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澳大利亚和新西兰皇家精神科医学院关于持续性精神病患者身体健康治疗、管理和监测的专家共识声明。

Royal Australian and New Zealand College of Psychiatrists expert consensus statement for the treatment, management and monitoring of the physical health of people with an enduring psychotic illness.

作者信息

Lambert Timothy Jr, Reavley Nicola J, Jorm Anthony F, Oakley Browne Mark A

机构信息

1 Collaborative Centre for Cardiometabolic Health in Psychosis, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia.

2 Sydney Medical School and the Discipline of Psychiatry, Sydney, Australia.

出版信息

Aust N Z J Psychiatry. 2017 Apr;51(4):322-337. doi: 10.1177/0004867416686693. Epub 2017 Feb 1.

Abstract

OBJECTIVE

To use expert consensus to inform the development of policy and guidelines for the treatment, management and monitoring of the physical health of people with an enduring psychotic illness.

METHOD

The Delphi method was used. A systematic search of websites, books and journal articles was conducted to develop a 416-item survey containing strategies that health professionals should use to treat, manage and monitor the physical health of people with an enduring psychotic illness. Three panels of Australian experts (55 clinicians, 21 carers and 20 consumers) were recruited and independently rated the items over three rounds, with strategies reaching consensus on a priori-defined levels of importance written into the expert consensus statement.

RESULTS

The participation rate for the clinicians across all three rounds was 65%, with consumers and carers only completing one round due to high endorsement rates. Finally, 386 strategies were endorsed as essential or important by one or all panels. The endorsed strategies provided information on engagement and collaborative partnerships; clinical governance; risk factors, morbidity and mortality in people with enduring psychotic illness; assessment, including initial and follow-up assessments; barriers to care; strategies to improve care of people with enduring psychotic illness; education and training; treatment recommendations; medication side effects; and the role of health professionals.

CONCLUSION

The consensus statement is intended to be used by health professionals, people with an enduring psychotic illness and their families and carers. The next step needed is an implementation strategy by the Royal Australian and New Zealand College of Psychiatrists and other stakeholders.

摘要

目的

运用专家共识为持续性精神病患者身体健康的治疗、管理及监测制定政策和指南。

方法

采用德尔菲法。对网站、书籍和期刊文章进行系统检索,以制定一份包含416项内容的调查问卷,其中涵盖卫生专业人员治疗、管理及监测持续性精神病患者身体健康应采用的策略。招募了三组澳大利亚专家(55名临床医生、21名护理人员和20名患者),并让他们在三轮中独立对各项内容进行评分,将在先验定义的重要性水平上达成共识的策略写入专家共识声明。

结果

临床医生在所有三轮中的参与率为65%,由于认可度高,患者和护理人员仅完成了一轮。最终,386项策略被一个或所有专家组认可为必不可少或重要。认可的策略提供了关于参与和合作关系、临床治理、持续性精神病患者的风险因素、发病率和死亡率、评估(包括初始评估和随访评估)、护理障碍、改善持续性精神病患者护理的策略、教育和培训、治疗建议、药物副作用以及卫生专业人员角色等方面的信息。

结论

该共识声明旨在供卫生专业人员、持续性精神病患者及其家人和护理人员使用。接下来需要澳大利亚和新西兰皇家精神病学院及其他利益相关者制定一项实施策略。

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