers, participated in in-depth interviews.

RESULTS

Telepsychiatry was perceived by most as preferable to in-person care and easy to attend and navigate. Alternatively, technological difficulties, personal preference for in-person care and scheduling conflicts related to the perinatal period were identified as barriers by some. Participants identified communication between care staff and patients, online patient portals, and appointment reminders as important for facilitating appointment preparedness and attendance.

CONCLUSIONS

The findings from this study suggest that telepsychiatry services are perceived positively by patients and care staff and have the potential to improve access to mental healthcare for perinatal patients.

摘要

目的

围产期精神健康障碍,如焦虑、抑郁和双相情感障碍,如果得不到适当的发现和治疗,可能会对妇女及其子女的健康产生负面影响。由于与面对面预约相关的心理健康症状和传播风险增加,许多诊所在 COVID-19 大流行期间过渡到提供远程精神病学护理。本研究旨在从患者、诊所工作人员和精神科医生的角度确定接受围产期远程精神病学护理的促进因素和障碍。

设计

基于深入半结构化访谈分析的定性研究。

地点

该研究在一个学术环境中的虚拟专业心理健康诊所进行。

参与者

2021 年 5 月 14 日至 8 月 1 日期间预约围产期远程精神病诊所的 8 名患者,其中 7 名已按预约安排就诊,1 名未就诊,以及包括精神科医生、导航员和诊所经理在内的 5 名工作人员参加了深入访谈。

结果

大多数人认为远程精神病学护理优于面对面护理,且易于参加和导航。然而,一些人认为技术困难、个人对面对面护理的偏好以及与围产期相关的日程安排冲突是障碍。参与者认为工作人员与患者之间的沟通、在线患者门户和预约提醒对于促进预约准备和就诊非常重要。

结论

本研究的结果表明,远程精神病学服务受到患者和护理人员的积极评价,有可能改善围产期患者获得精神保健的机会。

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