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秘鲁劳动者远程心理健康服务发展的障碍与局限——一种以用户为中心的方法

Barriers and limitations to the development of a telemental health service for workers in Peru- A user-centered approach.

作者信息

Astete Cornejo John, Cruz-Ausejo Liliana, Cainamarks Alejandro Jimmy, Burgos-Flores Miguel Angel, Ambrosio-Melgarejo Juan, Rosales Rimache Jaime, García Cruz Sebastián

机构信息

Centro Nacional de Salud Ocupacional y Protección del Ambiente para la Salud, Instituto Nacional de Salud, Lima, Peru.

Facultad de Ciencias Sociales, Pontificia Universidad Católica del Peru, Lima, Peru.

出版信息

PLoS One. 2025 Apr 9;20(4):e0321401. doi: 10.1371/journal.pone.0321401. eCollection 2025.

Abstract

INTRODUCTION

Over the past decade, the surge in digital healthcare services has transformed traditional healthcare, requiring multidisciplinary engagement to adapt to the digital realm. The rise of telehealth services, particularly amid COVID-19, has been widely embraced globally, but its implementation in Peru faces unique challenges, including infrastructure issues and economic constraints. Therefore, this research aims to identify the barriers and limitations in developing a telemental health service for screening, evaluation, and timely referral of vulnerable occupational groups.

MATERIALS AND METHODS

A qualitative study was undertaken. We adopted a phenomenological approach, utilizing semi-structured interviews with vulnerable occupational groups and decision-makers. We conducted 23 interviews: 5 providers of telemental health services, 5 teachers users, 5 police officers users and 5 health professionals of telemental health services, and 3 decision-makers involved in telemental health regulation in Peru.; exploring experiences, barriers, and facilitators related to mental telemental health. The interviews were recorded and transcribed verbatim, furthermore, a thematic analysis was done to identify key themes.

RESULTS

The research identified barriers and limitations to developing a telemental health services screening service based on the experiences of workers, some of them were related to user dissatisfaction, emphasizing the need for personalized solutions beyond technical aspects. Scheduling issues call for flexibility and improved communication. Healthcare professionals' varied experiences highlight the necessity for targeted training, while successful telemental health services integration demands addressing resource limitations through a comprehensive approach.

CONCLUSION

The study advocates for a holistic, user-centred paradigm in telemental health services implementation, addressing both technological aspects and human and systemic elements. Multifaceted challenges inherent in telemental health, particularly in Peru, emphasize the need for strategic interventions by stakeholders. The study calls for a policy shift towards enhancing telemental health equity through system-level changes and eliminating structural barriers for marginalized populations.

摘要

引言

在过去十年中,数字医疗服务的激增改变了传统医疗模式,需要多学科参与以适应数字领域。远程医疗服务的兴起,尤其是在新冠疫情期间,已在全球范围内得到广泛接受,但其在秘鲁的实施面临独特挑战,包括基础设施问题和经济限制。因此,本研究旨在确定为弱势职业群体开展远程心理健康服务以进行筛查、评估和及时转诊过程中的障碍和限制因素。

材料与方法

开展了一项定性研究。我们采用现象学方法,对弱势职业群体和决策者进行半结构化访谈。我们进行了23次访谈:5名远程心理健康服务提供者、5名教师用户、5名警察用户、5名远程心理健康服务的卫生专业人员,以及3名参与秘鲁远程心理健康监管的决策者;探讨与远程心理健康相关的经历、障碍和促进因素。访谈进行了录音并逐字转录,此外,还进行了主题分析以确定关键主题。

结果

该研究根据工作人员的经验确定了开展远程心理健康服务筛查服务的障碍和限制因素,其中一些与用户不满有关,强调除技术方面外还需要个性化解决方案。日程安排问题需要灵活性和改善沟通。医疗保健专业人员的不同经历凸显了针对性培训的必要性,而成功整合远程心理健康服务需要通过全面方法解决资源限制问题。

结论

该研究主张在远程心理健康服务实施中采用以用户为中心的整体范式,兼顾技术方面以及人文和系统因素。远程心理健康固有的多方面挑战,尤其是在秘鲁,强调利益相关者需要进行战略干预。该研究呼吁通过系统层面的变革来增强远程心理健康公平性,并消除边缘化人群的结构性障碍,从而实现政策转变。

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