L.O. Roebroek , J. Bruins , A. Boonstra , P.A. Delespaul , S. Castelein
{"title":"照常治疗与计算机化临床决策辅助工具对共同决策治疗精神病的影响","authors":"L.O. Roebroek , J. Bruins , A. Boonstra , P.A. Delespaul , S. Castelein","doi":"10.1016/j.ejpsy.2023.06.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objectives</h3><p>People with psychotic disorders can experience a lack of active involvement in their decisional process. Clinical decision aids are shared decision-making tools which are currently rarely used in mental healthcare. We examined the effects of Treatment E-Assist (TREAT), a computerized clinical decision aid in psychosis care, on shared decision-making and satisfaction with consultations as assessed by patients.</p></div><div><h3>Methods</h3><p>A total of 187 patients with a psychotic disorder participated. They received either treatment as usual in the first phase (TAU1), TREAT in the second phase or treatment as usual in the third phase of the trial (TAU2). The Decisional Conflict Scale was used as primary outcome measure for shared decision-making and patient satisfaction as secondary outcome.</p></div><div><h3>Results</h3><p>A linear mixed model analysis found no significant effects between TAU 1 (β = −0.54, SE = 2.01, <em>p</em> = 0.80) and TAU 2 (β = −1.66, SE = 2.63, <em>p</em> = 0.53) compared to TREAT on shared decision-making. High patient rated satisfaction with the consultations was found with no significant differences between TAU 1 (β = 1.48, SE = 1.14, <em>p</em> = 0.20) and TAU 2 (β = 2.26, SE = 1.33, <em>p</em> = 0.09) compared to TREAT.</p></div><div><h3>Conclusion</h3><p>We expected TREAT to enhance shared decision-making without decreasing satisfaction with consultations. However, no significant differences on shared decision-making or satisfaction with consultations were found. Our findings suggest that TREAT is safe to implement in psychosis care, but more research is needed to fully understand its effects on the decisional process.</p></div>","PeriodicalId":12045,"journal":{"name":"European Journal of Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The effects of treatment as usual versus a computerized clinical decision aid on shared decision-making in the treatment of psychotic disorders\",\"authors\":\"L.O. Roebroek , J. Bruins , A. Boonstra , P.A. Delespaul , S. Castelein\",\"doi\":\"10.1016/j.ejpsy.2023.06.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and objectives</h3><p>People with psychotic disorders can experience a lack of active involvement in their decisional process. Clinical decision aids are shared decision-making tools which are currently rarely used in mental healthcare. We examined the effects of Treatment E-Assist (TREAT), a computerized clinical decision aid in psychosis care, on shared decision-making and satisfaction with consultations as assessed by patients.</p></div><div><h3>Methods</h3><p>A total of 187 patients with a psychotic disorder participated. They received either treatment as usual in the first phase (TAU1), TREAT in the second phase or treatment as usual in the third phase of the trial (TAU2). The Decisional Conflict Scale was used as primary outcome measure for shared decision-making and patient satisfaction as secondary outcome.</p></div><div><h3>Results</h3><p>A linear mixed model analysis found no significant effects between TAU 1 (β = −0.54, SE = 2.01, <em>p</em> = 0.80) and TAU 2 (β = −1.66, SE = 2.63, <em>p</em> = 0.53) compared to TREAT on shared decision-making. High patient rated satisfaction with the consultations was found with no significant differences between TAU 1 (β = 1.48, SE = 1.14, <em>p</em> = 0.20) and TAU 2 (β = 2.26, SE = 1.33, <em>p</em> = 0.09) compared to TREAT.</p></div><div><h3>Conclusion</h3><p>We expected TREAT to enhance shared decision-making without decreasing satisfaction with consultations. However, no significant differences on shared decision-making or satisfaction with consultations were found. Our findings suggest that TREAT is safe to implement in psychosis care, but more research is needed to fully understand its effects on the decisional process.</p></div>\",\"PeriodicalId\":12045,\"journal\":{\"name\":\"European Journal of Psychiatry\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0213616323000307\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0213616323000307","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
The effects of treatment as usual versus a computerized clinical decision aid on shared decision-making in the treatment of psychotic disorders
Background and objectives
People with psychotic disorders can experience a lack of active involvement in their decisional process. Clinical decision aids are shared decision-making tools which are currently rarely used in mental healthcare. We examined the effects of Treatment E-Assist (TREAT), a computerized clinical decision aid in psychosis care, on shared decision-making and satisfaction with consultations as assessed by patients.
Methods
A total of 187 patients with a psychotic disorder participated. They received either treatment as usual in the first phase (TAU1), TREAT in the second phase or treatment as usual in the third phase of the trial (TAU2). The Decisional Conflict Scale was used as primary outcome measure for shared decision-making and patient satisfaction as secondary outcome.
Results
A linear mixed model analysis found no significant effects between TAU 1 (β = −0.54, SE = 2.01, p = 0.80) and TAU 2 (β = −1.66, SE = 2.63, p = 0.53) compared to TREAT on shared decision-making. High patient rated satisfaction with the consultations was found with no significant differences between TAU 1 (β = 1.48, SE = 1.14, p = 0.20) and TAU 2 (β = 2.26, SE = 1.33, p = 0.09) compared to TREAT.
Conclusion
We expected TREAT to enhance shared decision-making without decreasing satisfaction with consultations. However, no significant differences on shared decision-making or satisfaction with consultations were found. Our findings suggest that TREAT is safe to implement in psychosis care, but more research is needed to fully understand its effects on the decisional process.
期刊介绍:
The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.