Becker Sara J, Spirito Anthony, Vanmali Roshani
Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Health Educ J. 2016 Apr;75(3):358-369. doi: 10.1177/0017896915581061. Epub 2015 Apr 20.
Several national organisations in the USA have recently developed educational materials that encourage substance use disorder treatment consumers to seek out approaches supported by scientific evidence in order to promote the use of "evidence-based practice" (EBP). This study aimed to explore how adolescents (young people age 12-17 years) with substance use disorders and their caregivers perceive, understand, and react to the concept of EBP.
Qualitative focus groups and structured interviews were conducted with 29 caregivers and 24 adolescents with substance use disorders in the Northeastern USA. Discussions explored four themes: a) familiarity with EBP, b) assumptions about what EBP means, c) impressions of EBP after reading a common definition, and d) recommended terms to describe EBP in educational materials. Participants' responses were transcribed and qualitatively analysed by two independent coders.
Only two of the 53 participants had ever heard the term EBP, and only one was able to define it correctly. Common assumptions about the term "evidence-based" were that it referred to treatment based on the patient's medical history, legal evidence of substance use, or the clinician's prior experience. The misperception that EBP was associated with legal evidence was common among adolescents involved in the justice system. After reading a common definition of EBP, most participants thought that the approach sounded inflexible. Alternative terms the participants recommended to educate potential treatment consumers about EBP included proven, successful, better, and therapy that works.
Results suggest that future efforts to educate treatment consumers should use the phrase EBP with caution and emphasise the flexibility of the approach.
美国的几个全国性组织最近开发了教育材料，鼓励物质使用障碍治疗的消费者寻求科学证据支持的方法，以促进“循证实践”（EBP）的应用。本研究旨在探讨患有物质使用障碍的青少年（12至17岁的年轻人）及其照顾者如何看待、理解循证实践这一概念，以及对此作何反应。
对美国东北部29名患有物质使用障碍的照顾者和24名青少年进行了定性焦点小组访谈和结构化访谈。讨论围绕四个主题展开：a）对循证实践的熟悉程度，b）对循证实践含义的假设，c）阅读通用定义后对循证实践的印象，d）在教育材料中描述循证实践的推荐术语。参与者的回答由两名独立编码员进行转录和定性分析。
53名参与者中只有两人曾听说过循证实践这个术语，只有一人能够正确定义它。对“循证”一词的常见假设是，它指的是基于患者病史、物质使用的法律证据或临床医生既往经验的治疗。在涉及司法系统的青少年中，普遍存在循证实践与法律证据相关的误解。阅读循证实践的通用定义后，大多数参与者认为这种方法听起来缺乏灵活性。参与者推荐的用于向潜在治疗消费者介绍循证实践的替代术语包括“经过验证的”“成功的”“更好的”以及“有效的疗法”。
结果表明，未来在对治疗消费者进行教育时，应谨慎使用循证实践这个短语，并强调该方法的灵活性。
