Parrinello Michael C
Veterans Administration Medical Center, Northport, New York, USA.
J Psychosoc Nurs Ment Health Serv. 2012 Dec;50(12):36-44. doi: 10.3928/02793695-20121107-02.
Patients who are taking atypical antipsychotic medications have a high incidence of metabolic complications, including increased weight, waist circumference, blood sugar, lipid levels, and blood pressure. In 2004, the American Diabetic Association and three other associations, including the American Psychiatric Association, developed guidelines to screen for metabolic syndrome, but in practice, adherence to the guidelines varies. This article describes a process to implement the guidelines in a suburban psychiatric day treatment hospital using Rogers' Diffusion of Innovations model. Measurement of waist circumference was identified as an opportunity to improve the current metabolic screening protocol. Post-intervention evaluation revealed increased adherence to the guidelines (0% pre versus 95% post). Adherence to the guidelines demonstrates the effect of the systematic application of Rogers' model on acceptance of practice change. Fully implementing the guidelines meets recommendations for the standard of practice and can improve the health and quality of life of patients prescribed atypical antipsychotic medications.
服用非典型抗精神病药物的患者出现代谢并发症的发生率很高，包括体重增加、腰围增大、血糖升高、血脂水平升高和血压升高。2004年，美国糖尿病协会和其他三个协会，包括美国精神病学协会，制定了代谢综合征筛查指南，但在实际操作中，对这些指南的遵守情况各不相同。本文描述了一个在郊区精神病日间治疗医院使用罗杰斯创新扩散模型实施这些指南的过程。腰围测量被确定为改进当前代谢筛查方案的一个契机。干预后评估显示对指南的遵守情况有所增加（干预前为0%，干预后为95%）。对指南的遵守证明了系统应用罗杰斯模型对实践变革接受度的影响。全面实施这些指南符合实践标准的建议，并可改善服用非典型抗精神病药物患者的健康状况和生活质量。
