Telehealth and the Psychiatric Mental Health Nurse Practitioner: Beyond the COVID-19 Pandemic

Telehealth resources and utilization interest among women who sell sex: An explanatory sequential mixed methods study

Objective

Among a sample of women who sell sex (WSS), we examined unmet health needs, resources for telehealth, utilization interest, and attributes associated with interest in using telehealth.

Study design

Explanatory sequential mixed methods.

Methods

WSS (N = 52) completed a fixed choice survey and focus group (N = 6, 26 individuals) from drop-in centers serving WSS. Chi-square/t-tests and results from the survey data informed the semi-structured focus group interview guide. Thematic analysis of focus group data was conducted to identify themes.

Results

Over half (58 %) of participants expressed interest in using telehealth; however, some lack the necessary resources for use. While 60 % of participants own mobile phones and 46 % have access to a computer, only 35 % have a secure, private space for telehealth appointments. Interest in telehealth was higher among participants who self-identified as having high risk for HIV compared to low risk for HIV (79 % versus 46 %, p = 0.024), and among those considering PrEP for HIV prevention versus not considering PrEP (68 % versus 32 %, p = 0.046). Focus group participants preferred face-to-face encounters for complex medical concerns but expressed interest in telehealth for improved access to healthcare providers for routine care and mental health.

Conclusion

Incorporating telehealth into community organizations could be one strategy to address health inequities experienced by WSS. Access to resources, including technology and safe spaces may be well-accepted if offered at trusted community organizations. Such accessibility addresses a gap in care for WSS and paves the way for new avenues for HIV prevention, mental health support, and research related to unmet health needs among WSS.

A Theoretical Framework for Conducting Psychiatric Mental Health Nursing Virtual Care & Research

Despite rapid adoption and implementation, theoretical research considerations for virtual care (VC), defined simply as healthcare delivered using technology, are lacking across psychiatric mental health nursing (PMHN) scholarship. By adapting Hildegard Peplau's Interpersonal Relations Theory (IRT) and Media Richness Theory (MRT) using an intermodern and emancipatory knowing approach, a new framework was created for guiding modern PMHN VC research. Using this theoretical framework, readers can gain awareness of how the art and science of PMHN practice can be applied to VC scholarly endeavors in the modern healthcare space.

Trauma-informed mental health practice during COVID-19: Reflections from a Community of Practice initiative

This article discusses insights arising from a Community of Practice (CoP) initiative within a mental health short stay inpatient unit adjacent to a major Emergency Department to explore how COVID-19 has influenced engagement and support of people in mental distress. The present initiative was designed as a collaboration between the University of South Australia and SA Health. Community of Practice (CoP) is combined with a narrative review of current evidence to explain specific nursing care responses within an operating environment of pandemic-induced fear and uncertainty. Meetings discussed the challenges associated with delivering mental health care for people experiencing mental health distress in the COVID-19 context. Applying trauma-informed principles to mental health care delivery was identified to be of relevance in the context of an ongoing pandemic. Humanizing nursing care and increasing people's sense of predictability and safety contributed to therapeutic engagement and support during COVID-19. Factors discussed to mitigate the effects of safety measures include, for example, nuanced verbal and non-verbal engagement of health workers with people in mental distress when wearing personal protective equipment (PPE). We highlight the need to 'humanise' nursing and openly communicating that both practitioners and people in distress are navigating special circumstances. The CoP participants additionally acknowledged that the experience of moral distress among frontline health workers needs to be addressed in future policy responses to COVID-19. Person-centred and trauma-informed responses at the point of care might help to mitigate the pandemic short- and long-term effects for both service users and frontline health workers.