Canadian pediatric eating disorder programs and virtual care during the COVID-19 pandemic: a mixed-methods approach to understanding clinicians' perspectives.

IF 3.6 3区 医学 Q1 PSYCHIATRY Annals of General Psychiatry Pub Date : 2023-04-26 DOI:10.1186/s12991-023-00443-4
Kaylee Novack, Rachel Dufour, Louis Picard, Danielle Taddeo, Pierre-Olivier Nadeau, Debra K Katzman, Linda Booij, Nicholas Chadi
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Abstract

Background: As a result of the public health measures put in place during the COVID-19 pandemic in Canada, many health services, including those for the treatment of eating disorders, were provided at a distance. This study aims to describe the adaptations made in specialized pediatric eating disorder programs in Canada and the impact of these adaptations on health professionals' experience of providing care.

Methods: A mixed-methods design was used to survey healthcare professionals working in specialized pediatric eating disorder programs about adaptations to treatment made during the pandemic and the impact of these adaptations on their experience of providing care. Data were collected between October 2021 and March 2022 using a cross-sectional survey comprising 25 questions and via semi-structured interviews. Quantitative data were summarized using descriptive statistics and qualitative data were interpreted using qualitative content analysis.

Results: Eighteen healthcare professionals in Canada completed the online survey, of whom six also participated in the semi-structured interviews. The cross-sectional survey confirmed that, unlike in pre-pandemic times, the majority of participants provided medical care (15/18) and mental health care (17/18) at a distance during the pandemic, with most participants using telephone (17/18) and videoconferencing (17/18). Most (16/18) health professionals indicated that virtual care would continue to be used as a tool in pediatric ED treatment after the pandemic. Participants used a combination of virtual and in-person care, with most reporting weighing patients both in clinic (16/18) and virtually (15/18). Qualitative content analysis generated five themes: (1) responding to increased demand with insufficient resources; (2) adapting to changes in care due to the COVID-19 pandemic; (3) dealing with uncertainty and apprehension; (4) virtual care as an acceptable and useful clinical tool, and (5) optimal conditions and future expectations. Most interview participants (5/6) had globally positive views of virtual care.

Conclusions: Providing virtual multidisciplinary treatment for children and adolescents with eating disorders seemed feasible and acceptable to professionals during the pandemic. Moving forward, focusing on health professionals' perspectives and providing appropriate training in virtual interventions is essential given their central role in successful implementation and continued use of virtual and hybrid care models.

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2019冠状病毒病大流行期间的加拿大儿科饮食失调项目和虚拟护理:了解临床医生观点的混合方法
背景:由于加拿大在2019冠状病毒病大流行期间采取了公共卫生措施,许多卫生服务,包括治疗饮食失调的服务,都是远距离提供的。本研究旨在描述在加拿大专门的儿科饮食失调项目的适应,以及这些适应对卫生专业人员提供护理经验的影响。方法:采用混合方法设计,调查在儿科饮食失调专业项目工作的医疗保健专业人员,了解大流行期间对治疗的适应情况,以及这些适应对他们提供护理经验的影响。数据收集于2021年10月至2022年3月,采用包含25个问题的横断面调查和半结构化访谈。定量资料采用描述性统计进行汇总,定性资料采用定性内容分析进行解释。结果:加拿大的18位医疗保健专业人员完成了在线调查,其中6人还参加了半结构化访谈。横断面调查证实,与大流行前不同,在大流行期间,大多数参与者远距离提供医疗服务(15/18)和精神卫生服务(17/18),大多数参与者使用电话(17/18)和视频会议(17/18)。大多数(16/18)卫生专业人员表示,大流行后,虚拟护理将继续用作儿科急诊科治疗的工具。参与者使用虚拟和亲自护理的组合,大多数报告在诊所(16/18)和虚拟(15/18)称重患者。定性内容分析产生了五个主题:(1)在资源不足的情况下应对不断增长的需求;(2)适应COVID-19大流行带来的护理变化;(3)处理不确定和忧虑;(4)虚拟医疗作为一种可接受和有用的临床工具,以及(5)最佳条件和未来期望。大多数受访者(5/6)在全球范围内对虚拟医疗持积极态度。结论:在大流行期间,专业人员似乎可以为患有饮食失调的儿童和青少年提供实际的多学科治疗。展望未来,鉴于虚拟干预措施在成功实施和继续使用虚拟和混合护理模式方面的核心作用,关注卫生专业人员的观点并提供适当的培训至关重要。
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来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
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