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英国全科医疗中初级保健从业者和患者对焦虑症和抑郁症远程咨询的益处及挑战的看法:一项定性访谈研究

Primary care practitioners' and patients' views on the benefits and challenges of remote consulting for anxiety and depression in UK general practice: a qualitative interview study.

作者信息

Archer Charlotte, Ting Louise, Kessler David, Wiles Nicola, Turner Katrina M

机构信息

Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK

Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

出版信息

BMJ Open. 2025 Jun 8;15(6):e093795. doi: 10.1136/bmjopen-2024-093795.

DOI:10.1136/bmjopen-2024-093795
PMID:40484428
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12161304/
Abstract

OBJECTIVE

To explore primary care patients' and practitioners' views and experiences of remote consulting for common mental disorders (CMDs), to optimise their management in primary care.

DESIGN

Qualitative study using in-depth interviews and thematic analysis. A topic guide was used to ensure consistency across interviews. The interviews were audio-recorded, transcribed verbatim and analysed thematically. There was patient and public input throughout.

SETTING

Participants were recruited from general practices. Interviews were held by telephone or videocall between March 2023 and October 2023.

PARTICIPANTS

We interviewed 20 practitioners and 21 patients.

RESULTS

Interviewees suggested benefits included convenience, increased anonymity and were easier for those feeling very low or anxious. Challenges included practitioners finding it hard to assess risk, which lengthened consultation duration or led to further contact, increasing practice workload and patients feeling anxious waiting for the practitioner to call. In-person appointments were viewed as important for initial consultations and providing a safe space. Continuity of care and practitioner training were identified as facilitators for telephone consultations, and both patients and practitioners identified training needs around how to deliver mental healthcare remotely.

CONCLUSIONS

Practitioners should aim to offer continuity of care and in-person appointments when patients initially seek help. Remote consultations may not be more time or cost-efficient for individuals with CMDs as risk is harder to assess. There is a need to evaluate existing training on delivering remote consultations to identify whether remote mental healthcare is included or should be incorporated in the future.

摘要

目的

探讨基层医疗患者和从业者对常见精神障碍(CMDs)远程咨询的看法和体验,以优化基层医疗中对这些疾病的管理。

设计

采用深入访谈和主题分析的定性研究。使用主题指南以确保各访谈的一致性。访谈进行录音,逐字转录并进行主题分析。整个过程都有患者和公众参与。

背景

参与者从全科医疗诊所招募。访谈于2023年3月至2023年10月通过电话或视频通话进行。

参与者

我们访谈了20名从业者和21名患者。

结果

受访者提出的益处包括便利性、更高的匿名性,对情绪非常低落或焦虑的人来说也更容易。挑战包括从业者发现难以评估风险,这延长了咨询时间或导致进一步联系,增加了诊所工作量,以及患者在等待从业者回电时感到焦虑。面对面预约被视为初次咨询和提供安全空间的重要方式。连续护理和从业者培训被确定为电话咨询的促进因素,患者和从业者都确定了围绕如何远程提供精神卫生保健的培训需求。

结论

当患者最初寻求帮助时,从业者应致力于提供连续护理和面对面预约。对于患有CMDs的个体,远程咨询可能在时间或成本上并不更具效益,因为风险更难评估。有必要评估现有的远程咨询培训,以确定远程精神卫生保健是否已包含在内或未来是否应纳入。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5518/12161304/ba5e592ff3c4/bmjopen-15-6-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5518/12161304/ba5e592ff3c4/bmjopen-15-6-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5518/12161304/ba5e592ff3c4/bmjopen-15-6-g001.jpg

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