Juckel G, Stahl K, Norra C
Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum Bochum der Ruhr-Universität Bochum, Alexandrinenstr. 1, 44791, Bochum, Deutschland,
Nervenarzt. 2015 Jan;86(1):51-9. doi: 10.1007/s00115-013-3818-4.
Standardization in psychiatry is a developmental process which, following on from psychopathology and nosology is now increasingly affecting the field of treatment. The development of guidelines for the treatment of psychiatric diseases has now become well accepted, although the impact on routine practice is still limited. Treatment pathways bring recommendations from guidelines into a clear and practice-oriented algorithm. The prerequisite for this is the inclusion of all aspects and elements of the treatment as well as all professions involved in the treatment and a valid electronic data processing foundation. Such an approach is presented here with the example of the development and implementation of a clinical pathway for inpatients with schizophrenia. Initial results revealed that patients who received multi-professional treatment within such a clinical pathway, improved better than patients of the control group, as measured by CGI, PANSS and PSP. This shows that introduction of a clinical pathway leads to an improvement of treatment quality. Standardization of psychiatric treatment processes could be highly relevant in respect to the new remuneration system for psychiatry in Germany.
精神病学中的标准化是一个发展过程,它继精神病理学和疾病分类学之后,如今正越来越多地影响治疗领域。尽管对常规实践的影响仍然有限,但精神疾病治疗指南的制定现已得到广泛认可。治疗路径将指南中的建议转化为清晰且以实践为导向的算法。其前提是纳入治疗的所有方面和要素以及参与治疗的所有专业人员,并具备有效的电子数据处理基础。本文以精神分裂症住院患者临床路径的开发与实施为例介绍了这种方法。初步结果显示,通过临床总体印象量表(CGI)、阳性和阴性症状量表(PANSS)以及功能大体评定量表(PSP)测量,在这样的临床路径中接受多专业治疗的患者比对照组患者改善得更好。这表明引入临床路径可提高治疗质量。就德国精神病学的新薪酬体系而言,精神病治疗过程的标准化可能具有高度相关性。