E-mental health

Christensen, LF., Wilson, R., Hansen, JP., Nielsen, CT., Gildberg, FA. 2020. A qualitative study of patients’ and providers’ experiences with the use of videoconferences by older adults with depression. International Journal of Mental Health Nursing. doi.org/10.1111/inm.12803 Status: Published

The aim of this study was to investigate the experiences of patients and providersregarding the use of videoconferences in older patients with depression. The qualitative studyconsisted of semi-structured interviews with patients and providers and focus group interviewswith providers. Themes were identified through using thematic analysis. Three main themes wereas follows: 1. Technical Challenges experienced by patients and providers experiences; 2.Videoconferencing as clinical supportive technology; and 3. Therapeutic relationship across face-to-face and videoconferencing formats. Several subthemes describi ng patients’ and providers’experiences were identified. Taken together, there was a similarity between expectations, opinions,and attitudes in relation to experiences vertically acros s all main themes, and horizontally betweenthe main themes. An optimistic outlook influenced user expectations, opinions, and attitudes andacted to mitigate an negative sentiment about technical challenges. This increased the adoption ofvideoconferencing as a tool for clinical support and enabled the development of a therapeuticrelationship using videoconferencing, especially for provider users. Both patients and providersagreed that videoconferences could not replace all face-to-face conversations and thatvideoconferences, in most cases, were best suited for shorter follow-up consultations. Expectations,opinions, and attitudes, whether negative or positive, seemed to have significant impact on theexperiences of patients and especially providers

Lone Fisker Christensen, Anne Marie Moller, Jens Peter Hansen, Connie Thuroe Nielsen, Frederik Alkier Gildberg 2019. Patients’ and providers’ experiences with video consultations used in the treatment of older patients with unipolar depression: a systematic review. Journal of Psychiatric and Mental Health Nursing. jpm.12574. https://doi.org/10.1111/jpm.12574 Article, Peer reviewed. Status: Published!

Introduction: Depression is the leading cause of mental illness among an aging population and fewer than half of those who are affected receive treatment. There is an increased need for alternative ways of treating patients; the use of video consultations has been shown to be a viable option for delivering mental health care. However, none of the existing reviews have focused on satisfaction with the use of video consultations amongst older people with depression and providers. Aim: To conduct a systematic review of the existing literature focusing on patients’ and providers’ experiences of video consultations for depression. Method: Eight scientific databases were searched. In all, 3537 articles were identified and, of these, 21 peer-reviewed articles were included in this review. Results: The results show that video consultations support mental health practice, especially as a useful alternative when face-to-face therapy is not possible. Any initial skepticism quickly disappeared when video consultations were experienced in action. The challenges seem to consist of technical problems and lack of support from staff. Discussion: The experiences and satisfaction of older people with depression seem to be positive, although methodological limitations and deficiencies of the reviewed articles should be considered. More qualitative research is needed, and future studies should focus on specific diagnoses and providers’ experiences. Implications for practice: Video consultations support mental health practice, especially as a useful alternative when face-to-face therapy is not possible.

Christensen, L.F., Gildberg, F.A., Sibbersen, C., Skjoeth, M.M., Nielsen, C.T., Hansen, J.P. 2019. Videoconferences and treatment of depression: Satisfaction score correlated with number of sessions attended but not with age. Telemedicine and E-Health, tmj.2019.0129. https://doi.org/10.1089/tmj.2019.0129 Article, Article, Peer reviewed. Status: Published!

Aim: To investigatewhether there is a correlation between age and satisfaction with the use of videoconferences (VCs) and whether the number of video sessions had an impact on satisfaction. Methods: This study was a subanalysis of the joint European project, MasterMind, and participants were recruited from15 pilot studies in 11 different countries. The Client Satisfaction Questionnaire 8 (CSQ 8) was used as assessment tool, and scores were summed to give total scores. Results: Participants were included if they had filled out the CSQ 8 questionnaire and demographic datawere available. This resulted in a total of 199 participants. We found that the total score was not significantly correlated with age (Spearman’s rho=-0.0415, p = 0.563) and gender (Wilcoxon W= 5,066, p = 0.409). There was a significant positive correlation between number of sessions attended (Spearman’s rho = 0.5777, p < 0.001) and total score after adjusting for age, gender, region, symptoms score, and education level in a multiple linear regression model (coefficient = 0.170, SE = 0.059, p = 0.004). Excluded responders were significantly younger than included responders, had lower symptoms score, attended fewer sessions, had a higher education, and were more likely to be employed.
Conclusions: VC satisfaction scores in patients with unipolar depression do not depend on age but increase with experience in all age groups.
Keywords: videoconferences, depression, satisfaction, age,
telemedicine, telehealth, e-Health

Christensen, L. F., Gildberg, F., Sibbersen, C., Skjøth, M. M., Nielsen, C. T. & Hansen, J. P.  2019. Disagreement in satisfaction between patients and providers in the use of videoconferences by depressed adults. In: Telemedicine and e-Health. doi: 10.1089/tmj.2019.0055 Publikation: Article, Peer reviewed. Status: Published online!

Aim: To evaluate whether there was a difference in satisfaction scores between providers and patients in the use of videoconferences (VCs) by depressed adults. Method: This study was a subanalysis of the joint European project, MasterMind, and participants were recruited from 15
pilot studies in 11 different countries. The Client Satisfaction Questionnaire (CSQ)-3 was used as assessment tool, and scores were summed to give total scores. The questionnaire consists of three items evaluating general satisfaction, fulfillment of needs in treatment, and usability.
Results: A total of 362 respondents, 201 patients and 161 providers, completed the questionnaire. Providers had a mean total CSQ-3 score of 9.17 (95% confidence interval [CI] =
8.90–9.45), whereas patients had a mean of 9.70 (95% CI = 9.44–9.98). Mean scores for item 1 (the extent to which VCs had met the needs of the participants): patients 3.19, providers 2.93 ( p = 0.00048); for item 2 (general satisfaction): patients 3.22, providers 3.08 ( p = 0.083); and item
3 (whether participants wanted to use VCs again): patients 3.28 providers 3.16 ( p = 0.045). Conclusion: The results showed that total satisfaction scores were higher in patients than in providers. The differences between patients and providers were significant for items 1 and 3 ( p < 0.05), but we did not find a significant difference regarding item 2.

The Collavi Project

PhD-Student & project responsible: Lone Fisker, Ph.d-student, cand.mag. Institute of Regional Health Research, Faculty of Health Science, University of Southern Denmark

Head Supervisor: Frederik A.Gildberg, Ph.d., Professor (Associate) & Head of Research, Lecturer in Forensic Mental Health, PhD, MScN, RN. CPS, Institute of Regional Health Research, Faculty of Health Science, University of Southern Denmark. Lecturer & Head of Research, Dept. of Psychiatry Middelfart, Region of Southern Denmark.

Supervisor: Connie T Nilsen, PhD, Institute of Regional Health Research, Faculty of Health Science, University of Southern Denmark  & Head of Psychiatric Dept. Vejle-Kolding, Region of Southern Denmark

Supervisor: Jens Peter Hansen, Post Doc, PhD, MScN, RN, Institute of Regional Health Research, Faculty of Health Science, University of Southern Denmark  & Research koordinator, Dept. of Psychiatry Esbjerg, Region of Southern Denmark

(From 1.Sep. 2015 to 1.sep. 2018)

English Abstract

The aim of the The Collavi project is to provide scientific research about clinical change and experience of implementing and using a collaborative care model facilitated by videoconferencing. The background for the project is an increasing number of older people with depression, a trend to replace inpatient by outpatient care, political plans about using telepsychiatry and lack of psychiatrists. The project is an ongoing PhD project and a part of the European MasterMind project. For MasterMind, collaborative care is to be understood as care consisting of a multiprofessionel approach, structured management plan, scheduled patient follow-up and enhanced interprofessionel communication. Video will be used in diagnosing, monitoring and treating mild or moderate depression at patients above the age of seventy treated at home. A psychiatric team from the hospital is responsible for the treatment. The project uses video as communication in an integrated cross sectional collaboration between patients, psychiatrists and nurses. The primary goal is for psychiatrists to be able to treat patients by remote video from the hospital and all together the model allows for more frequently contact between staff and patient, possibility for supervision and possibility for assessing acute issues using video as communication with the psychiatrist on duty. In the Collavi project, clinical outcomes are evaluated as well as patients, staffs and organisations satisfaction and the challenges using and implementing the model. The learnings can be used to secure a solid knowledge base for optimized use, implementation and further development of telemedicine in the area. The project is designed as a mixed method study in the terms of personal interviews, focus group interviews and questionnaires to patients, healthcare professionals and mental healthcare organisations.