Psikozda Dijital Ruh Sağlığı Müdahalelerinin Kullanımı: Yararlar ve Riskler

Year 2023, Volume: 2 Issue: 2, 55 - 64, 12.10.2023

Sultan Bora

https://doi.org/10.59398/ahd.1279686

Abstract

Psikososyal müdahalelerin dijital formatlara çevrilmesiyle oluşan dijital ruh sağlığı müdahaleleri, geleneksel bakımın önündeki engelleri kaldırma ve ruhsal hastalığı olan bireylerin ruh sağlığı hizmetlerine erişimini artırma potansiyeline sahiptir. Psikotik bozukluklar, genellikle yineleyici olup kişinin gerçeklikle bağının kopmasına yol açan, tüm işlev alanlarında bozulmalarla seyreden, damgalama ve izolasyona neden olan bozukluklardır. Psikozda, etkili spesifik müdahalelere ilişkin kanıtlar yetersizdir. Ayrıca, dijital ruh sağlığı müdahalelerinin kullanımına olan ihtiyaç artmaktadır. Psikozun yönetiminde dijital teknolojilerin kullanım alanları genel olarak: klinik değerlendirme, tanılama, semptom izleme ve nüks önleme, öz-yönetim, standart müdahalelerin etkisini artırma, bilişi geliştirme, günlük işlevselliği destekleme ve sosyal ilişkileri kolaylaştırmadır. Kullanımdaki olumlu sonuçlarının yanı sıra bu müdahaleler psikozda kendilik ve gerçeklik algısı, iletişim, gizlilik ve güvenlik gibi etik konular ile maliyet ve kaynaklara ulaşma gibi teknik konularda bir çok riskler taşımaktadır. Bu derleme, dijital ruh sağlığı müdahalelerinin psikozda kullanımı hakkında bilgi sunarak, yararlarını ve risklerini ortaya koymaktadır.

Keywords

Dijital teknoloji, mobil uygulamalar, psikiyatri hemşireliği, psikotik bozukluklar, şizofreni

Digital Mental Health Interventions for Psychosis: Benefits and Risks

Abstract

Digital mental health interventions that convert psychosocial interventions into digital formats have the potential to overcome existing barriers to traditional care and increase access to mental health services for individuals with mental illness. Psychotic disorders are often recurrent and cause impairment of the connection with reality, a decrease in all functions, stigmatization, and isolation. In psychosis, the evidence for effective specific interventions is insufficient. In addition, the need for digital mental health interventions is increasing. The usage areas of digital technologies in psychosis management are generally: clinical assessment, diagnosis, symptom monitoring and relapse prevention, self-management, enhancing the effectiveness of standard interventions, improving cognition, supporting daily functioning, and facilitating social relationships. In addition to their positive results, these interventions cause many problems in psychosis, such as perception of self and reality, communication, privacy and security, cost, and access to resources. This review provides information on digital mental health interventions in psychosis and highlights the benefits and risks of using these interventions.

Keywords

Digital technology, mobile applications, psychiatric nursing, psychotic disorders, schizophrenia

References

• World Health Organization. Mental health atlas 2020 [Internet]. Geneva: 2021. Available from: https://apps.who.int/iris/rest/bitstreams/1376861. [Accessed 24 March 2023].
• Humpston CS, Jackson HJ. Current Conceptualisation of Psychosis-Clinical and Research Perspectives. In: Badcock JC, Paulik G. (eds.) A clinical introduction to psychosis. Academic Press; 2020. p.8-36.
• Alyahya NM, Munro I, Moss C. The experience of psychosis and recovery from consumers' perspectives: An integrative literature review. J Psychiatr Ment Health Nurs. 2022; 29(1): 99-115.
• Üçok A. İlk Epizot Psikozda Tedavi İlkeleri. Arch Neuropsychiatry. 2021;58:(Ek 1): 12−16.
• National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management (NICE guideline CG178). 2014. https://www.nice.org.uk/guidance/cg178.
• National Institute for Health and Care Excellence. Rehabilitation for adults with complex psychosis (NICE guideline NG181). 2020. https://www.nice.org.uk/guidance/ng181.
• Fusar-Poli P, Salazar de Pablo G, Correll CU, Meyer-Lindenberg A, Millan MJ, Borgwardt S, et al. Prevention of Psychosis: Advances in Detection, Prognosis, and Intervention. JAMA Psychiatry. 2020;77(7):755–765.
• Davies C, Cipriani A, Ioannidis JP, Radua J, Stahl D, Provenzani U, et al. Lack of evidence to favor specific preventive interventions in psychosis: a network meta‐analysis. World Psychiatry. 2018; 17(2): 196-209.
• World Health Organization. Global strategy on digital health 2020-2025. Geneva: 2021. Licence: CC BY-NC-SA 3.0 IGO. [Accessed 24 March 2023].
• Schroeder RA. Adaptation or Revolution: Telemental Health and Advanced Practice Psychiatric Nursing During COVID-19. J Am Psychiatr Nurses Assoc. 2022; 28(3): 241–248.
• Kim SK, Lee M, Jeong H, Jang YM. Effectiveness of mobile applications for patients with severe mental illness: A meta-analysis of randomized controlled trials. Jpn J Nurs Sci. 2022; 19(3): e12476.
• Bell IH, Lim MH, Thomas N. The therapeutic use of digital technologies in psychosis. In: Badcock JC, Paulik G. (eds.) A clinical introduction to psychosis. Academic Press; 2020. p.637-662.
• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Washington, DC: American Psychiatric Association: 2013.
• Moreno-Küstner B, Martin C, Pastor L. Prevalence of psychotic disorders and its association with methodological issues. A systematic review and meta-analyses. PloS One. 2018; 13(4), e0195687.
• Binbay T, Alptekin K, Elbi H, Zağlı N, Drukker M, Tanık FA, ve ark. İzmir kent merkezinde şizofreni ve psikotik belirtili bozuklukların yaşam boyu yaygınlığı ve ilişkili oldukları sosyodemografik özellikler. Turk Psikiyatri Derg. 2012; 23: 149-60.
• Aylak İ, Uluğ BD. Şizofrenide Yalın Kendilik Bozuklukları. Turk Psikiyatri Derg. 2022; 33(3).
• Roberts D. Psychosocial Nursing Care: A guide to nursing the whole person. Open University Press. 2013.
• Borghouts J, Eikey E, Mark G, De Leon C, Schueller SM, Schneider M, et al. Barriers to and facilitators of user engagement with digital mental health interventions: systematic review. J Med Internet Res. 2021; 23(3), e24387.
• Çetinkaya B, Uslu E. Parmak Ucundaki Bakım: Mobil Uygulama ve Şizofreni Hastalarının Bakımında Kullanımı. ACU Sağlık Bil Derg. 2020; (4): 574-581.
• Gire N, Caton N, McKeown M, Mohmed N, Duxbury J, Kelly J, et al. Care co-ordinator in my pocket': a feasibility study of mobile assessment and therapy for psychosis (TechCare). BMJ Open. 2021;16:11(11):e046755.
• Garety P, Edwards CJ, Ward T, Emsley R, Huckvale M, McCrone P, et al. Optimising AVATAR therapy for people who hear distressing voices: study protocol for the AVATAR2 multi-centre randomised controlled trial. Trials. 2021; 22 (366).
• Bucci S, Barrowclough C, Ainsworth J, Machin M, Morris R, Berry K, et al. Actissist: Proof-of-Concept Trial of a Theory-Driven Digital Intervention for Psychosis. Schizophr Bull. 2018; 44(5): 1070–1080.
• Griffiths H. The Acceptability and Feasibility of Using Text Messaging to Support the Delivery of Physical Health Care in those Suffering from a Psychotic Disorder: a Review of the Literature. Psychiatr Q. 2020; 91: 1305–1316.
• Välimäki M, Kannisto KA, Vahlberg T, Hätönen H, Adams CE. Short Text Messages to Encourage Adherence to Medication and Follow-up for People With Psychosis (Mobile.Net): Randomized Controlled Trial in Finland. J Med Internet Res. 2017; 19(7): e245.
• Valentine L, McEnery C, O’Sullivan S, D’Alfonso S, Gleeson J, Bendall S, et al. Young people’s experience of online therapy for first‐episode psychosis: A qualitative study. Psychology and Psychotherapy: Theory, Research and Practice. 2022; 95(1): 155-172.
• Jones S, Atanasova D, Dodd S, Flowers S, Rosala-Hallas A, Robinson H, et al. Use of an Online Forum for Relatives of People With Psychosis and Bipolar Disorder: Mixed Methods Study. JMIR mental health. 2022; 9(10): e35837.
• Kılıç T, Mızrak S, Ünver G. e-Mental sağlık, iyi uygulama örneği, Hollanda. Manisa CBU Sağlık Bilimleri Enstitüsü Dergisi. 2017; 4(3): 1006-1012.
• DeLuca JS, Andorko ND, Chibani D, Jay SY, Rakhshan Rouhakhtar PJ, Petti E, et al. Telepsychotherapy with youth at clinical high risk for psychosis: Clinical issues and best practices during the COVID-19 pandemic. J Psychother Integr. 2020; 30(2): 304–331.
• Botella C, Díaz-García A, Baños R, Quero S. Cybertherapy: Advantages, limitations, and ethical issues. PsychNology Journal. 2009; 7(1): 77 – 100.
• Chivilgina O, Elger BS, Jotterand F. Digital Technologies for Schizophrenia Management: A Descriptive Review. Sci Eng Ethics. 2021; 27(25).
• Terp M, Jørgensen R, Laursen BS, Mainz J, Bjørnes CD. A Smartphone App to Foster Power in the Everyday Management of Living With Schizophrenia: Qualitative Analysis of Young Adults' Perspectives. JMIR mental health. 2018; 5(4): e10157.
• Bauer M, Glenn T, Monteith S, Bauer R, Whybrow PC, Geddes J. Ethical perspectives on recommending digital technology for patients with mental illness. Int J Bipolar Disord. 2017; 5(1): 6.
• Rouleau G, Gagnon M, Côté J, Payne-Gagnon J, Hudson E, Dubois C. Impact of Information and Communication Technologies on Nursing Care: Results of an Overview of Systematic Reviews. J Med Internet Res 2017;19(4):e122.
• Foley T, Woollard J. The digital future of mental healthcare and its workforce. Health Education England: 2019.
• Thompson J, Boden ZV, Newton EK, Fenton K, Hickman G, Larkin M. The experiences of inpatient nursing staff caring for young people with early psychosis. J Res Nurs. 2019; 24(1-2): 75-85.
• Odeyemi C, Morrissey J, Donohue G. Factors affecting mental health nurses working with clients with first-episode psychosis: A qualitative study. J Psychiatr Ment Health Nurs. 2018; 25(7): 423–431.
• Kuosmanen L, Välimäki M, Joffe G, Pitkänen A, Hätönen H, Patel A, et al. The effectiveness of technology-based patient education on self-reported deprivation of liberty among people with severe mental illness: a randomized controlled trial. Nord J Psychiatry. 2009; 63(5): 383-389.
• Uslu E, Buldukoglu K. Randomized controlled trial of the effects of nursing care based on a telephone intervention for medication adherence in schizophrenia. Perspect Psychiatr Care. 2020; 56(1): 63–71.
• Barrera A, Gee C, Wood A, Gibson O, Bayley D, Geddes J. Introducing artificial intelligence in acute psychiatric inpatient care: qualitative study of its use to conduct nursing observations. BMJ Ment Health. 2020; 23(1): 34-38.
• Koivunen M, Saranto K. Nursing professionals' experiences of the facilitators and barriers to the use of telehealth applications: a systematic review of qualitative studies. Scand J Caring Sci. 2018; 32(1): 24–44.