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诊断标签和因果解释对医学生对精神病治疗方法的看法以及与服务使用者分享信息的必要性的影响。

Effect of diagnostic labeling and causal explanations on medical students' views about treatments for psychosis and the need to share information with service users.

机构信息

Department of Psychology, Second University of Naples, Viale Ellittico 31, 81100 Caserta, Italy.

出版信息

Psychiatry Res. 2013 Dec 15;210(2):402-7. doi: 10.1016/j.psychres.2013.07.022. Epub 2013 Jul 31.

Abstract

This study examines whether medical students' views of treatments for 'schizophrenia' and of patients' rights to be informed about their condition and their medication were influenced by diagnostic labeling and causal explanations and whether they differed over medical training. Three hundred and eighty-one Italian students attending their first or fifth/sixth year of medical studies read a vignette portraying someone who met diagnostic criteria for 'schizophrenia' and completed a self-report questionnaire. The study found that labeling the case as 'schizophrenia' and naming heredity among its causes were associated with confidence in psychiatrists and psychiatric drugs. Naming psychological traumas among the causes was associated with confidence in psychologists and greater acknowledgment of users' right to be informed about drugs. Compared to first year students, those at their fifth/sixth-year of studies more strongly endorsed drugs, had less confidence in psychologists and family support, and were less keen to share information on drugs with patients. These findings highlight that students' beliefs vary during training and are significantly related to diagnostic labeling and belief in a biogenetic causal model. Psychiatric curricula for medical students should include greater integration of psychological and medical aspects in clinical management of 'schizophrenia'; more information on the psychosocial causes of mental health problems.

摘要

本研究考察了医学生对“精神分裂症”治疗方法的看法,以及患者了解自身病情和用药的权利,以及他们是否受到诊断标签和因果解释的影响,是否因医学培训而有所不同。381 名意大利医学生,他们处于第一学年或第五/六学年,阅读了一个描述符合“精神分裂症”诊断标准的人的病例,并完成了一份自我报告问卷。研究发现,将病例标记为“精神分裂症”并将遗传列为其病因之一,与对精神科医生和精神科药物的信心有关。将心理创伤列为病因之一,与对心理学家的信心以及对用户了解药物权利的更大承认有关。与第一学年的学生相比,第五/六学年的学生更赞成使用药物,对心理学家和家庭支持的信心较低,不太愿意与患者分享药物信息。这些发现表明,学生的信念在培训期间会发生变化,并且与诊断标签和对生物遗传因果模型的信念密切相关。医学生的精神病学课程应包括在“精神分裂症”的临床管理中更加整合心理和医学方面;更多关于心理健康问题的心理社会原因的信息。

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