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捕捉患者和临床医生在精神卫生门诊服务中使用视频会诊的体验:定性主题分析

Capturing Patients' and Clinicians' Experiences of Using Video Consultations in Mental Health Outpatient Services: Qualitative Thematic Analysis.

作者信息

Shaker Ali Abbas, Simonsen Erik, Tarp Kristine, Borisov Radoslav Aleksandrov, Sørensen John Aasted, Bechmann Henrik, Austin Stephen F

机构信息

Psychiatric Research Unit, Slagelse, Denmark.

Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

出版信息

JMIR Form Res. 2024 Aug 21;8:e50580. doi: 10.2196/50580.

Abstract

BACKGROUND

Over the last decade, there has been an increase in the evidence base supporting the efficacy of video consultations (VCs) in mental health services. Furthermore, the potential of VC treatment was also demonstrated during the COVID-19 pandemic. Despite these promising results and conducive conditions for VCs, several studies have highlighted that the uptake and implementation of VCs continues to be slow, even after the pandemic. To facilitate and strengthen the implementation of VCs and exploit their potential as a useful tool for mental health disorder treatment, there is a need for a deeper understanding of the issues and experiences of implementing and using VCs as a treatment modality in clinical practice.

OBJECTIVE

The aim of this study was to investigate patients' and clinicians' experiences and attitudes toward using VCs in clinical practice.

METHODS

Treatment was conducted through the VC modality. Semistructured interviews were conducted individually with patients (n=10) and focus group interview were conducted with clinicians (n=4). Patients had participated in weekly VC treatment over 2 months as part of mental health outpatient services in Denmark. Data from these interviews were analyzed using thematic analysis.

RESULTS

Thematic analysis of the patient interviews yielded two main themes: (1) adjusting to the practicalities of the VC format and (2) the practice of therapy using VCs. Patients experienced that using VCs was easy and convenient, and it was possible to establish and maintain a therapeutic alliance. They also described the contact as different to in-person therapy. The thematic analysis conducted on clinicians' experiences of using VCs yielded three themes: (1) a shift in mindset from resistance to acceptance, (2) the contact is different when using the VC modality, and (3) adapting to a new way of working. Clinicians experienced that their initial concerns and resistance toward VC implementation gradually diminished over time as they gained clinical experience of using the modality. They expressed that contact with patients can be different when using the VC modality and that it took time to adjust to a new way of working therapeutically.

CONCLUSIONS

Both patients and clinicians experienced that VCs could enhance access to treatment and be meaningfully integrated into clinical practice. In addition, both groups described the contact when using the VC modality as being different to in-person therapy. Future research could examine patients' and clinicians' perceived differences regarding contact when using the VC modality and the implications for therapeutic interventions.

摘要

背景

在过去十年中,支持视频会诊(VC)在心理健康服务中有效性的证据基础有所增加。此外,在新冠疫情期间,视频会诊治疗的潜力也得到了证明。尽管取得了这些令人鼓舞的结果以及视频会诊的有利条件,但多项研究强调,即使在疫情之后,视频会诊的采用和实施仍然缓慢。为了促进和加强视频会诊的实施,并挖掘其作为心理健康障碍治疗有用工具的潜力,有必要更深入地了解在临床实践中实施和使用视频会诊作为一种治疗方式的问题和经验。

目的

本研究的目的是调查患者和临床医生在临床实践中使用视频会诊的经验和态度。

方法

通过视频会诊方式进行治疗。对患者(n = 10)进行了单独的半结构化访谈,并对临床医生(n = 4)进行了焦点小组访谈。作为丹麦心理健康门诊服务的一部分,患者在2个月内每周参加视频会诊治疗。使用主题分析法对这些访谈的数据进行了分析。

结果

对患者访谈的主题分析产生了两个主要主题:(1)适应视频会诊形式的实际情况,(2)使用视频会诊进行治疗的实践。患者体验到使用视频会诊轻松便捷,并且能够建立和维持治疗联盟。他们还描述这种接触与面对面治疗不同。对临床医生使用视频会诊经验的主题分析产生了三个主题:(1)心态从抵触到接受的转变,(2)使用视频会诊方式时接触有所不同,(3)适应新的工作方式。临床医生体验到,随着他们获得使用该方式的临床经验,他们最初对视频会诊实施的担忧和抵触情绪会随着时间逐渐减少。他们表示,使用视频会诊方式与患者接触可能会有所不同,并且需要时间来适应新的治疗工作方式。

结论

患者和临床医生都体验到视频会诊可以增加治疗机会,并能有意义地融入临床实践。此外,两组都描述了使用视频会诊方式时的接触与面对面治疗不同。未来的研究可以考察患者和临床医生在使用视频会诊方式时对接触的感知差异以及对治疗干预的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e08b/11375385/060b986f9dc4/formative_v8i1e50580_fig1.jpg

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