aSchool of Psychology, University of Sydney, New South Wales bSchool of Psychology and Speech Pathology, Curtin University, Perth, Australia.
Curr Opin Psychiatry. 2014 Jul;27(4):302-7. doi: 10.1097/YCO.0000000000000072.
There are complexities in communicating diagnostic information relating to schizophrenia spectrum disorders. There is a current dearth of research in understanding how clinicians effectively communicate with service users about such diagnostic news. In this review, we aim to synthesize the latest research throughout 2012 and 2013 that presented data relating to the communication of a diagnosis of schizophrenia spectrum disorders, including individuals who had experienced first-episode psychosis or were in at-risk mental states. Comprehensive database and manual searches were conducted which obtained data from both service users and health professional groups.
Fourteen quantitative and qualitative studies were found. The majority of studies were descriptive and heterogeneous in content. Key themes included service user preferences towards disclosure and diagnostic terminology, health professional training, stigma-related issues and the use of diagnostic communication models.
Overall, communication models that foster therapeutic relationships and actively encourage the health professional to reduce stigma may be a key to initial diagnostic discussions in clinical practice. Such communication models and intervention require further more rigorous evaluation, as none have been tested through randomized controlled protocols in clinical settings.
与精神分裂症谱系障碍相关的诊断信息交流较为复杂。目前,对于临床医生如何有效地与服务使用者就此类诊断信息进行交流,相关研究还很匮乏。在本次综述中,我们旨在综合 2012 年至 2013 年期间发表的最新研究,这些研究提供了与精神分裂症谱系障碍诊断交流相关的数据,包括经历首发精神病或处于高危精神状态的个体。通过全面的数据库和手动搜索,我们从服务使用者和卫生专业人员群体中获取了数据。
共发现 14 项定量和定性研究。大多数研究都是描述性的,内容存在异质性。关键主题包括服务使用者对披露和诊断术语的偏好、卫生专业人员的培训、与耻辱感相关的问题以及诊断沟通模式的使用。
总体而言,促进治疗关系并积极鼓励卫生专业人员减少耻辱感的沟通模式可能是临床实践中初始诊断讨论的关键。这些沟通模式和干预措施需要进一步更严格的评估,因为没有任何一种模式已经通过临床环境中的随机对照试验进行了测试。