Abstract

Objective

Identify factors influencing service delivery changes during COVID-19 and examine barriers and provider satisfaction with teleneuropsychology (teleNP).

Method

Licensed clinical neuropsychologists within the United States recruited via neuropsychology-specific listservs (July–August 2020) to complete an online survey.

Results

A total of 261 individuals completed the survey. Most (76%) reported delivering in-person testing in some capacity at the time of our survey. Relatively more private practitioners identified concerns with privacy/confidentiality (45.2% vs. 17.9%; χ²(2) = 6.99, p < 0.05), legal issues (47.6% vs. 17.9%; χ²(2) = 8.06, p < 0.05), and an undesirable precedent for legal/forensic cases (59.5% vs. 15.4%; χ²(2) = 17.54, p < 0.001) compared to hospital or other medical (non-VA) practitioners. Multiple resources informed teleNP protocols, such as organization guidelines (87.6%), literature review (75.9%), webinars (72.4%), and consultation (68%). Several factors influenced test selection, including availability of normative data (70.1%), test familiarity (66.4%), administration time (63.5%), and evidence base (60.6%). Reported barriers to continuing teleNP after COVID-19 included need for improved teleNP norms (85.9%), domain coverage (84.7%), improved patient access to technology (74.1%) and further validation studies (84.1%).

Conclusion

TeleNP may not be feasible in all settings and/or referrals. Respondents employed multiple resources in aggregating teleNP protocols and considered several factors when selecting tests. Results highlight the complex and varied decision-making processes utilized by respondents to adapt to service delivery changes. Considering the many benefits of teleNP, future research addressing some of the potentially modifiable factors (e.g., technology access, attitudes regarding teleNP) and significant development needs for teleNP itself (i.e., improved teleNP norms, further validation studies, etc.) is warranted.

中文翻译：

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美国 COVID-19 期间远程神经心理学实践调查

摘要

客观的

确定 COVID-19 期间影响服务交付变化的因素，并检查远程神经心理学 (teleNP) 的障碍和提供者满意度。

方法

通过特定于神经心理学的列表服务（2020 年 7 月至 8 月）招募的美国许可临床神经心理学家完成在线调查。

结果

共有 261 人完成了调查。大多数（76%）报告在我们调查时以某种身份提供了面对面测试。相对较多的私人从业者对隐私/保密（45.2% vs. 17.9%；χ ² (2) = 6.99, p  < 0.05）、法律问题（47.6% vs. 17.9%；χ ² (2) = 8.06, p  < 0.05)，并且是法律/法医案件的不良先例（59.5% 对 15.4%；χ ² (2) = 17.54，p < 0.001) 与医院或其他医疗（非 VA）从业人员相比。多种资源为 TeleNP 协议提供了信息，例如组织指南 (87.6%)、文献综述 (75.9%)、网络研讨会 (72.4%) 和咨询 (68%)。有几个因素影响了测试选择，包括规范数据的可用性（70.1%）、测试熟悉度（66.4%）、管理时间（63.5%）和证据基础（60.6%）。据报道，在 COVID-19 之后继续进行远程治疗的障碍包括需要改进远程治疗规范 (85.9%)、领域覆盖率 (84.7%)、改善患者获得技术的机会 (74.1%) 和进一步的验证研究 (84.1%)。

结论

TeleNP 可能并非在所有环境和/或转诊中都可行。受访者在汇总 TeleNP 协议时使用了多种资源，并在选择测试时考虑了几个因素。结果突出了受访者为适应服务交付变化而使用的复杂多样的决策过程。考虑到 TeleNP 的许多好处，未来的研究解决一些潜在的可修改因素（例如，技术访问、对 TeleNP 的态度）和 TeleNP 本身的重大发展需求（即，改进的 TeleNP 规范、进一步的验证研究等）是有必要的。