Berry Katherine, Haddock Gillian, Kellett Stephen, Awenat Yvonne, Szpak Karolina, Barrowclough Christine
University of Manchester.
University of Sheffield.
J Clin Psychol. 2017 Oct;73(10):1211-1225. doi: 10.1002/jclp.22434. Epub 2016 Dec 27.
Team formulation is advocated to improve quality of care in mental health care and evidence from a recent U.K.-based trial supports its use in inpatient settings. This study aimed to identify the effects of formulation on practice from the perspectives of staff and patient participating in the trial, including barriers and enhancers to implementing the intervention.
We carried out semistructured interviews with 57 staff and 20 patients. Data were analyzed using thematic analysis.
Main outcomes were: improved staff understanding of patients, better team collaboration and increased staff awareness of their own feelings. Key contextual factors were as follows: overcoming both staff and patient anxiety, unwelcome expert versus collaborative stance, competing demands, and management support.
Team formulation should be implemented to improve quality of care in inpatient settings and larger definitive trials should be carried out to assess the effect of this intervention on patient outcomes.
提倡采用团队诊疗方案来提高精神卫生保健的质量，并且一项近期基于英国的试验证据支持其在住院环境中的应用。本研究旨在从参与该试验的工作人员和患者的角度确定诊疗方案对实践的影响，包括实施该干预措施的障碍和促进因素。
我们对57名工作人员和20名患者进行了半结构化访谈。使用主题分析法对数据进行了分析。
主要结果如下：工作人员对患者的理解有所改善，团队协作更好，工作人员对自身感受的认识有所提高。关键背景因素如下：克服工作人员和患者的焦虑、不受欢迎的专家与协作立场、相互竞争的需求以及管理层的支持。
应实施团队诊疗方案以提高住院环境中的护理质量，并且应开展更大规模的确证性试验来评估该干预措施对患者结局的影响。
