Assessment of knowledge and perceptions of Tunisian psychiatrists regarding Telepsychiatry

##plugins.themes.academic_pro.article.main##

Samir Samaâli
Abir Hakiri
Azza Bouallaguia
Ghassen Amri
Rym Ghachem

Abstract

Introduction: Telemedicine has become a fundamental pillar of the evolution of healthcare worldwide. In Tunisia, the challenges of the health system, amplified by the COVID-19 pandemic, have highlighted the urgency to adopt innovative solutions. In this regard, the publication of Presidential Decree No. 318/2022 on April 8 in the Official Journal of the Tunisian Republic represents a significant advance in the regulation of telemedicine.


Aim: To assess the knowledge of Tunisian psychiatrists and child psychiatrists regarding telemedicine, its legal framework, and their perceptions of this new medical practice.


Methods: A descriptive cross-sectional study was conducted 8 months after the issuance of the presidential decree. The survey was conducted online through an electronic questionnaire on Google Forms.


Results: A total of 68 participants were included in this survey. The median number of professional years was 5±7 years. Among the participants, 82% worked in psychiatry and 18% worked in child psychiatry. The sector of practice was public in 69% and private in 31% of cases. Most of them (62%) did not know about the different telemedicine acts, and 57% of doctors were unaware of the existence of the presidential decree. The majority of doctors (84%) expressed a favorable opinion regarding the adoption of telepsychiatry, regardless of sex (p=0.69), professional status (p=0.512), specialty (p=1), years of experience (p=0.83), and practice sector (p=1).


Conclusion: Despite a low level of knowledge regarding telemedicine, the study highlights the interest of the participants in integrating telepsychiatry into their clinical practices.

Keywords:

Telemedicine , Psychiatry , knowledge, Legal status, Perception, Tunisia

##plugins.themes.academic_pro.article.details##

References

  1. WHO Group Consultation on Health Telematics (1997: Geneva S. A health telematics policy in support of WHO’s Health-for-all strategy for global health development : report of the WHO Group Consultation on Health Telematics, 11-16 December, Geneva, 1997 [Internet]. World Health Organization; 1998 [cité le 15 décembre 2022]. Report No.: WHO/DGO/98.1. Disponible sur : https://apps.who.int/iris/handle/10665/63857
  2. Ohannessian R, Duong TA, Odone A. Global Telemedicine Implementation and Integration Within Health Systems to Fight the COVID-19 Pandemic: A Call to Action. JMIR Public Health Surveill. 2020;6(2):e18810.
  3. Elmatri A. Télémédecine en Tunisie : liaisons avec les pays européens, arabes et africains. Tunisie: 4th International Conference: Sciences of Electronic, Technologies of Information and Telecommunications internet. Mars 2007. Disponible sur : http://www.setit.rnu.tn/last_edition/setit2007/T/2.pd
  4. République tunisienne. Loi n° 2018-43 du 11 juillet 2018, complétant la loi n° 91-21 du 13 mars 1991, relative à l’exercice et à l’organisation de la profession de médecin et de médecin dentiste. Journal Officiel du 17 Juillet 2018.
  5. République tunisienne. Loi n° 91-21 du 13 mars 1991, relative à l’exercice et à l’organisation des professions de médecin et de médecin dentiste. Journal Officiel du 15 mars 1991.
  6. Communiqué du Conseil National de l’Ordre des Médecins. A proposde la Télémédecine. Conseil National de l’Ordre des Médecins de laTunisie internet.. 15 mars 2020. Disponible au lien URL : http://www.ordre-medecins.org.tn/fr/
  7. République tunisienne. Décret Présidentiel n° 2022-318 du 8 avril 2022, fixant les conditions générales d’exercice de la télémédecine et les domaines de son application. Journal Officiel du 17 avril 2022.
  8. Brown FW. A survey of telepsychiatry in the USA. J Telemed Telecare. 1995;1(1):19–21.
  9. Zgueb Y, Bourgou S, Neffeti A, Amamou B, Masmoudi J, Chebbi H, et al. Psychological crisis intervention response to the COVID-19 pandemic: A Tunisian centralised Protocol. Psychiatry Res. 2020;289:113042.
  10. Mleyhi S, Ziadi J, Ben Hmida Y, Ghédira F, Ben Mrad M, Denguir R. La télémédecine et les réseaux sociaux dans la gestion des ECMO à l’ère de COVID-19 : l’expérience Tunisienne. Ann CardiolAngeiol. 2021;70(2):125–8.
  11. Brown FW. A survey of telepsychiatry in the USA. J Telemed Telecare. 1995;1(1):19–21.
  12. Charfi F, Ouali U, Spagnolo J, Belhadj A, Nacef F, Saidi O, Melki W. Highlighting successes and challenges of the mental health system in Tunisia: an overview of services, facilities, and human resources. J Ment Health. 2023 Feb;32(1):166-174.
  13. Mishkin AD, Cheung S, Capote J, Fan W, Muskin PR. Survey of Clinician Experiences of Telepsychiatry and Tele-Consultation-Liaison Psychiatry. J Acad Consult Liaison Psychiatry. 2022 Jul-Aug;63(4):334-344.
  14. Astruc B, Henry C, Masson M. Intérêt de la télé-psychiatrie pour la prise en charge des patients : enjeux et questions d’une pratique nouvelle. Ann Méd-PsycholRevPsychiatr. 2013;171(2):61–4.
  15. Bouchard S, Paquin B, Payeur R, Allard M, Rivard V, Fournier T, et al. Delivering cognitive-behavior therapy for panic disorder with agoraphobia in videoconference. Telemed J E-Health Off J Am Telemed Assoc. 2004;10(1):13–25.
  16. Desbordes M, Nebout S, Grès H, Guillin O, Haouzir S. La télémédecine en psychiatrie du sujet âgé : enjeux et perspectives. NPG Neurol - Psychiatr - Gériatrie. 2015;15(89):270–3.
  17. Romijn G, Batelaan N, Kok R, Koning J, van Balkom A, Titov N, et al. Internet-Delivered Cognitive Behavioral Therapy for Anxiety Disorders in Open Community Versus Clinical Service Recruitment: Meta-Analysis. J Med Internet Res. 2019;21(4):e11706.
  18. Albarrak AI, Mohammed R, Almarshoud N, Almujalli L, Aljaeed R, Altuwaijiri S, et al. Assessment of physician’s knowledge, perception and willingness of telemedicine in Riyadh region, Saudi Arabia. J Infect Public Health. 2021;14(1):97–102.
  19. Thèse. La télémédecine en psychiatrie : pratiques et représentations chez les psychiatres normands.
  20. Doyen CM, Oreve MJ, Desailly E, Goupil V, Zarca K, L’Hermitte Y, et al. Telepsychiatry for Children and Adolescents: A Review of the PROMETTED Project. Telemed J E-Health Off J Am Telemed Assoc. 2018;24(1):3–10.
  21. Kommu JVS, Sharma E, Ramtekkar U. Telepsychiatry for Mental Health Service Delivery to Children and Adolescents. Indian J Psychol Med. 2020;42(5 Suppl):46S-52S.
  22. Salem NH, Ouelha D, Gharbaoui M, Saadi S, Khelil MB. Aspects médico-légaux relatifs à la Télémédecine en Tunisie dans le contexte de la pandémie du Covid-19. Tunis Med.2020;98(6):423-33.