共同决策对成瘾医疗中治疗联盟的影响。
Effect of shared decision-making on therapeutic alliance in addiction health care.
作者信息
Joosten Eag, de Weert Gh, Sensky T, van der Staak Cpf, de Jong Caj
机构信息
Novadic-Kentron, Network for Addiction Treatment Services, Vught, the Netherlands;
出版信息
Patient Prefer Adherence. 2008 Feb 2;2:277-85. doi: 10.2147/ppa.s4149.
Abstract
BACKGROUND
In recent decades, shared decision-making (SDM) models have been developed to increase patient involvement in treatment decisions. The purpose of this study was to examine the effect of a shared decision-making intervention (SDMI) for substance-dependent patients on patients' and clinicians' perceptions of therapeutic alliance.
METHODS
Clinicians were randomly assigned to SDMI or usual procedures to reach a treatment agreement. SDMI is a structured, manualized, 5-session procedure to facilitate treatment agreement and consists of five standardized sessions.
RESULTS
Patients' perceptions of the therapeutic alliance were very favorable at start of treatment, and no differences were found between intervention groups. Clinicians' scores on perceived helpfulness and on the overall therapeutic alliance were higher in the SDMI group than in the controls, after 8 weeks of treatment and at the end of treatment.
CONCLUSION
The present study has shown that a specific intervention to enhance shared decision-making results in favorable changes in clinicians' perceptions of the therapeutic alliance.
摘要
背景
近几十年来，为提高患者对治疗决策的参与度，已开发出共同决策（SDM）模型。本研究的目的是检验针对物质依赖患者的共同决策干预（SDMI）对患者和临床医生治疗联盟认知的影响。
方法
临床医生被随机分配至SDMI组或常规程序组以达成治疗协议。SDMI是一种结构化、手册化的五阶段程序，用于促进治疗协议的达成，由五个标准化阶段组成。
结果
治疗开始时患者对治疗联盟的认知非常积极，干预组之间未发现差异。治疗8周后及治疗结束时，SDMI组临床医生在感知帮助性和整体治疗联盟方面的得分高于对照组。
结论
本研究表明，一项旨在加强共同决策的特定干预措施可使临床医生对治疗联盟的认知产生积极变化。
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