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探讨案例和临床医生性别对临床决策的影响。

An investigation of the influence of case and clinician gender in clinical decision-making.

机构信息

Department of Psychological and Brain Sciences, Texas A&M University.

出版信息

Personal Disord. 2019 May;10(3):286-290. doi: 10.1037/per0000326. Epub 2019 Feb 4.

Abstract

The present study was intended to assess the reliability of clinician judgments, with a particular interest in how such judgments vary by the gender of the case vignette and clinician. A national sample of 123 mental health professionals (57.7% male) provided clinical judgments on 12 case vignettes primarily representing personality pathology; two identical versions of each vignette were prepared, with the only difference being the use of masculine or feminine pronouns identifying the client. Clinical judgments included evaluations of adaptive functioning, long-term prognostic assessments, short-term risk evaluations, and treatment recommendations. Analyses included intraclass correlations between clinicians to assess reliability, as well as an examination of the variance of clinical judgments as a function of the identified gender of the case and the gender of the participating clinician. No significant two-way interactions were found between case gender and clinician gender in predicting the clinical judgments. A significant main effect of case gender in predicting vocational functioning was observed, such that female cases were rated as having better estimated vocational functioning than male cases. In addition, a significant main effect of clinician gender in predicting aggression and violence risk was found, such that ratings by female clinicians were higher than ratings by male clinicians. Results offer little if any evidence to suggest the influence of client or clinician gender on the majority of clinical judgments made in the present study. However, these results bear replication, particularly in light of the two significant main effects that did emerge. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

摘要

本研究旨在评估临床医生判断的可靠性,特别关注案例描述和临床医生的性别如何影响这些判断。一个由 123 名心理健康专业人员组成的全国性样本(57.7%为男性)对 12 个主要代表人格病理学的案例描述进行了临床判断;每个描述都准备了两个完全相同的版本,唯一的区别是使用男性或女性代词来识别客户。临床判断包括对适应功能、长期预后评估、短期风险评估和治疗建议的评估。分析包括评估临床医生之间的内部一致性以评估可靠性,以及检查临床判断的变异性作为案例确定性别和参与临床医生性别的函数。在预测临床判断方面,没有发现案例性别和临床医生性别之间存在显著的双向交互作用。观察到案例性别对职业功能预测有显著的主效应,即女性案例的职业功能评估比男性案例更好。此外,还发现临床医生性别对攻击和暴力风险预测有显著的主效应,即女性临床医生的评估高于男性临床医生。结果提供的证据很少,如果有的话,表明客户或临床医生性别对本研究中做出的大多数临床判断有影响。然而,这些结果需要复制,特别是考虑到确实出现的两个显著的主效应。(PsycINFO 数据库记录(c)2019 APA,保留所有权利)。

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