Multi-stakeholder perspectives regarding preferred modalities for mental health intervention delivered in the orthopedic clinic: a qualitative analysis

BMC Psychiatry

Research

Joanna Abraham¹  Christopher J. Dy²  Ryan P. Calfee²  Melissa A. Armbrecht³  Abby L. Cheng³  Ashwin J. Leo⁴ 

[1] Department of Anesthesiology & Institute for Informatics, Washington University School of Medicine, 4990 Children’s Place, 63110, St. Louis, MO, USA;Division of Hand and Wrist, Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 South Euclid Avenue, 63110, St. Louis, MO, USA;Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 South Euclid Avenue, 63110, St. Louis, MO, USA;Washington University School of Medicine, 660 South Euclid Avenue, 63110, St. Louis, MO, USA;

关键词: Digital mental health intervention;    Chronic musculoskeletal pain;    Anxiety;    Depression;    Equity;    Digital divide;    Feasibility;    Usability;    Implementation;   

DOI  :  10.1186/s12888-023-04868-9

 received in 2022-11-29, accepted in 2023-05-13,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAlthough depressive and anxious symptoms negatively impact musculoskeletal health and orthopedic outcomes, a gap remains in identifying modalities through which mental health intervention can realistically be delivered during orthopedic care. The purpose of this study was to understand orthopedic stakeholders’ perceptions regarding the feasibility, acceptability, and usability of digital, printed, and in-person intervention modalities to address mental health as part of orthopedic care.MethodsThis single-center, qualitative study was conducted within a tertiary care orthopedic department. Semi-structured interviews were conducted between January and May 2022. Two stakeholder groups were interviewed using a purposive sampling approach until thematic saturation was reached. The first group included adult orthopedic patients who presented for management of ≥ 3 months of neck or back pain. The second group included early, mid, and late career orthopedic clinicians and support staff members. Stakeholders’ interview responses were analyzed using deductive and inductive coding approaches followed by thematic analysis. Patients also performed usability testing of one digital and one printed mental health intervention.ResultsPatients included 30 adults out of 85 approached (mean (SD) age 59 [14] years, 21 (70%) women, 12 (40%) non-White). Clinical team stakeholders included 22 orthopedic clinicians and support staff members out of 25 approached (11 (50%) women, 6 (27%) non-White). Clinical team members perceived a digital mental health intervention to be feasible and scalable to implement, and many patients appreciated that the digital modality offered privacy, immediate access to resources, and the ability to engage during non-business hours. However, stakeholders also expressed that a printed mental health resource is still necessary to meet the needs of patients who prefer and/or can only engage with tangible, rather than digital, mental health resources. Many clinical team members expressed skepticism regarding the current feasibility of scalably incorporating in-person support from a mental health specialist into orthopedic care.ConclusionsAlthough digital intervention offers implementation-related advantages over printed and in-person mental health interventions, a subset of often underserved patients will not currently be reached using exclusively digital intervention. Future research should work to identify combinations of effective mental health interventions that provide equitable access for orthopedic patients.Trial registrationNot applicable.

【 授权许可】

CC BY   
© The Author(s) 2023