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

IF 2.5 4区 医学 Q2 PSYCHIATRY European Journal of Psychiatry Pub Date : 2024-01-01 DOI:10.1016/j.ejpsy.2023.06.002
L.O. Roebroek , J. Bruins , A. Boonstra , P.A. Delespaul , S. Castelein
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引用次数: 0

摘要

背景和目的精神障碍患者在决策过程中可能缺乏主动参与。临床决策辅助工具是一种共同决策工具,目前在精神卫生保健领域很少使用。我们研究了治疗电子辅助工具(TREAT)(一种用于精神病护理的计算机化临床决策辅助工具)对共同决策的影响以及患者对咨询满意度的评估。他们在试验第一阶段(TAU1)、第二阶段(TREAT)或第三阶段(TAU2)接受了常规治疗。结果线性混合模型分析发现,与TREAT相比,TAU1(β=-0.54,SE=2.01,P=0.80)和TAU2(β=-1.66,SE=2.63,P=0.53)对共同决策没有显著影响。患者对会诊的满意度较高,TAU 1(β = 1.48,SE = 1.14,p = 0.20)和 TAU 2(β = 2.26,SE = 1.33,p = 0.09)与 TREAT 相比无显著差异。然而,在共同决策和会诊满意度方面没有发现明显差异。我们的研究结果表明,在精神病护理中实施 TREAT 是安全的,但还需要更多的研究来充分了解它对决策过程的影响。
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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.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
40
审稿时长
43 days
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.
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