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临床医生对儿童和青少年精神病学中标准化评估与诊断的态度。

Clinicians' attitudes toward standardized assessment and diagnosis within child and adolescent psychiatry.

作者信息

Danielson M, Månsdotter A, Fransson E, Dalsgaard S, Larsson J-O

机构信息

1Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden.

2Stockholm Child and Adolescent Psychiatry, Stockholm County Council, Box 17914, 118 95 Stockholm, Sweden.

出版信息

Child Adolesc Psychiatry Ment Health. 2019 Feb 12;13:9. doi: 10.1186/s13034-019-0269-0. eCollection 2019.

Abstract

BACKGROUND

There is a strong call for clinically useful standardized assessment tools in everyday child and adolescent psychiatric practice. The attitudes of clinicians have been raised as a key-facilitating factor when implementing new methods. An explorative study was conducted aimed to investigate the clinicians' attitudes regarding standardized assessments and usefulness of diagnoses in treatment planning.

METHODS

411 mental health service personnel working with outpatient and inpatient assessment and treatment within the specialist child and adolescent mental health services, Stockholm County Council were asked to participate in the study, of which 345 (84%) agreed answer a questionnaire. The questionnaire included questions regarding Attitudes toward Standardized Assessment and Utility of Diagnosis. Descriptive analyses were performed and four subscales were compared with information from a similar study in US using the same instruments. The demographic and professional characteristics (age, working years, gender, education, profession, management position, involvement in assessment, level of service) in terms of prediction of attitudes were studied by univariate and multivariate linear regressions.

RESULTS

Overall, the clinicians had quite positive attitudes and were more positive compared to a similar study conducted in the US earlier. There were differences in attitudes due to several characteristics but the only characteristic predicting all subscales was type of profession (counselor, nurse, psychiatrist, psychologist, other), with counselors being less positive than other groups.

CONCLUSION

The overall positive attitudes toward standard assessment are of importance in the development of evidence-based practice and our study implies that clinicians in general value and are willing to use standardized assessment. Nevertheless, there are specific issues such as adequate training and available translated assessment instrument that need to be addressed. When implementing new methods in practice, there are general as well as specific resistances that need to be overcome. Studies in different cultural settings are of importance to further extend the knowledge of what is general and what is specific barriers.

摘要

背景

在日常儿童和青少年精神病学实践中,对临床有用的标准化评估工具的需求强烈。在实施新方法时,临床医生的态度已被视为关键促进因素。进行了一项探索性研究,旨在调查临床医生对标准化评估的态度以及诊断在治疗计划中的有用性。

方法

邀请瑞典斯德哥尔摩郡议会儿童和青少年心理健康专科服务中心从事门诊和住院评估及治疗工作的411名心理健康服务人员参与研究,其中345人(84%)同意回答问卷。问卷包括关于对标准化评估的态度和诊断效用的问题。进行了描述性分析,并使用相同工具将四个子量表与美国一项类似研究的信息进行了比较。通过单变量和多变量线性回归研究了人口统计学和专业特征(年龄、工作年限、性别、教育程度、职业、管理职位、参与评估情况、服务级别)对态度的预测情况。

结果

总体而言,临床医生态度相当积极,且比美国早些时候进行的类似研究更积极。由于多种特征,态度存在差异,但唯一能预测所有子量表的特征是职业类型(顾问、护士、精神科医生、心理学家、其他),顾问比其他群体积极性低。

结论

对标准评估的总体积极态度对循证实践的发展很重要,我们的研究表明临床医生总体上重视并愿意使用标准化评估。然而,仍有一些具体问题需要解决,如充分的培训和可用的翻译评估工具。在实践中实施新方法时,存在需要克服的普遍阻力和具体阻力。在不同文化背景下进行研究对于进一步扩展对普遍障碍和具体障碍的认识很重要。

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