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协作决策技能培训:一项新干预措施的可行性和初步结果。

Collaborative decision skills training: Feasibility and preliminary outcomes of a novel intervention.

机构信息

Department of Psychology.

出版信息

Psychol Serv. 2020 Feb;17(1):54-64. doi: 10.1037/ser0000275. Epub 2018 Aug 13.

Abstract

Increasing consumer empowerment and agency in treatment decision-making is a priority for improving recovery among people with serious mental illness (SMI), as it is associated with a number of positive outcomes, including improved treatment engagement and satisfaction. Although there are many tools to promote initiation of shared decision-making by providers, there are few tools empowering consumers to independently initiate collaborative decision-making (CDM). Therefore, this study tests the feasibility of a novel skills training intervention for outpatients with SMI, collaborative decision skills training (CDST). Twenty-one consumers with SMI currently receiving community-based day services participated in CDST. Four areas of feasibility were assessed-acceptability, demand, practicality, and preliminary evidence of efficacy. Feasibility results were favorable, including high acceptability and practicality. Demand results were mixed: rates of attendance were high and attrition was low, but participants did not complete homework as often as expected. Finally, there was evidence CDST has a positive impact on targeted outcomes; participants reported an increased sense of personal recovery, and displayed improvements in both knowledge and skills targeted by CDST. CDST is feasible to implement with fidelity and is received well by participants. Next steps include larger controlled trials of CDST, which will better inform efficacy and implementation related questions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

摘要

增强消费者在治疗决策中的自主权和代理权是改善严重精神疾病(SMI)患者康复的重中之重,因为这与许多积极的结果相关,包括改善治疗参与度和满意度。虽然有许多工具可以促进提供者发起共同决策,但很少有工具可以赋予消费者独立发起协作决策(CDM)的能力。因此,本研究测试了一种针对 SMI 门诊患者的新型技能培训干预措施——协作决策技能培训(CDST)的可行性。目前正在接受基于社区的日间服务的 21 名 SMI 消费者参加了 CDST。评估了四个方面的可行性——可接受性、需求、实用性和初步疗效证据。可行性结果是有利的,包括高度的可接受性和实用性。需求结果喜忧参半:出席率高,流失率低,但参与者没有像预期的那样经常完成家庭作业。最后,有证据表明 CDST 对目标结果有积极影响;参与者报告说个人康复感增强,并且在 CDST 针对的知识和技能方面都有所提高。CDST 可以按照规定实施,并且受到参与者的好评。下一步包括更大规模的 CDST 对照试验,这将更好地阐明疗效和实施相关问题。(PsycINFO 数据库记录(c)2020 APA,保留所有权利)。

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