Department of Psychiatry and Psychotherapy II, Ulm University, Ludwig-Heilmeyer-Str 2, 89312 Günzburg, Germany.
BMC Psychiatry. 2010 Nov 10;10:90. doi: 10.1186/1471-244X-10-90.
A considerable amount of research has been conducted on clinical decision making (CDM) in short-term physical conditions. However, there is a lack of knowledge on CDM and its outcome in long-term illnesses, especially in care for people with severe mental illness.
METHODS/DESIGN: The study entitled "Clinical decision making and outcome in routine care for people with severe mental illness" (CEDAR) is carried out in six European countries (Denmark, Germany, Hungary, Italy, Switzerland and UK). First, CEDAR establishes a methodology to assess CDM in people with severe mental illness. Specific instruments are developed (and psychometric properties established) to measure CDM style, key elements of CDM in routine care, as well as CDM involvement and satisfaction from patient and therapist perspectives. Second, these instruments are being put to use in a multi-national prospective observational study (bimonthly assessments during a one-year observation period; N = 560). This study investigates the immediate, short- and long-term effect of CDM on crucial dimensions of clinical outcome (symptom level, quality of life, needs) by taking into account significant variables moderating the relationship between CDM and outcome.
The results of this study will make possible to delineate quality indicators of CDM, as well as to specify prime areas for further improvement. Ingredients of best practice in CDM in the routine care for people with severe mental illness will be extracted and recommendations formulated. With its explicit focus on the patient role in CDM, CEDAR will also contribute to strengthening the service user perspective. This project will substantially add to improving the practice of CDM in mental health care across Europe.
ISRCTN75841675.
已有相当数量的研究针对短期身体状况下的临床决策制定（CDM）展开，但对于长期疾病（尤其是严重精神疾病患者的护理）中的 CDM 及其结果，我们知之甚少。
方法/设计：题为“常规护理中严重精神疾病患者的临床决策制定和结果（CEDAR）”的研究在六个欧洲国家（丹麦、德国、匈牙利、意大利、瑞士和英国）开展。首先，CEDAR 制定了一种评估严重精神疾病患者 CDM 的方法。开发了特定的工具（并确定了心理测量特性），以衡量 CDM 风格、常规护理中 CDM 的关键要素，以及从患者和治疗师的角度来看的 CDM 参与度和满意度。其次，这些工具将在一项多国家前瞻性观察研究（为期一年的观察期内每两个月评估一次；N=560）中使用。该研究通过考虑调节 CDM 与结果之间关系的重要变量，调查 CDM 对临床结果关键维度（症状水平、生活质量、需求）的即时、短期和长期影响。
该研究的结果将有可能描绘出 CDM 的质量指标，并确定进一步改进的主要领域。将提取出严重精神疾病患者常规护理中 CDM 的最佳实践要素，并制定建议。CEDAR 明确关注 CDM 中患者的角色，也将有助于加强服务使用者的视角。该项目将极大地促进欧洲各地改善精神卫生保健中的 CDM 实践。
ISRCTN75841675。
