Stuart Joanna, Sheridan Nicole, Cloutier Paula, Reid Sarah, Tse Sandy, Spettigue Wendy, Gray Clare
Children's Hospital of Eastern Ontario Research Institute, Canada.
Faculty of Medicine, University of British Columbia, Canada.
Clin Child Psychol Psychiatry. 2025 Jan;30(1):79-94. doi: 10.1177/13591045241286562. Epub 2024 Oct 17.
Increased mental health (MH) needs during the COVID-19 pandemic led to the implementation of a novel pediatric Emergency Department Virtual Care (EDVC) service. Our study aimed to describe the pediatric MH patient population that used EDVC by comparing patient-specific factors of those who obtained services virtually to those seen in-person. This retrospective chart review was conducted at a pediatric hospital in Eastern Ontario. Children and youth (aged 3-17) who received virtual or in-person emergency MH services from May to December 2020 were included. Patient demographics, clinical presentation details and disposition were compared between the virtual and in-person groups. Data was analyzed using descriptive statistics. 1104 youth (96.1%) utilized the in-person ED for MH concerns; 45 (3.9%) used EDVC. In-person youth had a higher level of perceived risk (78.9% vs. 41.9%) and were more likely to present with concerns of depression, suicidal ideation, self-harm, or laceration (46.1% vs. 35.6%). Anxiety/situational crises or behavioural issues were more likely to present virtually. Eight patients (17.8%) were redirected to the ED from EDVC. Several patient-specific factors varied between youth seen in-person or virtually for MH concern. Study results can assist with the design and implementation of virtual MH care platforms.
在新冠疫情期间，心理健康需求增加，促使一项新型儿科急诊科虚拟护理（EDVC）服务得以实施。我们的研究旨在通过比较虚拟获得服务的患者与现场就诊患者的特定因素，来描述使用EDVC的儿科心理健康患者群体。这项回顾性病历审查在安大略省东部的一家儿科医院进行。纳入了2020年5月至12月期间接受虚拟或现场紧急心理健康服务的儿童和青少年（3至17岁）。比较了虚拟组和现场组之间的患者人口统计学、临床表现细节和处置情况。使用描述性统计分析数据。1104名青少年（96.1%）因心理健康问题使用了现场急诊科；45名（3.9%）使用了EDVC。现场就诊的青少年感知风险水平更高（78.9%对41.9%），更有可能表现出抑郁、自杀意念、自我伤害或割伤等问题（46.1%对35.6%）。焦虑/情境危机或行为问题更有可能通过虚拟方式出现。8名患者（17.8%）从EDVC被转至急诊科。在因心理健康问题现场就诊或虚拟就诊的青少年之间，几个特定患者因素存在差异。研究结果有助于虚拟心理健康护理平台的设计和实施。
