| dc.description.abstract | Background: Mental disorders are a significant cause of disability worldwide, Uganda inclusive. In 2019, they accounted for 4.92% and 3.94% of the disease burden in the world and Uganda, respectively. Adolescents are at a relatively higher risk of these disorders due to developmental biological and psychological vulnerabilities to environmental stressors. Telemental health (TMH) can be used to increase access to mental health services for adolescents. However, its effectiveness will depend on its acceptability by adolescent patients, their caretakers, and mental health professionals (MHPs).
Main objective: To assess the acceptability of TMH for adolescent patients at Butabika Hospital among adolescent patients, their caretakers, and MHPs, and determine the associated factors among the patients and their caretakers.
Methods: A concurrent mixed-methods design was used. The quantitative research component was a cross-sectional design among 63 patients and 188 caretakers. Quota sampling was used. Data were collected using a researcher-administered questionnaire. It was managed in EpiData Manager and analysed using Stata software. The qualitative research component was with four mental health professionals, six patients, and eight caretakers. An exploratory descriptive qualitative approach was used. Data were collected through in-depth and key-informant interviews. It was managed in OpenCode and analysed by thematic analysis. Results from the qualitative were triangulated with those from the quantitative research component at the interpretation phase.
Results: Most patients were female (61.9%), did not own phones (59.7%), and had no experience with any TMH service (77.4%), while most caretakers were female (72.3%), owned phones (97.9%), and had no experience with any TMH service (81.4%).
The prevalence of high acceptability among patients was 77.8% (95% CI: 67.2% - 88.3%), and among caretakers was 93.1% (95% CI: 89.4% - 96.7%). None of the candidate factors was associated with high acceptability among patients, while caretaker acceptability was associated with phone ownership (aPR 0.940, 95% CI: 0.900 - 0.982). There were no confounding or interaction effects in the data. Most participants favoured using or providing the TMH service at Butabika Hospital. Furthermore, while using or providing the service was ethical, it presented difficulties in the case of providing it to minors who were non-emancipated patients. The mental health professionals also anticipated minimal opportunity costs, except if they had to provide it outside working hours. Finally, most participants believed that physical limits hampered the efficiency of the service.
Conclusion: Most patients and caretakers expressed high acceptability of the TMH service for adolescent patients at Butabika Hospital. Among caretakers, not owning a phone was associated with a high acceptability of TMH. However, the study was underpowered to detect associations between any candidate predictor and high acceptability. Most participants had favourable opinions about the service. However, they also expressed concerns about its limitations. The management of Butabika Hospital could consider conducting formative research about the TMH service. All TMH providers should endeavour to innovate within prevailing constraints to mitigate the limitations of TMH. Finally, future researchers should use large homogeneous samples from study populations to ensure adequate study power. | en_US |
