远程医疗提供的酒精使用障碍治疗中的心理疗法：COVID-19 时代的患者视角。
Telehealth-delivered Psychotherapy for the Treatment of Alcohol Use Disorder: Patient Perspectives in the Age of COVID-19.
机构信息
From the University of Rhode Island, Department of Psychology, Kingston, RI (RG); VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI (JF, LAL); Heinz College of Information Systems and Public Policy, Carnegie Mellon University, Pittsburgh, PA (EP); Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI (EEB, AF, LAL); and Injury Prevention Center, University of Michigan, Ann Arbor, MI (EEB).
出版信息
J Addict Med. 2023;17(6):e367-e373. doi: 10.1097/ADM.0000000000001210. Epub 2023 Aug 11.
OBJECTIVES
The COVID-19 pandemic precipitated increases in alcohol use and ushered in virtually delivered health care, creating an opportunity to examine the impacts of telehealth on alcohol use disorder (AUD) treatment. To understand these impacts, we explored perspectives on telehealth-delivered psychotherapy among individuals with AUD.
METHODS
This was a qualitative study using semi-structured interviews. Participants (N = 31) were patients with AUD who had received telehealth-delivered AUD psychotherapy in the last 2 years (n = 11) or had never experienced AUD psychotherapy (n = 20), recruited from two large academically-affiliated health care systems in Michigan between July and August 2020. Participants were asked about perceived barriers and facilitators to AUD psychotherapy, benefits and drawbacks of telehealth-delivered AUD psychotherapy, and changes needed to improve psychotherapy delivery. Interviews were transcribed, coded, and analyzed iteratively using thematic analysis.
RESULTS
Participants identified factors relating to perceptions of and experience with telehealth-delivered AUD psychotherapy. Findings reflected four major themes: treatment accessibility, treatment flexibility, treatment engagement, and stigma. Perceptions about telehealth's impact on treatment accessibility varied widely and included benefits (e.g., eliminating transportation challenges) and barriers (e.g., technology costs). Treatment flexibility and treatment engagement factors included the ability to use phone and video and perceptions of receiving care via telehealth, respectively. Telehealth impacts on treatment stigma were also a key theme.
CONCLUSIONS
Overall, perceptions of telehealth treatment for AUD varied. Participants expressed the importance of options, flexibility, and collaborating on decisions with providers to determine treatment modality. Future research should explore who benefits most from telehealth and avenues to enhance implementation.
目的
新冠疫情导致酒精使用量增加，并开启了虚拟医疗保健服务，这为研究远程医疗对酒精使用障碍（AUD）治疗的影响提供了机会。为了了解这些影响，我们探讨了 AUD 患者对远程医疗心理治疗的看法。
方法
这是一项使用半结构式访谈的定性研究。参与者（N=31）为过去 2 年内接受过远程医疗 AUD 心理治疗的 AUD 患者（n=11）或从未接受过 AUD 心理治疗的患者（n=20），他们来自密歇根州的两家大型学术附属医疗保健系统，于 2020 年 7 月至 8 月期间招募。参与者被问及对 AUD 心理治疗的感知障碍和促进因素、远程医疗提供的 AUD 心理治疗的优缺点，以及改善心理治疗的必要性。访谈内容被转录、编码，并使用主题分析进行迭代分析。
结果
参与者确定了与远程医疗 AUD 心理治疗的看法和经验相关的因素。研究结果反映了四个主要主题：治疗可及性、治疗灵活性、治疗参与度和污名化。对远程医疗对治疗可及性影响的看法差异很大，包括好处（例如，消除交通挑战）和障碍（例如，技术成本）。治疗灵活性和治疗参与度因素分别包括使用电话和视频的能力以及通过远程医疗接受治疗的看法。治疗污名化也是一个关键主题。
结论
总体而言，对 AUD 远程治疗的看法各不相同。参与者表示，治疗方案的选择、灵活性以及与提供者合作决定治疗方式非常重要。未来的研究应探索谁最受益于远程医疗以及增强实施的途径。
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