Toward establishing telepsychology guideline. Turning the challenges of COVID-19 into opportunity.

INTRODUCTION: The COVID-19 pandemic has obstructed the classical practices of psychological assessment and intervention via face-to-face interaction. Patients and all health professionals have been forced to isolate and become innovative to continue receiving and providing exceptional healthcare services while minimizing the risk of exposure to, or transmission of, COVID-19. AIM: This document is proposed initially as a guide to the extraordinary implementation of telepsychology in the context of the COVID-19 pandemic and to extend its implementation to use fundamentally as the main guideline for telepsychology services in Saudi Arabia and other Arabic communities. METHOD: A professional task force representing different areas of professional psychology reviewed, summarized, and documented methods, policies, procedures, and other resources to ensure that the recommendations and evidence reviews were valid and consistent with best practices. RESULTS: The practice of telepsychology involves the consideration of legal and professional requirements. This paper provides a guideline and recommendations for procedural changes that are necessary to address psychological services as we transition to telepsychology, as well as elucidates and demonstrates practical telepsychology frameworks, procedures, and proper recommendations for the provision of services during COVID-19. It adds a focused examination and discussion related to factors that could influence the telemedicine guideline, such as culture, religion, legal matters, and how clinical psychologists could expand their telepsychology practice during COVID-19 and after, seeking to produce broadly applicable guidelines for the practice of telepsychology. Professional steps in practical telemedicine were illustrated in tables and examples. CONCLUSION: Telepsychology is not a luxury or a temporary response. Rather, it should be considered part of a proactive governance model to secure a continuity of mental health care services. Arabic communities could benefit from this guideline to telepsychology as an essential protocol for providing mental health services during and after the COVID-19 pandemic.

INTRODUCTION: La pandémie COVID-19 fait obstacle aux pratiques classiques d'évaluation et d'intervention psychologiques par le biais d'une interaction en face à face. Les patients et tous les professionnels de la santé ont été contraints de s'isoler et d'innover pour continuer à recevoir et à fournir des services de santé exceptionnels tout en minimisant le risque d'exposition à la COVID-19 ou de transmission de cette maladie. OBJECTIF: Ce document se propose dans un premier temps comme un guide pour la mise en œuvre extraordinaire de la télépsychologie dans le contexte de la pandémie COVID-19 et ensuite pour étendre sa mise en œuvre afin de l'utiliser comme principale ligne directrice pour les services de télépsychologie en Arabie Saoudite et dans d'autres communautés arabes. MÉTHODE: Un groupe de travail professionnel représentant différents domaines de la psychologie professionnelle a examiné, résumé et documenté les méthodes, politiques, procédures et autres ressources afin de s'assurer que les recommandations et les examens des preuves étaient valides et conformes aux meilleures pratiques. RÉSULTATS: La pratique de la télépsychologie implique la prise en compte des exigences légales et professionnelles. Ce document fournit une ligne directrice et des recommandations pour les changements de procédure qui sont nécessaires pour traiter les services psychologiques lors de la transition vers la télépsychologie, ainsi qu'il élucide et démontre les cadres pratiques de la télépsychologie, les procédures et les recommandations appropriées pour la fourniture de services pendant la COVID-19. Il ajoute un examen et une discussion ciblés liés aux facteurs qui pourraient influencer la directive sur la télémédecine, tels que la culture, la religion, les questions juridiques, et la façon dont les psychologues cliniques pourraient étendre leur pratique de la télépsychologie pendant COVID-19 et après, en cherchant à produire des directives largement applicables pour la pratique de la télépsychologie. Les étapes professionnelles de la télémédecine pratique ont été illustrées dans des tableaux et des exemples. CONCLUSION: La télépsychologie n'est pas un luxe ni une réponse temporaire. Elle doit plutôt être considérée comme faisant partie d'un modèle de gouvernance proactive visant à assurer la continuité des services de soins de santé mentale. Les communautés arabes pourraient tirer profit de cette directive sur la télépsychologie en tant que protocole essentiel pour la fourniture de services de santé mentale pendant et après la pandémie COVID-19.

The impact of functional dyspepsia on health-related quality of life in Saudi patients.

OBJECTIVE: The purpose of this study was to evaluate the impact of non-ulcer dyspepsia (NUD) on health-related quality of life (HRQOL), which was assessed using the Nepean Dyspepsia Index, the Short Form-12 quality of life (QOL) scale, the general health questionnaire (GHQ-30) and the self-reporting questionnaire (SRQ-20). MATERIALS AND METHODS: Validated Arabic versions of the four scales were administered to 158 subjects (54 with NUD, 50 with gastroesophageal reflux disease [GERD] and 54 with no history of gastrointestinal [GI] disease), with a mean age of 46.6 years and SD 10.7. RESULTS: Subjects with NUD showed the poorest scores in all indices of general QOL and HRQOL. The differences between the NUD patients and the health control in all HRQOL indices were statistically significant (P < 0.05 to P < 0.001). Comparison between NUD and GERD patients showed significant differences only in the indices of psychological health related QOL ( P < 0.05) but not in the indices of other components of QOL, including physical health components. The study also showed that the women scored lower than men in HRQOL indices, particularly those of psychological and mental health components (P < 0.05 to P < 0.001). Finally, it was found that severity of symptoms is associated with the degree of impairments in HRQOL - (r = 0.69) was significant at (P < 0.001). CONCLUSION: Results of our study showed that HRQOL was significantly impaired in the NUD group. Psychological and mental health related quality of life was particularly impaired in this group compared to both normal patients and patients with similar GI disease. This magnitude of effects on HRQOL was also found to be associated with the severity of symptoms. The implications of these findings for the management of NUD are discussed.

A comparison of public attitudes in Britain and Saudi Arabia towards auditory hallucinations.

BACKGROUND: The successful introduction of community interventions is partly dependent on public beliefs about the aetiology and treatment of psychiatric difficulties and tolerance of community integration. METHOD: This study examined community attitudes towards auditory hallucinations in Saudi Arabia (SA) and the United Kingdom (UK) concerning (a) causes of auditory hallucinations, (b) the efficacy of interventions and (c) levels of social rejection. RESULTS: Responses from 281 patients attending their general practitioners indicated that those living in Saudi Arabia were most likely to believe that hallucinations are caused by Satan or due to magic, while the UK sample were more likely to cite schizophrenia or brain damage. While the Saudi sample believed that religious assistance would be most effective, the UK sample supported medication and psychological therapies. Beliefs about aetiology and treatment were unrelated to educational attainment. There was a greater degree of social rejection of patients in Saudi Arabia, but here educational attainment was of significance. CONCLUSIONS: These results suggest that beliefs about aetiology are related to treatment recommendations and social distancing, and thus have implications for the care of Arabic patients living in Western countries as well as for the use of Western interventions in non-Western cultures.

A cross-cultural study of the attitudes of mental health professionals towards auditory hallucinations.

The usefulness of psychological interventions for auditory hallucinations is becoming increasingly accepted in Western cultures, but there are few data concerning the views of professionals working in non-Western societies. In this study, 195 psychologists and psychiatrists working in Saudi Arabia (SA) and Britain (UK) responded to a questionnaire regarding their (a) attitudes towards various clinical aspects of auditory hallucinations, (b) perceptions of the clinical value of psychological and pharmacological treatments and of the inputs of the two professions and (c) levels of social distance from people who experience auditory hallucinations. UK staff believed that there is a greater range of possible causes and diagnoses for auditory hallucinations than SA staff, who in turn had more confidence in the efficacy of psychological and pharmacological treatments. UK staff reported significantly less social distance from this group of patients. The results suggest that the use of psychological approaches to helping people with auditory hallucinations could be affected by cultural views of the causes and treatment.

Coping with auditory hallucinations: a cross-cultural comparison between western (British) and non-western (Saudi Arabian) patients.

The majority of schizophrenic patients from Western backgrounds develop strategies to cope with the positive symptoms of their condition. However, there is little evidence to indicate how these coping mechanisms are affected by cultural background. Seventy schizophrenic patients from Saudi Arabia (SA) and the United Kingdom (UK) who reported auditory hallucinations were interviewed to explore the ways in which they coped with their voices and sounds. Patients from both cultures had several coping mechanisms, but these varied between cultures. The majority of SA patients used strategies associated with their religion whereas UK patients were more likely to use distraction or physiologically based approaches. The majority of patients were slightly or not at all confident about the effectiveness of their coping strategies. This study suggests that clinicians, when they attempt to facilitate the use of such strategies, may find greater patient acceptance and efficacy if they are familiar with culturally specific factors.

The content and characteristics of auditory hallucinations in Saudi Arabia and the UK: a cross-cultural comparison.

This study investigated the content and characteristics of auditory hallucinations reported by 75 patients in Saudi Arabia (SA) and the UK. Each patient was asked to report on the content and characteristics of their hallucinations with regard to several dimensions, including loudness, frequency, clarity and perceived validity. In general, the characteristics of the voices did not vary between the SA and UK patients, but the content differed between cultures. Much of the content of the hallucinations of SA patients was religious and superstitious in nature, whereas instructional themes and running commentary were common in the UK patients. The results suggest that cultural differences need to be taken into account when applying psychological methods to this group of patients.