COVİD-19 pandemisi sürecinde psikiyatri hastalarının telepsikiyatrihizmetlerini kullanma sıklığı ve dijital okuryazarlık düzeyinintelepsikiyatrik uygulamaların kullanımı üzerindeki etkisi

Objective: In this study, we wanted to evaluate whether psychiatric patients used telepsychiatry services during the two-year pandemic. It was aimed to determine the frequency of use of telepsychiatry and the factors affecting the use of telepsychiatry services, the patients' attitudes towards telemedicine, the level of digital literacy, and the relationship between DL and attitudes towards telemedicine during the pandemic. Method: Literate 354 outpatients over 18 years of age with psychiatric disorders who applied to the Psychiatry outpatient clinics of Akdeniz University Faculty of Medicine were included in this cross-sectional, single-center study. By following the scale development steps, Adult Digital Literacy Scale (ADLS) and Telemedicine Attitude Scale (ATS) were developed and validity-reliability analyzes were applied. The multivariate logistic regression analysis was used to evaluate the independent risk factors associated with the negative attitude toward telemedicine. Results: A total of 354 patients, 247 of whom were women (69.8%), with a mean age of 40.9±15.2 (18-81) years, participated in the study. 57.6% of the patients had depressive disorders, 29.1% had anxiety disorders and 7.6% had obsessive-compulsive disorders. 84.2% of the patients had used the internet daily, and the median usage time was 4 (1-10) hours. 11% of the patients stopped psychiatric treatment and follow-up during the twoyear pandemic, and 34.5% had difficulty in continuing their psychiatric treatment and follow-up. The frequency of use of telepsychiatry was found at 0.6%. 29.5% of the patients have limited/insufficient DL and 29.9% have a negative attitude towards telemedicine. Insufficient/limited digital literacy was found to be an independent risk factor alone for negative attitudes towards telemedicine practices in psychiatric patients [OR=4.76 (2.15-10.54)]. Age over 40 years [OR=13.55 (5.76-31.87); p<0.001], being primary/secondary school graduate [OR=7.54 (3.45-16.49); p<0.001] and not working [OR=2.84 (1.26-6.38); p=0.012] were found to be independent risk factors for insufficient/limited digital literacy. Conclusion: In this study, the frequency of using one of the telepsychiatry services in the first two years of the pandemic was below 1% of the psychiatric patients. Although there has been an increase in the use of telemedicine applications in the world during the pandemic, there is not yet a complete infrastructure for the use of telepsychiatry in our country, where legal regulations have been made quite recently, and the use of telepsychiatry services is still at a limited level. Inadequate/limited DL results in negative attitudes towards telemedicine. Psychiatric patients with older age, low education level, and not working in any job need support in telemedicine applications due to inadequate/limited DL authorship. Keywords: Telemedicine, Telepsychiatry, Digital literacy, Attitude, COVID-19, Psychiatric disorders