Muutos psykiatristen avohoitokäyntien toteutuksessa ja johtajien kokemukset etäasiointia estävistä ja edistävistä tekijöistä COVID-19 aikakaudella

Authors

  • Elina Laukka Finnish Institute for Health and Welfare
  • Kia Gluschkoff Terveyden ja hyvinvoinnin laitos
  • Anu-Marja Kaihlanen Terveyden ja hyvinvoinnin laitos
  • Jaana Suvisaari Terveyden ja hyvinvoinnin laitos
  • Jukka Kärkkäinen Terveyden ja hyvinvoinnin laitos
  • Helena Vorma Sosiaali- ja terveysministeriö
  • Tarja Heponiemi Terveyden ja hyvinvoinnin laitos

DOI:

https://doi.org/10.23996/fjhw.98228

Keywords:

psychiatry [http://www.yso.fi/onto/yso/p4372], telemedicine [http://www.yso.fi/onto/yso/p20333], leadership (activity) [http://www.yso.fi/onto/yso/p554], COVID-19 [http://www.yso.fi/onto/yso/p38829]

Abstract

Psychiatric outpatient care has been actively digitalized even before the COVID-19 outbreak. However, COVID-19 has increased the adoption of digital and remote health services. The aim of this cross-sectional study was to examine whether COVID-19 has impacted on the form of psychiatric outpatient services and describe psychiatric healthcare leaders’ experiences of digital and remote services. The results of this study can be used to evaluate and develop psychiatric outpatient services and to facilitate further research.

The data was collected through an online survey after the COVID-19 outbreak in May 2020. The questionnaire contained structured and open-ended questions. A total of 39 adult psychiatric, youth psychiatric and pediatric psychiatric service leaders answered the survey from 19 different health care districts. Quantitative questions about the forms of psychiatric outpatient services were reported using percentages, whereas open-ended questions were analyzed using inductive content analysis.

The results showed that the relative amount of digital and remote services increased after the COVID-19 outbreak. Of the psychiatric outpatient visits, 9 % were conducted using phone or remote access in January and 48 % in May (rose by 39 percentage units). The challenges for using remote services were related to the lack of IT equipment and inoperative programs, customers’ lack of devices, connections and room, remote services’ unsuitability for all operations, negative attitude of professionals and customers, insufficient IT knowledge, and organizational problems. The supporters of remote service usage were related to customers’ and professionals’ positive attitude and atmosphere, the necessity for the remote services caused by the COVID-19, suitability and familiarity of remote services in psychiatry, familiarity of the customers, long distances, well-functioning remote networks and time savings, functional technology, programs and devices, and sufficient support.

Digital and remote services have enabled psychiatric outpatient services to those patients for whom they are suitable and who can use them. The importance of digital and remote services in the era of COVID-19 epidemic has been important, but it is important to innovate other solutions to those patients who are not able to use digital or remote services for any reason.

References

Terveyden ja hyvinvoinnin laitos. Koronavirus COVID-19. THL; 5.6.2020 [viitattu 18.8.2020]. Saa-tavilla: https://thl.fi/fi/web/infektiotaudit-ja-rokotukset/taudit-ja-torjunta/taudit-ja-taudinaiheuttajat-a-o/koronavirus-covid-19

Wind TR, Rijkeboer M, Andersson G, Riper H. The COVID-19 pandemic: The ‘black swan’ for mental health care and a turning point for e-health. Edito-rial. Internet Interv. 2020 Apr;20:100317. https://doi.org/10.1016/j.invent.2020.100317

Häkkinen P, Mölläri K, Saukkonen SM, Väyrynen R, Mielikäinen L, Järvelin J. HILMO Sosiaali- ja ter-veydenhuollon hoitoilmoitus 2020. Määrittelyt ja ohjeistus. Helsinki: Terveyden ja hyvinvoinnin laitos; 2019. http://urn.fi/URN:ISBN:978-952-343-346-5

Berryhill MB, Culmer N, Williams N, Halli-Tierney A, Detancourt A, Roberts H, King M. Videoconfer-encing Psychoteraphy and Depression: A Systematic Review. Telemed J E Health. 2019 Jun;25(6):435-446. https://doi.org/10.1089/tmj.2018.0058

Andersson G. Internet-Delivered Psychological Treatments. Annu Rev Clin Psychol. 2016;12:157-79. https://doi.org/10.1146/annurev-clinpsy-021815-093006

Karyotaki E, Ebert DD, Donkin L, Riper H, Twisk J, Burger S, et al. Do guided internet-based interven-tions result in clinically relevant changes for patients with depression? An individual participant data me-ta-analysis. Clin Psychol Rev. 2018 Jul;63:80-92. https://doi.org/10.1016/j.cpr.2018.06.007

Mielonen ML, Moring J, Isohanni M. Vi-deoneuvottelun mahdollisuudet telepsykiatriassa. Suom Lääkäril. 1996;17(51):1881.

Mielonen M, Ohinmaa A, Moring J, Isohanni M. The use of videoconferencing for telepsychiatry in Finland. J Telemed Telecare. 1998;4(3):125-31. https://doi.org/10.1258/1357633981932073

Syrjäpalo K, Vuokkila-Oikkonen P, Kuusimäki M. Kokemuksia telepsykiatrisesta yhteistyöstä Pohjois-Suomessa. Suom Lääkäril. 2004;8:799–803.

Stenberg J-H, Blanco Sequeiros S, Holi M, Kampman O, Kieseppä T, Korkeila J, et al. Mielen-terveyttä etänä? Lääkärilehti. 2016;35(71):2106–11.

Bykachev K, Karppi J, Turunen H. Launching a video consultation service for child psychiatry in Pohjois-Savo region: opinions and experiences of the trained target groups. FinJeHeW. 2018;10(2–3):319–325. https://doi.org/10.23996/fjhw.69178

Taiminen H, Saraniemi S, Joffe G, Stenberg J-H, Parkinson J. Lääkärien suhtautuminen nettiterapi-aan positiivista mutta varovaista. Suom Lääkäril. 2019;74(3).

Sirnelä-Rif E, Holttinen T, Haapasalo-Pesu KM. Nuorten hoitosuunnitelmaan tehtävä kirjaus etä-hoidon osuudesta. Lääkärilehti. 2020;36:1787–9.

Moore RC, Depp CA, Harvey PD, Pinkham AE. Assessing the real-time mental health challenges of COVID-19 in individuals with serious mental illness-es: Protocol for a quantitative study. JMIR Res Pro-toc. 2020 May 22;9(5):e19203. https://doi.org/10.2196/19203

Yao H, Chen JH, Xu YF. Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry. 2020 Apr;7(4):e21. https://doi.org/10.1016/S2215-0366(20)30090-0

Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, Rubion GJ. The psychologi-cal impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020 Mar 14;395(10227):912-920. https://doi.org/10.1016/S0140-6736(20)30460-8

Kawohl W, Nordt C. COVID-19, unemployment, and suicide. Lancet Psychiatry. 2020 May;7(5):389-390. https://doi.org/10.1016/S2215-0366(20)30141-3

Li LZ, Wang S. Prevalence and predictors of general psychiatric disorders and loneliness during COVID-19 in the United Kingdom. Psychiatry Res. 2020 Sep;291:113267. https://doi.org/10.1016/j.psychres.2020.113267

Terveyden ja hyvinvoinnin laitos. COVID-19-pandemia ja sen vaikutukset alkoholinkulutukseen, rikollisuuteen ja päihdepalveluihin Suomessa (CO-VALC). THL; 21.9.2020 [viitattu 24.2.2021]. Saatavil-la: https://thl.fi/fi/tutkimus-ja-kehittaminen/tutkimukset-ja-hankkeet/covid-19-pandemia-ja-sen-vaikutukset-alkoholinkulutukseen-rikollisuuteen-ja-paihdepalveluihin-suomessa-covalc-

Terveyden ja hyvinvoinnin laitos. Koronaepi-demian vaikutukset hyvinvointiin, palveluihin ja ta-louteen. THL; 2020. http://urn.fi/URN:NBN:fi-fe2020052038462

Greenberg N, Tracy D. What healthcare leaders need to do to protect the psychological well-being of frontline staff in the COVID-19 pandemic. Edito-rial. BMJ Leader 2020;4:101-102. https://doi.org/10.1136/leader-2020-000273

Greenberg N, Docherty M, Gnanapragasam S, Wessely S. Managing mental health challenges faced by healthcare workers during covid-19 pan-demic. BMJ. 2020 Mar 26;368:m1211. https://doi.org/10.1136/bmj.m1211

Cresswell K, Sheikh A. Organizational issues in the implementation and adoption of health infor-mation technology innovations: An interpretative review. Int J Med Inform. 2013 May;82(5):e73-86. https://doi.org/10.1016/j.ijmedinf.2012.10.007

Laukka E, Huhtakangas M, Heponiemi T, Kanste O. Identifying the Roles of Healthcare Leaders in HIT Implementation: A Scoping Review of the Quan-titative and Qualitative Evidence. Int J Environ Res Public Health. 2020 Apr 21;17(8):2865. https://doi.org/10.3390/ijerph17082865

Kyngäs H. Inductive Content Analysis. Teokses-sa Kyngäs H, Mikkonen K, Kääriäinen M. (toim.) The Application of Content Analysis in Nursing Science Research. Springer Nature; Switzerland AG; 2020. https://doi.org/10.1007/978-3-030-30199-6_6

Vuononvirta T, Kanste O, Timonen M, Keinä-nen-Kiukaanniemi S, Timonen O, Ylitalo K, et al. Miten videovälitteinen etäterveydenhuolto onnis-tuu? Lääkärilehti. 2011;26–31:2165–9.

Heponiemi T, Jormanainen V, Leemann L, Manderbacka K, Aalto AM, Hyppönen H. Digital Divide in Perceived Benefits of Online Health Care and Social Welfare Services: National Cross-Sectional Survey Study. J Med Internet Res. 2020 Jul 7;22(7):e17616. https://doi.org/10.2196/17616

Downloads

Published

2021-02-27

Issue

Section

Scientific articles

How to Cite

Muutos psykiatristen avohoitokäyntien toteutuksessa ja johtajien kokemukset etäasiointia estävistä ja edistävistä tekijöistä COVID-19 aikakaudella . (2021). Finnish Journal of EHealth and EWelfare, 13(1), 49–62. https://doi.org/10.23996/fjhw.98228