telepsychiatry

Telepsychiatry
  • 文章类型: Journal Article
    对过去10年中针对远程口腔健康(TMH)提供者的教育和培训(E&T)计划进行系统的文献综述,以定性地阐明现场产品和方法。以及确定未来增长的领域。
    我们搜索了五个主要的电子数据库:PubMed、PsycINFO,Scopus,CINAHL,和WebofScience于2013年1月至2023年5月在TMHE&T上的原始出版物。我们从每个出版物中提取信息,并总结培训计划的关键特征,包括设置,目标群体,研究目的,训练方式,质量评估方法,和结果。
    总共选择了20篇文章进行最终审查。符合包容性标准的文章主要包括案例研究和评论,专注于针对特定地区/人口的TMH服务/实践,并在2020年之后执行。所有选定的研究表明,测量的知识显着增加,技能,和TMH训练后参与者的能力。然而,培训方法仍然缺乏标准化,有限的样本量和人口统计,研究方法的可变性,和不同研究的能力目标不一致。
    本系统综述强调了TMHE&T方法的多样性。关于这一主题的未来研究可能包括更多样化和更大规模的研究,以进一步验证和扩展当前的发现,以及探讨TMH培训计划对提供者态度和患者结局的潜在长期影响。
    UNASSIGNED: To conduct a systematic literature review of education and training (E&T) programs for telemental health (TMH) providers in the past 10 years to qualitatively clarify field offerings and methodologies, as well as identify areas for future growth.
    UNASSIGNED: We searched five major electronic databases: PubMed, PsycINFO, Scopus, CINAHL, and Web of Science for original publications on TMH E&T from January 2013 to May 2023. We extracted information from each publication and summarized key features of training programs including setting, target group, study aims, training modality, methods of assessing quality, and outcomes.
    UNASSIGNED: A total of 20 articles were selected for the final review. Articles meeting inclusionary criteria were predominantly comprised of case studies and commentaries, focused on a TMH service/practice for a specific region/population, and were performed after 2020. All of the selected studies demonstrated a significant increase in the measured knowledge, skills, and abilities of the participants after TMH training. Nevertheless, there remains a lack of standardization of training methodologies, limited sample sizes and demographics, variability in study methodologies, and inconsistency of competency targets across studies.
    UNASSIGNED: This systematic review highlighted the diversity of methods for TMH E&T. Future research on this topic could include more varied and larger-scale studies to further validate and extend current findings, as well as explore potential long-term effects of TMH training programs on both provider attitudes and patient outcomes.
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  • 文章类型: Systematic Review
    未经证实:缺乏在线心理治疗在管理COVID-19相关痛苦方面的有效性的定量综合。本研究旨在评估在线心理干预对COVID-19相关心理困扰的有效性和相关因素。
    UNASSIGNED:多数据库,包括PubMed,EBSCO,ProQuest,和Cochrane被反复搜查,直到2022年6月底。相关论文也采用手工采摘。抑郁症,焦虑,压力,和睡眠质量作为结果进行评估.使用Cochrane工具评估偏倚风险。数据分析通过ReviewManager(5.4.1版)进行。
    UNASSIGNED:共有13项研究纳入1,897名参与者进行荟萃分析。结果显示,在线心理治疗显著降低了抑郁水平[标准均值差异,SMD=-0.45,95%CI(-0.69,-0.20)],焦虑[SMD=-0.67,95%CI(-0.99,-0.36)],和应力[SMD=-0.73,95%CI(-1.11,-0.34)],但不是睡眠质量[SMD=-0.53,95%CI(-1.23,0.17)]。此外,指导治疗在降低焦虑水平方面比自助治疗更有效(χ2=5.58,p=0.02,I2=82.1%),≤2周的每日干预比2个月的每周干预更有效(χ2=7.97,p=0.005,I2=87.5%)。
    未经评估:在线心理干预可有效降低COVID-19相关抑郁,焦虑,和压力水平,有效性受到指导、持续时间和频率等设置的影响。
    UNASSIGNED:https://inplasy.com/inplasy-2022-7-0081/,标识符:INPLASY202270081。
    UNASSIGNED: A quantitative synthesis of online psychotherapies\' effectiveness in managing COVID-19 related distress is lacking. This study aimed to estimate online psychological interventions\' effectiveness and associated factors on COVID-19 related psychological distress.
    UNASSIGNED: Multi-databases including PubMed, EBSCO, ProQuest, and Cochrane were searched repeatedly till the end of June 2022. Hand-picking was also utilized for relevant papers. Depression, anxiety, stress, and quality of sleep were evaluated as outcomes. The risk of bias was evaluated using the Cochrane tool. Data analyses were conducted through Review Manager (version 5.4.1).
    UNASSIGNED: A total of 13 studies involving 1,897 participants were included for meta-analysis. Results showed that online psychotherapy significantly reduced the levels of depression [standard mean difference, SMD = -0.45, 95% CI (-0.69, -0.20)], anxiety [SMD = -0.67, 95% CI (-0.99, -0.36)], and stress [SMD = -0.73, 95% CI (-1.11, -0.34)], but not quality of sleep [SMD = -0.53, 95% CI (-1.23, 0.17)]. In addition, guided therapies were more effective than self-help ones on reducing levels of anxiety (χ2 = 5.58, p = 0.02, and I 2 = 82.1%), and ≤ 2 weeks\' daily interventions were more effective on treating depression than 2-month weekly interventions (χ2 = 7.97, p = 0.005, I 2 = 87.5%).
    UNASSIGNED: Online psychological interventions effectively reduced COVID-19 related depression, anxiety, and stress levels, and the effectiveness was influenced by settings like guidance and duration and frequency.
    UNASSIGNED: https://inplasy.com/inplasy-2022-7-0081/, identifier: INPLASY202270081.
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  • 文章类型: Journal Article
    获得精神病护理对于从精神病院出院的患者至关重要,以确保护理的连续性。当无法进行面对面随访或不受欢迎时,心灵感应成为一种有希望的选择。本研究旨在调查与采用心灵感应相关的医院和县级特征。3475家急性护理医院的全国横断面数据来自2017年美国医院协会年度调查。使用广义线性回归模型来识别与心灵感应采用相关的特征。
    大约六分之一(548[15.8%])的医院报告有心灵感应,各州差异很大。与农村微型城市(13.6%)和城市县(19.4%)相比,农村非核心医院采用心灵感应的可能性较小(8.3%)。同时提供门诊和住院精神病护理服务的医院(边际差异[95%CI]:16.0%[12.1%至19.9%])和仅提供门诊精神病服务的医院(6.5%[3.7%至9.4%])比没有精神病服务的医院更有可能进行心灵感应。联邦医院(48.9%[32.5至65.3%]),系统附属医院(3.9%[1.2%至6.6%]),病床尺寸较大的医院(四分位数IV与I:6.2%[0.7%至11.6%]),以及医疗补助住院天数与总住院天数比例较高的医院(四分位数IV与I:4.9%[0.3%至9.4%])比同行更可能有心灵感应。私人非营利性医院(-6.9%[-11.7%至-2.0%])和指定为整个精神卫生专业短缺地区的县的医院(-6.6%[-12.7%至-0.5%])不太可能有心灵感应。
    在Covid-19大流行之前,2017年,美国医院的电话心理疗法采用率很低,不同城市和农村状况以及各州的差异很大。这引起了人们对获得精神病服务和出院患者护理连续性的担忧。
    Access to psychiatric care is critical for patients discharged from hospital psychiatric units to ensure continuity of care. When face-to-face follow-up is unavailable or undesirable, telepsychiatry becomes a promising alternative. This study aimed to investigate hospital- and county-level characteristics associated with telepsychiatry adoption.
    Cross-sectional national data of 3475 acute care hospitals were derived from the 2017 American Hospital Association Annual Survey. Generalized linear regression models were used to identify characteristics associated with telepsychiatry adoption.
    About one-sixth (548 [15.8%]) of hospitals reported having telepsychiatry with a wide variation across states. Rural noncore hospitals were less likely to adopt telepsychiatry (8.3%) than hospitals in rural micropolitan (13.6%) and urban counties (19.4%). Hospitals with both outpatient and inpatient psychiatric care services (marginal difference [95% CI]: 16.0% [12.1% to 19.9%]) and hospitals only with outpatient psychiatric services (6.5% [3.7% to 9.4%]) were more likely to have telepsychiatry than hospitals with neither psychiatric services. Federal hospitals (48.9% [32.5 to 65.3%]), system-affiliated hospitals (3.9% [1.2% to 6.6%]), hospitals with larger bed size (Quartile IV vs. I: 6.2% [0.7% to 11.6%]), and hospitals with greater ratio of Medicaid inpatient days to total inpatient days (Quartile IV vs. I: 4.9% [0.3% to 9.4%]) were more likely to have telepsychiatry than their counterparts. Private non-profit hospitals (- 6.9% [- 11.7% to - 2.0%]) and hospitals in counties designated as whole mental health professional shortage areas (- 6.6% [- 12.7% to - 0.5%]) were less likely to have telepsychiatry.
    Prior to the Covid-19 pandemic, telepsychiatry adoption in US hospitals was low with substantial variations by urban and rural status and by state in 2017. This raises concerns about access to psychiatric services and continuity of care for patients discharged from hospitals.
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  • 文章类型: Journal Article
    背景:在COVID-19大流行期间,有人注意到使用远程医疗作为减少COVID-19感染的一种方法,因此放松管制.然而,远程医疗监管的程度因国家而异,这可能会改变远程医疗的广泛使用。这项研究旨在阐明在COVID-19大流行之前和期间每个合作国家/地区的心灵感应法规。
    方法:我们在国际心灵感应专家的全球网络中使用了滚雪球采样。来自17个不同国家/地区的30名合作者回答了关于使用和实施心灵感应护理障碍的问卷,包括2019年底和2020年5月的法规和报销等政策因素。
    结果:17个地区中有13个报告由于大流行而放松了法规;因此,所有接受调查的地区都表示,远程医疗现在在其公共医疗系统中是可能的。在一些地区,对通过心灵感应疗法允许的处方药的限制得到了缓解,但是在17个地区中的11个,仍然有限制的处方药物通过心灵感应。在四个地区重新评估了心灵感应咨询诉面对面咨询的较低保险报销金额,因此,在15个地区,心灵感应服务的报销率与COVID-19大流行期间的当面会诊相同(或更高).
    结论:我们的结果证实,由于COVID-19,大多数接受调查的国家正在改变以前限制远程医疗传播的远程医疗法规。这些发现提供了可以指导未来政策和监管决策的信息,这促进了全球心灵感应的更大规模和传播。
    During the COVID-19 pandemic, the use of telemedicine as a way to reduce COVID-19 infections was noted and consequently deregulated. However, the degree of telemedicine regulation varies from country to country, which may alter the widespread use of telemedicine. This study aimed to clarify the telepsychiatry regulations for each collaborating country/region before and during the COVID-19 pandemic.
    We used snowball sampling within a global network of international telepsychiatry experts. Thirty collaborators from 17 different countries/regions responded to a questionnaire on barriers to the use and implementation of telepsychiatric care, including policy factors such as regulations and reimbursement at the end of 2019 and as of May 2020.
    Thirteen of 17 regions reported a relaxation of regulations due to the pandemic; consequently, all regions surveyed stated that telepsychiatry was now possible within their public healthcare systems. In some regions, restrictions on prescription medications allowed via telepsychiatry were eased, but in 11 of the 17 regions, there were still restrictions on prescribing medications via telepsychiatry. Lower insurance reimbursement amounts for telepsychiatry consultations v. in-person consultations were reevaluated in four regions, and consequently, in 15 regions telepsychiatry services were reimbursed at the same rate (or higher) than in-person consultations during the COVID-19 pandemic.
    Our results confirm that, due to COVID-19, the majority of countries surveyed are altering telemedicine regulations that had previously restricted the spread of telemedicine. These findings provide information that could guide future policy and regulatory decisions, which facilitate greater scale and spread of telepsychiatry globally.
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  • 文章类型: Journal Article
    Objective: To explore and summarize (1) the existing digital health applications in mental health care (MHC) for immigrants and refugees and its outcomes; (2) how the ethical standards of digital health applications in MHC are implemented and reported; and (3) the challenges for scaling up digital health applications in MHC for immigrants and refugees. Methods: This review adopted a rapid review methodology. Available literature was searched in three online databases January 1, 2005, to February 28, 2019. Studies were included if they (1) applied digital health technologies, (2) focused on immigrants, refugees, or asylum seekers without age and country limitation, (3) reported nonclinical and/or clinical outcomes, and (4) were published in English or Indonesian. Narrative synthesis was developed based on the data extraction and quality assessment. Results: A total of 16 studies were reviewed that applied software, website, and videoconferencing technologies. These applications were applied in various stages of MHC (screening, assessment, diagnosis, and intervention). Participants reported satisfaction and positive attitudes toward applications of digital health in MHC, and positive improvement on their anxiety, depression, and post-traumatic stress disorder symptoms. However, the ethical standards of these digital health applications were poorly implemented and reported. Stigma toward mental disorders and lack of technology literacy were the main challenges in scaling up digital health applications for immigrants and refugees. Conclusion: Digital health applications in MHC are promising innovations that can improve the wellbeing of immigrants and refugees. As these technologies expand, ethical standards of practice and reporting need to be improved in delivering scalable digital MHC for immigrants and refugees.
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  • 文章类型: Journal Article
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