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首页> 外文期刊>BMC Psychiatry >Community based telepsychiatry service for older adults residing in a rural and remote region- utilization pattern and satisfaction among stakeholders
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Community based telepsychiatry service for older adults residing in a rural and remote region- utilization pattern and satisfaction among stakeholders

机译：面向农村和偏远地区老年人的基于社区的远程精神病学服务-利用模式和利益相关者的满意度

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Evaluation of telepsychiatry (via videoconference) for older adults is mostly focussed on nursing homes or inpatients. We evaluated the role of a community based program for older adults in rural and remote regions of South Australia. The utilization pattern was studied using retrospective chart review of telepsychiatry assessments over 24?months (2010–2011). Satisfaction was evaluated through prospective post-consultation feedback (using a 5-point Likert scale), from patients, community based clinicians and psychiatrist participating in consecutive assessments from April–November 2012. Descriptive analysis was used for the utilization. Mean scores and proportions were calculated for the feedback. Mann Whitney U test was used to compare patient subgroups based on age, gender, prior exposure to telepsychiatry services and inpatient/ outpatient status. Feedback comments were analysed for emerging themes. On retrospective review of 134 consults, mean age was 75.89?years (SD 7.55), 60.4% (81) were females, and 71.6% (96) lived independently. Patients had a broad range of psychiatric disorders, from mood disorders to delirium and dementia, with co-morbid medical illness in 83.5% (112). On feedback evaluation (N?=?98), mean scores ranged from 3.88–4.41 for patients, 4.36–4.73 for clinicians and 3.67–4.45 for psychiatrists. Feedback from inpatients (14 out of 37) was significantly lower compared to outpatients (37 out of 61) (chi sq.?=?0.808, p??0.05), and they were significantly less satisfied with the wait time (U?=?163.0, p??0.05) and visual clarity (U?=?160.5, p??0.05). Audio clarity was the most common aspect of dissatisfaction (mean score less than 3) among patients (6, 11%). Psychiatrists reported a preference for telepsychiatry over face to face in 55.4% (46) assessments. However, they expressed discomfort in situations of cognitive or sensory disabilities in patients. In rural and remote areas, community-based telepsychiatry program can be a useful adjunct for psychiatrist input in the care of older adults. Innovations to overcome sensory deficits and collaboration with community services should be explored to improve its acceptance among the most vulnerable population.
机译：对老年人的远程精神病学评估（通过视频会议）主要集中在疗养院或住院病人身上。我们评估了针对南澳大利亚农村和偏远地区老年人的社区计划的作用。使用回顾性图表回顾了远程精神病学评估在24个月（2010-2011年）中的使用模式。通过对患者，社区临床医生和精神科医生进行前瞻性咨询后反馈（使用5分制Likert量表）对满意度进行了评估，这些反馈来自2012年4月至11月的连续评估。使用了描述性分析。计算平均分数和比例以得到反馈。曼恩·惠特尼（Mann Whitney U）测试用于根据年龄，性别，以前接受过远程精神病学服务以及住院/门诊病人状况来比较患者亚组。分析反馈意见中的新兴主题。通过对134名咨询者的回顾性研究，他们的平均年龄为75.89岁（标准差7.55），女性为60.4％（81），独立生活率为71.6％（96）。患者患有广泛的精神疾病，从情绪障碍到del妄和痴呆，合并病的医学疾病占83.5％（112）。根据反馈评估（N？=？98），患者的平均评分范围为3.88-4.41，临床医生为4.36-4.73，精神科医生为3.67-4.45。住院病人（37人中有14人）的反馈意见比门诊病人（61人中37人）的反馈要低得多（chi sq。== 0.808，p 0.05），并且他们对等待时间的满意度也大大降低（U？ ＝≥163.0，p≤＜0.05）和视觉清晰度（U≥＝ 160.5，p≤＜0.05）。音频清晰度是患者（6％，11％）中最不满意的地方（平均分低于3）。精神科医生报告说，在55.4％（46）的评估中，远程精神病患者比面对面患者更为偏爱。但是，他们对患者的认知或感觉障碍情况感到不适。在农村和偏远地区，以社区为基础的远程精神病学计划可以作为心理医生在老年人护理中的有用辅助。应该探索克服感官缺陷的创新以及与社区服务的合作，以提高其在最弱势人群中的接受度。

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