Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK.
Acta Psychiatr Scand. 2011 Nov;124(5):403-11. doi: 10.1111/j.1600-0447.2011.01737.x. Epub 2011 Jul 8.
To derive an in-depth understanding of the decision-making process in psychiatry and to explore similarities and differences in psychiatrists' decision-making process and the factors that may influence psychiatrists' decisions.
A total of 31 psychiatrists were interviewed on their approaches to decision making in psychiatric practice, using a semistructured interview guide. Framework analysis was undertaken to derive a qualitative understanding of decision making in psychiatry.
The analysis generated seven main themes, which collectively influenced the decision-making process in psychiatry: information gathering, training in psychiatry, intuition and experience, evidence-based practice, cognitive reasoning, uncontrollable factors and multidisciplinary team influences.
No single approach to decision making emerged from the analysis. Approaches to decision making were influenced by the level of clinical experience and external pressures, such as time and treatment availability. Findings were consistent with dual-processing theory of decision making.
深入了解精神病学中的决策过程，并探讨精神科医生决策过程中的异同以及可能影响精神科医生决策的因素。
采用半结构式访谈指南，对 31 名精神科医生的精神科实践决策方法进行访谈。采用框架分析方法对精神科决策进行定性理解。
分析产生了七个主要主题，这些主题共同影响了精神科的决策过程：信息收集、精神病学培训、直觉和经验、循证实践、认知推理、不可控因素和多学科团队影响。
分析中没有出现单一的决策方法。决策方法受到临床经验水平和时间、治疗可及性等外部压力的影响。研究结果与决策的双重加工理论一致。
