在新西兰奥特亚罗瓦 COVID-19 期间使用远程精神病学:经验、教训和文化安全

Lauren Barnett, Alisha Vara, Mark Lawrence, E. Ma’u, Rodrigo Ramalho, Yan Chen, Grant Christie, Gary Cheung
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摘要

目的在 COVID-19 封锁期间,新西兰奥特亚罗瓦的许多精神科医生和受训人员都使用了远程精神病治疗,尽管他们在该领域的经验和培训极少。奥特亚罗瓦地区缺乏对文化安全远程精神病学框架的研究。本研究旨在更好地了解奥特亚罗瓦地区的远程精神病治疗情况,并找出当前实践中可能存在的差距,重点是探讨毛利人、太平洋岛屿族裔和亚洲人使用远程精神病治疗的情况。设计/方法/途径本定性研究以毛利人考帕帕(Kaupapa Maori)方法和泛太平洋研究中的 "让路规则 "为指导原则,以确保分析和结果符合当地文化。研究人员从澳大利亚和新西兰皇家精神医学院的奥特亚罗亚会员中抽取了部分精神科医生和实习生,对他们进行了半结构化访谈。然后使用一般归纳主题分析法对定性数据进行分析,以确定主要的主题。原创性/价值对主要主题的分析为提供文化上安全的远程精神病治疗预约提供了实用的思路,也为开发尤其适用于毛利人、太平洋人和亚洲人精神健康用户的远程精神病治疗服务提供了更广泛的基础。该领域缺乏资源和专业知识,需要进一步建立支持基础设施和培训的框架。
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The use of telepsychiatry during COVID-19 in Aotearoa New Zealand: experiences, learnings and cultural safety
Purpose Many psychiatrists and trainees in Aotearoa New Zealand used telepsychiatry during COVID-19 lockdowns, despite minimal experience and training in the area. Research on a culturally safe telepsychiatry framework is lacking in Aotearoa. This study aims to provide a better understanding of telepsychiatry in the Aotearoa context and identify potential gaps with the current practice, with a focus on exploring telepsychiatry use with Maori, Pacific peoples and Asians. Design/methodology/approach This qualitative study was guided by the principles of the Kaupapa Maori methodology and the “Give Way Rule” from Pan-Pacific studies, to ensure culturally appropriate analysis and outcomes. Semi-structured interviews were conducted with a sample of psychiatrists and trainees recruited from Aotearoa members of the Royal Australian and New Zealand College of Psychiatrists. The qualitative data were then analysed using general inductive thematic analysis to identify the major themes. Findings In total, 18 participants were interviewed. Three key themes were identified: cultural safety such as preparation for a telepsychiatry session, cultural practices and equity issues; clinical practice such as continuity of care, patient selection and limitations; and process of running a telepsychiatry service. Originality/value The analysis of the main themes gives both practical ideas for providing a culturally safe telepsychiatry appointment, as well as a wider base for developing a telepsychiatry service that works particularly for Maori, Pacific and Asians mental health users. Issues around resources and expertise in the field are lacking and further frameworks to support infrastructure and training are needed.
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