‘I didn’t know what to expect’: Exploring patient perspectives to identify targets for change to improve telephone-delivered psychological interventions

BMC Psychiatry

Nicky Lidbetter¹  Karina Lovell²  Kerry Ardern³  Christopher J. Armitage⁴  Penny Bee⁵  Kelly Rushton⁶  Peter Bower⁶  Charlotte Welsh⁶  Elinor Hopkin⁶  Judith Gellatly⁶  Cintia Faija⁶ 

[1] Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre;Anxiety UK;Department of Psychology, University of Sheffield;Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, United Kingdom;NIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, Manchester Academic Health Science Centre, University of Manchester;School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester;

关键词: Telephone therapy;    Anxiety;    Depression;    Psychological wellbeing practitioner;    IAPT;    Mental health;   

DOI  :  10.1186/s12888-020-02564-6

来源: DOAJ

【 摘 要 】

Abstract Background Remote delivery of psychological interventions to meet growing demand has been increasing worldwide. Telephone-delivered psychological treatment has been shown to be equally effective and as satisfactory to patients as face-to-face treatment. Despite robust research evidence, however, obstacles remain to the acceptance of telephone-delivered treatment in practice. This study aimed to explore those issues using a phenomenological approach from a patient perspective to identify areas for change in current provision through the use of theoretically based acceptability and behaviour change frameworks. Methods Twenty-eight semi-structured interviews with patients experiencing symptoms of common mental health problems, waiting, receiving or having recently received telephone-delivered psychological treatment via the UK National Health Service’s Improving Access to Psychological Therapies (IAPT) programme. Interviews were recorded, transcribed verbatim, and analysed using the Theoretical Domains Framework (TDF) and Theoretical Framework of Acceptability (TFA). Results The majority of data clustered within five key domains of the TDF (knowledge, skills, cognitive and interpersonal, environmental context and resources, beliefs about capabilities, beliefs about consequences) and mapped to all constructs of the TFA (affective attitude, ethicality, intervention coherence, self-efficacy, burden, opportunity costs, and perceived effectiveness). Themes highlighted that early stages of treatment can be affected by lack of patient knowledge and understanding, reservations about treatment efficacy, and practical obstacles such as absent non-verbal communication, which is deemed important in the development of therapeutic alliance. Yet post-treatment, patients can reflect more positively, and report gaining benefit from treatment. However, despite this, many patients say that if they were to return for future treatment, they would choose to see a practitioner face-to-face. Conclusions Using a combination of theoretically underpinned models has allowed the identification of key targets for change. Addressing knowledge deficits to shift attitudes, highlighting the merits of telephone delivered treatment and addressing skills and practical issues may increase acceptability of, and engagement with, telephone-delivered treatment.

【 授权许可】

Unknown