Mental Health Provider Knowledge and Attitudes Toward Diagnosing Anxiety Disorders in the Veterans Health Administration.

IF 1.6 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Journal of Clinical Psychology in Medical Settings Pub Date : 2024-12-15 DOI:10.1007/s10880-024-10060-2
Maribel Plasencia, Patricia V Chen, Natalie E Hundt, Mark E Kunik, Traber D Giardina, Israel C Christie, Shubhada Sansgiry, Terri L Fletcher
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Abstract

Clinical practice guidelines indicate treatments for specific anxiety diagnoses. Misdiagnosing specific anxiety disorders as unspecified anxiety may prevent patients from receiving appropriate care. Provider knowledge and attitudes may influence diagnostic practices. This study evaluated provider knowledge of diagnostic criteria for anxiety disorders and attitudes toward diagnostic processes and the relevance of diagnosis to patients' treatment. This qualitative analysis of interviews included 32 Veterans Health Administration providers in Primary Care Behavioral Health and Specialty Mental Health. Interview guides were created using a framework that outlines barriers regarding provider knowledge, attitudes, and behaviors as they pertain to following clinical practice guidelines. Most providers described themselves as familiar with diagnostic criteria for anxiety disorders and discussed consulting the Diagnostic and Statistical Manual of Mental Disorders if unsure about criteria. Providers were divided on the relevance of diagnostic specificity to a patient's treatment plan and outcomes. In the Veterans Health Administration, providers across different settings, roles, and tendency toward assigning specific diagnosis disagree on the relevance of diagnostic specificity for a patient's treatment and outcomes. Future research should seek to understand this divide and evaluate methods for optimizing a patient's likelihood of receiving a proper, accurate diagnosis.

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临床实践指南指出了针对特定焦虑诊断的治疗方法。将特定焦虑症误诊为不明焦虑症可能会妨碍患者接受适当的治疗。医疗服务提供者的知识和态度可能会影响诊断实践。本研究评估了医疗服务提供者对焦虑症诊断标准的了解、对诊断过程的态度以及诊断与患者治疗的相关性。这项定性分析访谈的对象包括退伍军人健康管理局的 32 名初级保健行为健康和专科心理健康服务提供者。访谈指南是利用一个框架创建的,该框架概述了医疗服务提供者在遵循临床实践指南方面的知识、态度和行为障碍。大多数医疗服务提供者认为自己熟悉焦虑症的诊断标准,并讨论了在不确定标准的情况下参考《精神疾病诊断与统计手册》的问题。对于诊断的特异性与患者治疗计划和结果的相关性,医疗服务提供者意见不一。在退伍军人健康管理局中,不同环境、不同角色、不同倾向于指定具体诊断的医疗服务提供者在诊断特异性与患者治疗和结果的相关性问题上存在分歧。未来的研究应设法了解这一分歧,并评估各种方法,以优化患者获得适当、准确诊断的可能性。
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来源期刊
CiteScore
4.00
自引率
4.50%
发文量
93
期刊介绍: Journal of Clinical Psychology in Medical Settings is an international forum for the publication of peer-reviewed original papers related to all areas of the science and practice of psychologists in medical settings. Manuscripts are chosen that have a broad appeal across psychology as well as other health care disciplines, reflecting varying backgrounds, interests, and specializations. The journal publishes original research, treatment outcome trials, meta-analyses, literature reviews, conceptual papers, brief scientific reports, and scholarly case studies. Papers accepted address clinical matters in medical settings; integrated care; health disparities; education and training of the future psychology workforce; interdisciplinary collaboration, training, and professionalism; licensing, credentialing, and privileging in hospital practice; research and practice ethics; professional development of psychologists in academic health centers; professional practice matters in medical settings; and cultural, economic, political, regulatory, and systems factors in health care. In summary, the journal provides a forum for papers predicted to have significant theoretical or practical importance for the application of psychology in medical settings.
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