Relating to socio-demographic characteristics and telemedicine practice
In the current study, more than half of the sample had no hospital-based telemedicine unit, and more than three-quarters used telemedicine for distant consulting. This may be because telemedicine was not well-known before the COVID-19 outbreak, but things have changed since then. Telemedicine technology is now a way to provide patients with quality treatment without raising the danger of COVID-19 transmission to patients during in-hospital clinic visits. Additionally, telemedicine helps medical professionals since it lowers the risk of contracting infections, eases hospital stress, gives them an appropriate instrument for treating and monitoring patients, and offers a good method for offering mental health treatments. In the same line, Carrillo et al. (2022), who studied the effectiveness of teleconsultations in primary care, reported that teleconsultations over the phone or through videoconference are a useful alternative to face-to-face consultations for many individuals utilizing primary care and mental health services. On the contrary, Abdel Nasser et al. [1], who studied measuring the patients’ satisfaction about telemedicine used in Saudi Arabia during the COVID-19 pandemic, found that old age participants in our study would prefer to use face-to-face consultation in the future rather than telemedicine,this may be due to the older generation’s need for in-person contact to discuss more emotional issues and to express all the concerns verbally and nonverbally.
In the present study, the vast majority of respondents spent time in individual therapy, group therapy, and assessment by telemedicine. This might be owing to the importance of individual and group therapy inpatient treatment, as it allows the patient to build a trusting relationship with a counselor that will not judge them, discuss feelings and problems, thus freeing themselves from burdens, and allows the counselor to teach a variety of important coping skills that help the individual manage the stress in their lives. In the same line, Sugarman et al. [25], who studied patients’ perceptions of telehealth services for outpatient treatment of substance use disorders during the COVID‐19 pandemic, reported that most respondents getting outpatient substance use disorder care found telehealth sessions to be an acceptable treatment modality, especially those receiving individual therapy. Ratings were in the majority for individual therapy and more than half for group therapy. Challenges remain for telemedicine group therapy.
In the present study, more than one-third of the studied sample reported that having easy access to a psychiatrist anywhere is the benefit of telemedicine. This may be owing to the abstention of many people from going to a psychiatrist in some cases (such as avoiding the stigma of going to psychiatric clinics, or being in remote areas that make it difficult to reach a therapist faster and more conveniently), as telemedicine provides better access. Because not everyone who has an ongoing relationship with a doctor can go to them when they need it, many online medical networks provide access at any time of the day and night or anywhere. In the same line, Arumugam et al. [6], who studied the perception of doctors regarding telemedicine use for general practice in Chennai, reported that nearly two-thirds of physicians say that healthcare services can be easily accessed through the practice of telemedicine, and nearly three-fifths of physicians would like to continue telemedicine practice even after the COVID-19 lockdown period.
In the present study, more than two-fifths of the studied sample reported distance as the reason for using telemedicine. This may be owing to eliminating the travel barrier for those living in rural or isolated communities, as well as for patients who may have limited mobility, increasing accessibility to care. This increased accessibility provides the opportunity for patients to have a more involved role in their health by reducing the distance barrier. In the same line, Ross et al. [23], who studied the implementation and patient experience of outpatient teleneurology, reported that virtual visits reduced travel significantly and increased patient satisfaction. The significant percentage of nearby patients would suggest that telemedicine offers significant access for reasons other than proximity to patients.
In the present study, more than one-fifth of the studied sample reported the absence of empathy as a reason for not using telemedicine. This may be owing to the gap in communication between psychiatrist and patient, as well as the loss of non-verbal cues and touch. On the contrary Cheshire et al. [11], who studied the patient perception of physician empathy in stroke telemedicine, found that there was no difference in how patients perceive doctors’ empathy during acute stroke therapy between in-person and telemedicine consultations. This could be because, in a telemedicine encounter, empathy can be conveyed through voice, facial expression, and attentiveness and, in the context of acute stroke treatment, does not require physical touch or closeness.
In the present study, half of the studied sample did not prefer to use telemedicine for specific psychotherapies. This may be owing to the inability to see and hear all the verbal and non-verbal communication of the patient. Also, it is difficult for them to respond quickly and effectively in crisis situations or serious psychiatric illnesses.
Differences between the levels of the studied variables among mental healthcare providers (psychiatrists, nurses, and clinical psychologists)
In the present study, psychiatrists had the highest awareness of telemedicine. This might be because physicians are engaged in more courses, workshops, and conferences than other healthcare workers, and this allows them to be more up-to-date with the latest technologies. In the same line, Shouman et al. [24], who studied the awareness and attitude of healthcare workers towards telehealth in Cairo, Egypt, found that telehealth awareness was the highest among physicians than other healthcare workers, as it represented about half of the total awareness.
In the present study, psychiatrists had the highest knowledge of telemedicine. This might be owing to their continuing knowledge of the latest developments in healthcare providing. In the same line, Alghamdi et al. [4], who studied telepsychiatry: knowledge, effectiveness, and willingness, assessments of psychiatrists in Saudi Arabia, found that psychiatrists’ knowledge regarding telepsychiatry was deemed insufficient; more than half of the psychiatrists showed a poor level of knowledge regarding telepsychiatry.
The studied psychiatrists had the highest attitude toward telemedicine. This may be owing to the psychiatrists’ being in contact with patients and familiar with the various and advanced psychological treatments associated with dealing with patients, such as telemedicine and telepsychiatry, especially after the COVID-19 pandemic. On the contrary, Biruk et al. (2018), who studied the knowledge and attitude of health professionals toward telemedicine in resource-limited settings in northwest Ethiopia, found that nurses had a good attitude toward telemedicine.
In the present study, skills had an average mean among the studied sample. This might be owing to the unavailability of computer and Internet services for some of the studied samples. In the same line, Elhadi et al. [14], who studied telemedicine awareness, knowledge, attitude, and skills of healthcare workers in a low-resource country during the COVID-19 pandemic in Libya, found that only one-third of the studied sample had computer skills when compared to other variables; knowledge and attitude were more than three-quarters, and awareness was more than half.
Concerning awareness relation with socio-demographic characteristics
In the present study, awareness was average among the studied sample. This might be owing to the limited talk about telemedicine and its importance, as well as the limited training and awareness courses and programs that are offered about telemedicine. This might also be because the majority of the sample were psychologists, and they did not have enough experience in the field of work or in the ways of providing mental healthcare services through telemedicine. Another study conducted in India [12] reported that the majority of participants had high scores for awareness, knowledge, and attitude toward telemedicine.
In the present study, the studied sample whose age group was between 41 and 50 years had the highest level of awareness. This might be owing to their experience in providing medical care. On the contrary, Zayapragassarazan and Kumar [28], who studied awareness, knowledge, attitude, and skills of telemedicine among health professional faculty working in teaching hospitals, found that the highest mean value for awareness of telemedicine was recorded among the respondents whose age group was between 30 and 40 years.
In the present study, females had the highest awareness. This might be owing to the desire of females more than males to develop themselves; the continuous interest in attending training courses, workshops, and conferences; and the aspiration to know everything new and updated in the world of providing medical services, especially during the period of the COVID-19 pandemic. In the same line, Elhadi et al. [14], who studied telemedicine awareness, knowledge, attitude, and skills of healthcare workers in a low-resource country during the COVID-19 pandemic, reported that females had significantly higher mean awareness than males.
In the present study, the master’s degree holders of the studied sample had the highest awareness regarding telemedicine. This might be owing to their continuous knowledge of the latest means of providing medical care, as well as the ability to adapt to modern and emerging scientific developments thanks to their experiences. In the same line, Shouman et al. [24], who studied the awareness and attitude of healthcare workers towards telehealth in Cairo, Egypt, found that two-thirds of healthcare workers with master’s degrees were aware of telehealth, compared to around one-third of those with a diploma.
Regarding knowledge relation with socio-demographic characteristics
In the present study, knowledge was average among the studied sample. This might be because there was no urgent need to use it before, it was not highlighted enough. This may change because the current epidemiological situation in the country has revealed the importance of telemedicine, which has given impetus to a greater number of telemedicine adoptions. In the same line, Albarrak et al. [3], who studied the assessment of physicians’ knowledge, perception, and willingness of telemedicine in Riyadh region, Saudi Arabia, reported that more than two-fifths of participants have average knowledge about telemedicine technology.
In the present study, the studied sample, who had less than or equal to 30 years of age, had the highest knowledge. This might be owing to being young and enthusiastic to learn about the latest developments and technology that serve the field of work, and because there was no urgent need to use it before that, it was not highlighted enough. This may change because the current epidemiological situation in the country has revealed the importance of telemedicine, which has given impetus to a greater number of telemedicine adoptions. In the same line, Ahmed et al. [2], who studied knowledge, attitudes, and perceptions related to telemedicine among young doctors and nursing staff at the King Abdul-Aziz University Hospital Jeddah, KSA, found that when compared to the senior staff participants in the study, the youthful nursing staff’s knowledge and attitude were relatively better.
In the present study, females had the highest knowledge. This might be because females tend to seek more information related to health issues by attending conferences, speeches, or meetings held regarding telemedicine technology. In the same line, Umayam et al. [26], who studied knowledge, attitudes, and perceptions on the use of telemedicine among adults aged 18–34 in Manila, Philippines, during the COVID-19 pandemic, found that females had a higher mean knowledge score compared to males.
In the present study, the master’s degree holders in the studied sample had the highest knowledge regarding telemedicine. This might be because the majority of master’s degree holders are doctors and doctors are keener than others to attend conferences and workshops and aspire to develop themselves in the field of providing medical services. On the contrary, Biruk et al. (2018), who studied knowledge and attitude of health professionals toward telemedicine in resource-limited settings in northwest Ethiopia, found that more than three-quarters of health professionals who were considered to have good knowledge of telemedicine were bachelor’s degree holders.
Concerning attitude relation with socio-demographic characteristics
In the present study, the attitude had the highest mean among the studied sample. This might be owing to the widespread use of telemedicine in medical education. It aids in providing healthcare facilities through the use of mobile health clinics and online consultations with specialists for a disease’s diagnosis, screening, and management (including follow-up). On the contrary, Malhotra et al. [18], who studied knowledge, perception, and attitude of using telehealth services among college-going students of Uttarakhand, India, found that there is a lack of familiarity and awareness of telemedicine among students.
In the present study, the studied sample, which was less than or equal to 30 years old, had the highest attitude. This might be because young people use smart boards (iPads), messaging, and software and take pictures, so they know more about technology and can deal with it proficiently. In the same line, Biruk et al. (2018), who studied the knowledge and attitude of health professionals toward telemedicine in resource-limited settings in northwest Ethiopia, found that more than half of the age group between 20 and 29 years had a good attitude toward telemedicine.
In the present study, males had the highest attitude toward telemedicine. This might be because the COVID-19 pandemic has forced some professions to work from home, and the use of Internet services has increased to maintain the continuity of work. Telemedicine was one of the applications that people used more at that time. The attitude toward telemedicine itself, the patient-physician interaction, and the level of technology usage may all have an impact on how willing a person is to utilize telemedicine. On the contrary, Elhadi et al. [14], who studied telemedicine awareness, knowledge, attitude, and skills of healthcare workers in a low-resource country during the COVID-19 pandemic in Libya, found that there was no difference in the attitude between males and females.
The master’s degree had the highest attitude toward telemedicine. This might be because telemedicine has become an important means for both the doctor and the patient as it reduces time, the patient can express his feelings, and develop the ability to talk with others, so doctors tend to use it. In the same line, Elsaie et al. [15], who studied Egyptian dermatologists’ attitude toward telemedicine amidst the COVID-19 pandemic in Egypt, found that the master’s degree holders showed the most significant attitude toward telemedicine.
Concerning skills relation with socio-demographic characteristics
In the present study, males had the highest skills. This might be owing to secure income for family members, men’s interest in using modern advanced means such as telemedicine has increased, as they are responsible for the family and its well-being, which helps them to live a better and safe life. On the contrary, Elhadi et al. [14], who studied telemedicine awareness, knowledge, attitude, and skills of healthcare workers in a low-resource country during the COVID-19 pandemic in Libya, found that more than three-quarters of females had high computer skills, which were higher than those of males.
