McCabe Rosemarie, Saidi Marya, Priebe Stefan
Department of Psychiatry, University of London, Newham Centre for Mental Health, UK.
Br J Psychiatry Suppl. 2007 Aug;50:s21-8. doi: 10.1192/bjp.191.50.s21.
Patient-reported outcomes are increasingly used to evaluate the care of people with schizophrenia.
To review established and emerging patient-reported outcomes in schizophrenia research, assessmenttools and key findings.
A non-systematic review addressing relevant constructs, the associated scales and key empirical findings.
Patient-reported outcomes in schizophrenia relate either to evaluation of illness and benefit from treatment or to resilience of the self. Of the former, needs for care, treatment satisfaction and the therapeutic relationship are most common. Less common are symptoms, insight, attitude towards medication, and clinical communication. Increasing expectations of treatment have led to new measures assessing resilience ofthe self, including empowerment, self-esteem, sense of coherence and recovery. Scores of different patient-related outcomes overlap and are influenced by a general tendency, largely influenced by mood, for more or less positive appraisal.
The conceptual and empirical basis for different patient-reported outcomes varies, with most data available for treatment satisfaction. More than one such outcome should be used only if there is a specific hypothesis. For new patient-reported outcomes, relative independence from existing constructs should be demonstrated.
患者报告的结局越来越多地用于评估精神分裂症患者的护理情况。
回顾精神分裂症研究中已确立和新出现的患者报告结局、评估工具及主要研究结果。
对相关概念、相关量表及主要实证研究结果进行非系统性综述。
精神分裂症患者报告的结局要么与疾病评估及治疗获益相关，要么与自我恢复力相关。在前者中，护理需求、治疗满意度及治疗关系最为常见。症状、自知力、对药物的态度及临床沟通则较少见。对治疗期望的增加促使了新的评估自我恢复力的措施出现，包括赋权、自尊、连贯感及康复。不同患者相关结局的得分相互重叠，并受到一种总体倾向的影响，这种倾向在很大程度上受情绪影响，表现为或多或少的积极评价。
不同患者报告结局的概念和实证基础各不相同，治疗满意度的相关数据最多。只有在有特定假设时才应使用不止一种此类结局。对于新的患者报告结局，应证明其相对于现有概念的相对独立性。
