bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2022-56-1-43-53bekhterev-651Research ArticleИССЛЕДОВАНИЯINVESTIGATIONSТелемедицинское консультирование «пациент-врач» в детской психиатрии: методология и практикаTelemedicine consultation «patient-doctor» in child psychiatry: methodology and practicehttps://orcid.org/0000-0001-6545-6170МорозовС. П.MorozovS P

Морозов Сергей Павлович — д.м.н., профессор, директор, главный внештатный специалист по лучевой и инструментальной диагностике

г. Москва

Sergey P. Morozov

Moscow

morozov@npcmr.ruhttps://orcid.org/0000-0001-7976-0800БебчукМ. А.BebchukM A

Бебчук Марина Александровна — к.м.н, доцент, директор, главный внештатный специалист детский психиатр

г. Москва

Marina A. Bebchuk

Moscow

Bebchukma@suhareva-center.mos.ruhttps://orcid.org/0000-0002-9842-3524ВладзимирскийА. В.VladzymyrskyyA V

Владзимирский Антон Вячеславович — д.м.н., заместитель директора по научной работе

г. Москва

Anton V. Vladzymyrskyy

Moscow

a.vladzimirsky@npcmr.ruhttps://orcid.org/0000-0002-9842-3524ХайретдиновО. З.KhairetdinovO Z

Хайретдинов Олег Замильевич — к.м.н, ведущий научный сотрудник

г. Москва

Oleg Z. Khairetdinov

Moscow

KhayretdinovOZ@suhareva-center.mos.ruНаучно-практический клинический центр диагностики и телемедицинских технологийРоссияResearch and Practice Clinical Center for Diagnostics and Telemedicine TechnologiesRussian FederationНаучно-практический центр психического здоровья детей и подростков им. Г.Е. СухаревойРоссияScientific-practical Сhildren’s and Adolescents Mental Health Center n.a. G. SukharevaRussian FederationНаучно-практический клинический центр диагностики и телемедицинских технологий; Первый Московский государственный медицинский университет имени И.М. СеченоваРоссияResearch and Practice Clinical Center for Diagnostics and Telemedicine Technologies; I.M. Sechenov First Moscow State Medical UniversityRussian Federation2022300320225614353Copyright © Морозов С.П., Бебчук М.А., Владзимирский А.В., Хайретдинов О.З., 20222022Морозов С.П., Бебчук М.А., Владзимирский А.В., Хайретдинов О.З.Morozov S.P., Bebchuk M.A., Vladzymyrskyy A.V., Khairetdinov O.Z.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/651

Телепсихиатрическая помощь в формате «врач — пациент» находится на этапе формирования и требует решения правовых, организационных и методологических вопросов. Целью исследования было обоснование методологии телемедицинских консультаций пациентов (законных представителей) в детской психиатрии. Материал и методы. Проведен анализ результатов 1129 телемедицинских консультаций (ТМК) в формате «пациент — врач» для 559 пациентов в возрасте от 2 до 18 лет. Результаты. Дистанционные консультации апробированы при всем спектре психических расстройств детского и подросткового возраста. При проведении первичных ТМК «пациент-врач» выявлен ряд серьезных нормативно-правовых и технических ограничений. Повторные ТМК «пациент — врач» в детской психиатрической практике определены как наиболее оптимальные и безопасные. Отмечены значительное увеличение количества повторных ТМК и расширения специальностей консультантов в период ограничительных мер в связи с пандемией COVID-19. Проведена оценка результативности ТМК путем социологического опроса (анкетирования) врачей и пациентов (законных представителей). Заключение. Разработана методология организации и проведения телемедицинских консультаций пациентов в возрасте до 18 лет (законных представителей) по профилю «психиатрия». Опрос получателей помощи зафиксировал их высокую готовность и удовлетворенность дистанционным консультированием. Опрос медицинских работников выявил положительную динамику отношения к проведению ТМК. Отрицательная динамика мнений специалистов в связи с повышением уровня трудовой нагрузки свидетельствует о необходимости дальнейшей организационно-методической и образовательной работы по применению телемедицинских технологий.

Telepsychiatric assistance in the “doctor-patient” format is at the stage of formation and requires the solution of legal, organizational and methodological issues. The aim of the study was to substantiate the methodology of telemedicine consultations of patients (legal representatives) in child psychiatry. Material and methods. The analysis of the results of 1129 telemedicine consultations (TMK) in the «patient-doctor» format for 559 patients aged 2 to 18 years was carried out. Results. Remote consultations have been tested for the entire spectrum of mental disorders in childhood and adolescence. During the primary patient-doctor TMK, a number of serious regulatory and technical limitations were identified. Repeated TMK «patient — doctor» in child psychiatric practice are defined as the most optimal and safe. There was a significant increase in the number of repeated TMKs and the expansion of the specialties of consultants during the period of restrictive measures in connection with the COVID-19 pandemic. The assessment of the effectiveness of TMK was carried out by means of a sociological survey (questionnaire) of doctors and patients (legal representatives). Conclusion. A methodology has been developed for organizing and conducting telemedicine consultations for patients under the age of 18 (legal representatives) in the field of psychiatry. A survey of beneficiaries recorded their high readiness and satisfaction with remote counseling. A survey of medical workers revealed a positive trend in attitudes towards carrying out TMK. The negative dynamics of the opinions of specialists in connection with the increase in the level of workload indicates the need for further organizational, methodological and educational work on the use of telemedicine technologies.

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The authors declare that there are no conflicts of interest present.