van Fenema E M, van der Wee N J A, Onstein E, Zitman F G
afdeling Psychiatrie, Leids Universitair Medisch Centrum (LUMC), Leiden.
Tijdschr Psychiatr. 2010;52(5):299-310.
Most mental health providers in the Netherlands have implemented programmes of care. However, little is known about the extent to which care programmes are adhered to in routine clinical practice.
To investigate the extent to which care programmes are adhered to in routine clinical practice.
For three consecutive years we randomly selected 100 patients with a unipolar mood disorder, anxiety disorder or somatoform disorder and investigated retrospectively the extent to which care programmes were actually implemented in the first phase of treatment. We used a set of clinical process indicators based on the care programmes. The investigation took place on the premises of one of the 'Rivierduinen' mental health providers. We used patient records and data collected by means of routine outcome monitoring (ROM).
Over the three years under study scores for most of the indicators ranged from fair to good. Scores were lower for the indicators 'ROM follow-up measurements' and 'frequency of psychotherapy'. Only the number of routine measurements of the severity of the psychopathology in the diagnostic phase appeared to have increased significantly over the three years under study.
On the premises of the mental health care provider Rivierduinen where the study was conducted, care programmes during the first phase of treatment for mood disorder, anxiety disorder and somatoform disorders were adhered to reasonably well. Further research will have to concentrate on the subsequent phases of treatment. Another important matter that requires investigation is the relationship between the use of care programmes in daily practice and treatment outcomes.
荷兰的大多数心理健康服务提供者都实施了护理计划。然而，对于常规临床实践中护理计划的遵循程度知之甚少。
调查常规临床实践中护理计划的遵循程度。
连续三年，我们随机选取了100例单相情感障碍、焦虑症或躯体形式障碍患者，回顾性调查了治疗第一阶段护理计划的实际实施程度。我们使用了一组基于护理计划的临床过程指标。调查在“Rivierduinen”心理健康服务提供者之一的场所进行。我们使用了患者记录以及通过常规结果监测（ROM）收集的数据。
在研究的三年中，大多数指标的得分从一般到良好。“ROM随访测量”和“心理治疗频率”指标的得分较低。在研究的三年中，只有诊断阶段精神病理学严重程度的常规测量次数似乎显著增加。
在进行研究的Rivierduinen心理健康服务提供者场所，情绪障碍、焦虑症和躯体形式障碍治疗第一阶段的护理计划得到了较好的遵循。进一步的研究将不得不集中在后续治疗阶段。另一个需要调查的重要问题是日常实践中护理计划的使用与治疗结果之间的关系。
