PDF(Pubmed)
Abstract：
BACKGROUND: Digital mental health interventions (DMHIs) are getting increasingly important for mental health care. In the case of eating disorders (EDs), DMHIs are still in early stages. Few studies so far investigated the views of mental health professionals for EDs on the integration of DMHIs in routine care.
OBJECTIVE: To gain insights into the experiences, perspectives, and expectations of mental health professionals for EDs regarding DMHIs and to identify requirements for the future integration of DMHIs into routine care.
METHODS: Semi-structured qualitative telephone interviews with 24 German mental health professionals treating patients with EDs were conducted. A content analysis following a deductive-inductive approach asked for experiences, advantages and chances, disadvantages and boundaries, desired functions and properties, target groups, and general conditions and requirements for DMHIs for patients with EDs.
RESULTS: Only few professionals reported experiences with DMHIs besides video-based psychotherapy during the pandemic. From the therapists\' point of view, DMHIs have the potential to deliver low-threshold access for patients with EDs. Useful functionalities were seen in digital meal records, skills training, and psychoeducation. However, a stable therapeutic alliance was reported as an important prerequisite for the successful integration into care. Therapists expressed concerns in case of severe anorexia nervosa or suicidality. The participants felt to be informed inadequately on recent developments and on the evidence base of DMHIs.
CONCLUSIONS: Mental health professionals for EDs show positive attitudes towards DMHIs, however many barriers to the integration in routine care were observed. The highest potential was seen for the use of DMHIs in addition to outpatient care and in aftercare. Specific requirements for DMHIs are related to different areas of the healthcare spectrum and for the different symptom profiles in anorexia nervosa, bulimia nervosa and binge eating disorder. Targeted DMHIs are needed and appropriate especially for concepts of blended care.
Digital mental health interventions are therapeutic services for people with a mental disorder that can be delivered on electronic devices. They are getting increasingly important, as many patients have to wait long for a therapy. In eating disorders these interventions are still in early stages. Twenty-four telephone interviews were held with German professionals treating adolescent and adult patients with eating disorders. The aim was to understand their experiences, perspectives, and expectations regarding digital mental health interventions and to find out what is needed to integrate them into care in the future. In general, the interview partners showed positive attitudes towards these interventions. However, only few reported experiences and many obstacles were observed. The highest potential was seen for the use in addition to care outside the hospital setting and after treatment has ended. However, in case of a severe eating disorder, such as anorexia, or self-harm and suicidality, they were against the use of digital interventions. A stable personal relationship to their patients was seen as particularly important before recommending a digital intervention. Finally, the interview partners felt not informed in a sufficient way on the scientific basis and regulations regarding digital mental health interventions.
OBJECTIVE: To gain insights into the experiences, perspectives, and expectations of mental health professionals for EDs regarding DMHIs and to identify requirements for the future integration of DMHIs into routine care.
METHODS: Semi-structured qualitative telephone interviews with 24 German mental health professionals treating patients with EDs were conducted. A content analysis following a deductive-inductive approach asked for experiences, advantages and chances, disadvantages and boundaries, desired functions and properties, target groups, and general conditions and requirements for DMHIs for patients with EDs.
RESULTS: Only few professionals reported experiences with DMHIs besides video-based psychotherapy during the pandemic. From the therapists\' point of view, DMHIs have the potential to deliver low-threshold access for patients with EDs. Useful functionalities were seen in digital meal records, skills training, and psychoeducation. However, a stable therapeutic alliance was reported as an important prerequisite for the successful integration into care. Therapists expressed concerns in case of severe anorexia nervosa or suicidality. The participants felt to be informed inadequately on recent developments and on the evidence base of DMHIs.
CONCLUSIONS: Mental health professionals for EDs show positive attitudes towards DMHIs, however many barriers to the integration in routine care were observed. The highest potential was seen for the use of DMHIs in addition to outpatient care and in aftercare. Specific requirements for DMHIs are related to different areas of the healthcare spectrum and for the different symptom profiles in anorexia nervosa, bulimia nervosa and binge eating disorder. Targeted DMHIs are needed and appropriate especially for concepts of blended care.
Digital mental health interventions are therapeutic services for people with a mental disorder that can be delivered on electronic devices. They are getting increasingly important, as many patients have to wait long for a therapy. In eating disorders these interventions are still in early stages. Twenty-four telephone interviews were held with German professionals treating adolescent and adult patients with eating disorders. The aim was to understand their experiences, perspectives, and expectations regarding digital mental health interventions and to find out what is needed to integrate them into care in the future. In general, the interview partners showed positive attitudes towards these interventions. However, only few reported experiences and many obstacles were observed. The highest potential was seen for the use in addition to care outside the hospital setting and after treatment has ended. However, in case of a severe eating disorder, such as anorexia, or self-harm and suicidality, they were against the use of digital interventions. A stable personal relationship to their patients was seen as particularly important before recommending a digital intervention. Finally, the interview partners felt not informed in a sufficient way on the scientific basis and regulations regarding digital mental health interventions.
摘要：
背景：数字心理健康干预措施（DMHI）对于精神卫生保健越来越重要。在饮食失调（ED）的情况下，DMHIs仍处于早期阶段。到目前为止，很少有研究调查ED的精神卫生专业人员对DMHI在常规护理中的整合的看法。
目标：为了获得对经验的见解，观点，以及精神卫生专业人员对ED对DMHIs的期望，并确定将来将DMHIs整合到常规护理中的要求。
方法：对24名治疗ED患者的德国精神卫生专业人员进行了半结构化定性电话访谈。遵循演绎归纳法的内容分析要求经验，优势和机会，缺点和界限，所需的功能和属性，目标群体,以及ED患者DMHIs的一般条件和要求。
结果：在大流行期间，除了基于视频的心理治疗外，只有少数专业人士报告了使用DMHI的经验。从治疗师的角度来看，DMHI有可能为ED患者提供低阈值访问。在数字膳食记录中可以看到有用的功能，技能培训,和心理教育。然而,据报道,稳定的治疗联盟是成功纳入治疗的重要前提.治疗师对严重的神经性厌食症或自杀表示担忧。与会者感到对最近的事态发展和DMHI的证据基础没有充分了解。
结论：ED的心理健康专业人员对DMHI表现出积极的态度，然而,观察到许多常规护理整合的障碍.除了门诊护理和善后护理外，DMHI的使用潜力最大。DMHIs的具体要求与医疗保健领域的不同领域以及神经性厌食症的不同症状概况有关，神经性贪食症和暴食症。需要有针对性的DMHIs，尤其适用于混合护理的概念。
数字心理健康干预是为患有精神障碍的人提供的治疗服务，可以通过电子设备提供。它们变得越来越重要，因为许多患者必须等待很长时间才能接受治疗。在饮食失调中，这些干预措施仍处于早期阶段。与德国专业人员进行了24次电话采访，以治疗患有饮食失调的青少年和成年患者。目的是了解他们的经历，观点，以及对数字心理健康干预措施的期望，并找出未来将其纳入护理所需的内容。总的来说,访谈伙伴对这些干预措施表现出积极的态度。然而,只有少数报告的经验和许多障碍被观察到。除了医院以外的护理和治疗结束后，使用的潜力最高。然而,在严重的饮食失调的情况下，如厌食症，或者自我伤害和自杀，他们反对使用数字干预措施。在建议进行数字干预之前，与患者建立稳定的人际关系尤为重要。最后,访谈伙伴认为没有充分了解有关数字心理健康干预措施的科学依据和法规。
目标：为了获得对经验的见解，观点，以及精神卫生专业人员对ED对DMHIs的期望，并确定将来将DMHIs整合到常规护理中的要求。
方法：对24名治疗ED患者的德国精神卫生专业人员进行了半结构化定性电话访谈。遵循演绎归纳法的内容分析要求经验，优势和机会，缺点和界限，所需的功能和属性，目标群体,以及ED患者DMHIs的一般条件和要求。
结果：在大流行期间，除了基于视频的心理治疗外，只有少数专业人士报告了使用DMHI的经验。从治疗师的角度来看，DMHI有可能为ED患者提供低阈值访问。在数字膳食记录中可以看到有用的功能，技能培训,和心理教育。然而,据报道,稳定的治疗联盟是成功纳入治疗的重要前提.治疗师对严重的神经性厌食症或自杀表示担忧。与会者感到对最近的事态发展和DMHI的证据基础没有充分了解。
结论：ED的心理健康专业人员对DMHI表现出积极的态度，然而,观察到许多常规护理整合的障碍.除了门诊护理和善后护理外，DMHI的使用潜力最大。DMHIs的具体要求与医疗保健领域的不同领域以及神经性厌食症的不同症状概况有关，神经性贪食症和暴食症。需要有针对性的DMHIs，尤其适用于混合护理的概念。
数字心理健康干预是为患有精神障碍的人提供的治疗服务，可以通过电子设备提供。它们变得越来越重要，因为许多患者必须等待很长时间才能接受治疗。在饮食失调中，这些干预措施仍处于早期阶段。与德国专业人员进行了24次电话采访，以治疗患有饮食失调的青少年和成年患者。目的是了解他们的经历，观点，以及对数字心理健康干预措施的期望，并找出未来将其纳入护理所需的内容。总的来说,访谈伙伴对这些干预措施表现出积极的态度。然而,只有少数报告的经验和许多障碍被观察到。除了医院以外的护理和治疗结束后，使用的潜力最高。然而,在严重的饮食失调的情况下，如厌食症，或者自我伤害和自杀，他们反对使用数字干预措施。在建议进行数字干预之前，与患者建立稳定的人际关系尤为重要。最后,访谈伙伴认为没有充分了解有关数字心理健康干预措施的科学依据和法规。
