ABSTRACT
Introduction: The COVID-19 pandemic has renewed the interest in telepsychiatry as a way to help psychiatrists care for their patients, but mental health providers' unfamiliarity and concerns may impede implementation of such services. This study aimed to determine the effect of an online educational intervention on awareness, knowledge, attitude, and skills (AKAS) of telepsychiatry among psychiatrists. Methods: The study used a pre-post-test design to compare AKAS of telepsychiatry among psychiatrists participating in an online course of practical telepsychiatry. The telemedicine AKAS questionnaire adapted to telepsychiatry was applied before and after the educational intervention, during the months of October to December 2020. Results: Responses from 213 participants were analyzed before the educational intervention and from 152 after it. The knowledge showed by Spanish psychiatrists before the educational intervention was good in 61% of participants, fair in 37%, and inadequate in 2%. With respect to attitudes toward telepsychiatry, 62% self-reported a high attitude, 33% moderate, and 5% low. With regard self-reported skills, 57% of the participating psychiatrists were highly skilled or experts, 22% moderately skilled, and 9% unskilled in handling telepsychiatry equipment. Despite the high baseline values, the educational intervention significantly improved psychiatrists' awareness, knowledge and attitudes toward telepsychiatry although not their skills. Conclusions: Online course of practical telepsychiatry was effective although future editions need to improve its focus on skills. This educational intervention represents an effort to promote the implementation of telepsychiatry as a health care alternative.
ABSTRACT
Resumen Este trabajo de revisión analiza el estado de los conocimientos sobre la Telepsiquiatría (TP) tras la crisis provocada por el COVID y la consiguiente necesidad de utilizar nuevas modalidades de atención. Se abordan seis aspectos inherentes a la TP: la satisfacción de los pacientes y del personal de salud mental, la fiabilidad diagnóstica, la eficacia de la intervención de la TP, la rentabilidad en términos de coste-oportunidad (o eficiencia) y los aspectos legales inherentes a la confidencialidad y la privacidad en particular y la actitud de los profesionales hacia la TP. La satisfacción con el TP es aceptable tanto entre los pacientes como entre los profesionales, siendo estos últimos los más reacios. La fiabilidad diagnóstica está demostrada, pero requiere de más estudios que confirmen esta fiabilidad en diferentes diagnósticos y entornos sanitarios. La eficacia de los tratamientos con TP no es inferior a la atención presencial, como se ha comprobado en psicoterapias específicas. Por último, hay que destacar que la actitud del psiquiatra es el elemento más decisivo que limita o facilita la implantación del TP. This review paper analyzes the state of knowledge on Telepsychiatry (TP) after the crisis caused by COVID and the resulting need to use new modalities of care. Six essential aspects of TP are addressed: patient’s and mental health staff satisfaction, diagnostic reliability, effectiveness of TP interventions, cost-effectiveness in terms of opportunity cost (or efficiency), legal aspects inherent to confidentiality and privacy in particular and the attitude of professionals towards TP. Satisfaction with TP is acceptable among both patients and professionals, the latter being the most reluctant. Diagnostic reliability has been demonstrated, but requires further studies to confirm this reliability in different diagnoses and healthcare settings. The efficacy of TP treatments is not inferior to face-to-face care, as has been proven in specific psychotherapies. Finally, it should be noted that the attitude of the psychiatrist is the most decisive element that limits or facilitates the implementation of TP.