BIDMC Social Work Department, Harvard Medical School , Boston , MA , USA.
BIDMC Division of General Medicine, Harvard Medical School , Boston , MA , USA.
J Ment Health. 2019 Oct;28(5):527-535. doi: 10.1080/09638237.2019.1644490. Epub 2019 Jul 31.
Though patients' access to clinicians' visit notes may improve patient engagement and strengthen patient-clinician relationships, it is unknown whether these benefits extend to mental health settings. Examine patients' attitudes and experiences reading their psychotherapists' notes online. Using a mixed methods design, we conducted telephone interviews and an online survey of patients at an academic medical center who had opened ≥1 of their psychotherapy notes online. Eleven patients who had read ≥6 psychotherapy notes participated in semi-structured interviews, and 85 patients completed an online survey (response rate = 24%). Nearly all survey respondents (94%) agreed that having open therapy notes is a good idea, and 87% wanted it to continue. More than half reported therapy notes were "very important" (≥7/10 on 0-10 scale) for feeling in control of their care, trusting their providers and taking care of themselves. Two respondents felt offended, and 7 (11%) felt judged by something they read in a note. Interview data supported survey findings. Our pilot findings indicate that most patients who read open therapy notes find them valuable for understanding and engaging in their mental health care, with minimal adverse effects. Larger studies with diverse patient populations are needed.
虽然患者查阅临床医生的就诊记录可以提高患者的参与度并加强医患关系，但尚不清楚这些益处是否会延伸到心理健康治疗环境中。本研究旨在探讨患者在线阅读心理治疗师记录的态度和体验。采用混合方法设计，我们对在学术医疗中心至少在线查阅过 1 次心理治疗记录的患者进行了电话访谈和在线调查。11 名至少阅读过 6 次心理治疗记录的患者参加了半结构化访谈，85 名患者完成了在线调查（应答率为 24%）。几乎所有的调查受访者（94%）都认为公开治疗记录是一个好主意，87%的受访者希望继续公开。超过一半的受访者报告说，治疗记录对他们掌控自己的护理、信任自己的医疗服务提供者和照顾自己“非常重要”（0-10 分制中≥7 分）。有 2 名受访者感到受到冒犯，有 7 名（11%）受访者觉得自己在记录中被评判了。访谈数据支持调查结果。我们的初步研究结果表明，大多数阅读公开治疗记录的患者认为这些记录对理解和参与他们的心理健康护理很有价值，只有极少数患者产生了负面影响。需要在更广泛的患者群体中开展更大规模的研究。
