McGuire Alan B, Bonfils Kelsey A, Kukla Marina, Myers Laura, Salyers Michelle P
Health Services Research and Development, Richard L Roudebush VAMC, IN, USA; Department of Psychology, Indiana University Purdue University Indianapolis, IN, USA.
Psychiatry Res. 2013 Dec 30;210(3):684-9. doi: 10.1016/j.psychres.2013.08.008. Epub 2013 Sep 5.
Given the important role of treatment attendance as an indicator of program implementation and as a potential moderator of program effectiveness, this study sought to develop useful indicators of attendance for evidence-based practices. The current study examined consumer attendance patterns in a randomized controlled trial comparing illness management and recovery (n=60) to a problem solving control condition (n=58). Associations were examined between consumer clinical indicators, demographics, and level of recovery and indices of attendance. Attendance was poor, but comparable to rates found in many other studies. Four indicators of attendance (percent sessions attended, time enrolled, periods of attendance, and longest period of attendance) were highly inter-related and were more sensitive to baseline differences than a traditional approach of dichotomizing participants into "attenders" and "non-attenders." Older age, lower hostility, fewer psychotic symptoms, and more education were associated with higher group attendance in both treatment conditions; the client-reported illness management and recovery scale was associated with attendance in the control group. Indicators of attendance were an advancement over dichotomous classification. Strategies to increase attendance are still needed, particularly for younger consumers with greater positive symptoms.
鉴于治疗参与率作为项目实施指标以及项目效果潜在调节因素的重要作用，本研究旨在为循证实践制定有用的参与率指标。当前研究在一项随机对照试验中考察了消费者的参与模式，该试验将疾病管理与康复项目组（n = 60）与问题解决控制组（n = 58）进行了比较。研究考察了消费者临床指标、人口统计学特征、康复水平与参与率指标之间的关联。参与率较低，但与许多其他研究中的比率相当。四个参与率指标（参加课程的百分比、注册时间、参与时段以及最长参与时段）高度相关，并且比将参与者二分法分为“参与者”和“非参与者”的传统方法对基线差异更敏感。在两种治疗条件下，年龄较大、敌意较低、精神病症状较少以及受教育程度较高都与较高的组内参与率相关；客户报告的疾病管理与康复量表与控制组的参与率相关。参与率指标是对二分法分类的一种改进。仍需要提高参与率的策略，特别是针对具有更多阳性症状的年轻消费者。
