1Klinik und Poliklinik für Psychiatrie und Psychotherapie der Technischen Universität München, München, Germany.
Int J Soc Psychiatry. 2014 May;60(3):227-35. doi: 10.1177/0020764013482311. Epub 2013 Apr 30.
A deeper engagement into medical decision-making is demanded by treatment guidelines for patients with affective disorders. There is to date little evidence on what facilitates active behaviour of patients with depression. In general medicine 'question prompt sheets' (QPSs) have been shown to change patients' behaviour in the consultation and improve treatment satisfaction but there is no evidence for such interventions for mental health settings.
To study the effects of a QPS on active patient behaviour in the consultation.
Randomized controlled trial (involving N = 100 outpatients with depression) evaluating the effects of a QPS on patients' behaviour in the consultation.
The QPS showed no influence on the number of topics raised by patients (p = .13) nor on the external rater's perception of 'Who made the decisions in today's consultation?' (p = .50).
A QPS did not change depressed patients' behaviour in the consultation. More complex interventions might be needed to change depressed patients' behaviour within an established doctor-patient dyad. Patient seminars addressing behavioural aspects have been shown to be effective in other settings and may also be feasible for outpatients with affective disorders.
治疗情感障碍患者的治疗指南要求更深入地参与医疗决策。迄今为止,关于什么可以促进抑郁症患者的积极行为的证据很少。在一般医学中,“问题提示表”(QPS)已被证明可以改变患者在咨询中的行为并提高治疗满意度,但没有证据表明这种干预措施适用于精神卫生环境。
研究 QPS 对咨询中患者积极行为的影响。
这是一项随机对照试验(涉及 100 名抑郁症门诊患者),评估 QPS 对患者在咨询中行为的影响。
QPS 对患者提出的话题数量没有影响(p =.13),也没有对外评者对“今天的咨询中谁做出了决策?”的看法产生影响(p =.50)。
QPS 并未改变抑郁患者在咨询中的行为。可能需要更复杂的干预措施来改变既定医患二人组中抑郁患者的行为。已经证明,针对行为方面的患者研讨会在其他环境中是有效的,也可能适用于情感障碍的门诊患者。