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对儿童和青少年心理健康服务中使用结果测量指标的态度的质性探索。

A qualitative exploration of attitudes towards the use of outcome measures in child and adolescent mental health services.

作者信息

Sharples Evelyn, Qin Chuan, Goveas Vinita, Gondek Dawid, Deighton Jessica, Wolpert Miranda, Edbrooke-Childs Julian

机构信息

Evidence Based Practice Unit, Anna Freud Centre and University College London, UK.

出版信息

Clin Child Psychol Psychiatry. 2017 Apr;22(2):219-228. doi: 10.1177/1359104516652929. Epub 2016 Jun 23.

Abstract

The aim of the present research was to explore clinician attitudes to outcome measures and, in particular, the facilitators and barriers to implementing outcome measures. An up-to-date exploration of clinician attitudes is especially needed in the context of recent policies on the implementation of outcome measures in child and adolescent mental health services (CAMHS), and because evidence suggests that there is a disparity between policy recommendations and the use of outcome measures in clinical practice. Semi-structured interviews were conducted with nine CAMHS clinicians from a Mental Health Trust in South London. Two levels of implementation emerged from the analysis: (1) the service level, regarding the implementation of outcome measures across a service to inform service improvement and (2) the session level, regarding the implementation of outcome measures within individual clinical sessions. The present research described training and ongoing support as a crucial facilitator of use at both service and session levels. This included help overcoming local contextual barriers, such as resources, information systems and administrative processes. The research showed that a balance is needed between a mandatory and uniform approach across a service and providing clinicians with support to use outcome measures with all service users for whom they are appropriate.

摘要

本研究的目的是探究临床医生对疗效评估指标的态度,尤其是实施疗效评估指标的促进因素和障碍。鉴于近期儿童和青少年心理健康服务(CAMHS)中实施疗效评估指标的相关政策,以及有证据表明政策建议与临床实践中疗效评估指标的使用之间存在差异,对临床医生态度进行最新的探究尤为必要。对来自伦敦南部一家心理健康信托机构的9名CAMHS临床医生进行了半结构化访谈。分析得出了两个实施层面:(1)服务层面,即 across a service to inform service improvement and (2) 会话层面,即在个体临床会话中实施疗效评估指标。本研究将培训和持续支持描述为在服务和会话层面使用疗效评估指标的关键促进因素。这包括帮助克服当地的背景障碍,如资源、信息系统和行政流程。研究表明,在整个服务中采用强制性和统一的方法与为临床医生提供支持以使其对所有适用的服务使用者使用疗效评估指标之间需要取得平衡。 (注:原文中“across a service to inform service improvement”表述不太完整准确,翻译可能稍显生硬,但已尽量忠实原文)

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