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基于网络的创伤后应激障碍临床实践指南传播干预的随机对照试验:创伤后应激障碍临床医生交流。

Randomized Controlled Trial of a Web-Based Intervention to Disseminate Clinical Practice Guidelines for Posttraumatic Stress Disorder: The PTSD Clinicians Exchange.

机构信息

Dissemination and Training Division, National Center for PTSD, Menlo Park, California, USA.

VA Palo Alto Health Care System, Menlo Park, California, USA.

出版信息

J Trauma Stress. 2020 Apr;33(2):190-196. doi: 10.1002/jts.22483. Epub 2020 Feb 26.

DOI:10.1002/jts.22483
PMID:32103542
Abstract

Delivery of best-practice care for posttraumatic stress disorder (PTSD) is a priority for clinicians working with active duty military personnel and veterans. The PTSD Clinicians Exchange, an Internet-based intervention, was designed to assist in disseminating clinically relevant information and resources that support delivery of key practices endorsed in the Veterans Administration (VA)-Department of Defense (DoD) Clinical Practice Guidelines (CPG) for the Management of Posttraumatic Stress. We conducted a randomized controlled trial to examine the effectiveness of the Clinicians Exchange intervention in increasing familiarity and perceived benefits of 26 CPG-related and emerging practices. The intervention consisted of ongoing access to an Internet resource featuring best-in-class resources for practices, self-management of burnout, and biweekly e-mail reminders highlighting selected practices. Mental health clinicians (N = 605) were recruited from three service sectors (VA, DoD, community); 32.7% of participants assigned to the Internet intervention accessed the site to view resources. Individuals who were offered the intervention increased their practice familiarity ratings significantly more than those assigned to a newsletter-only control condition, d = 0.27, p = .005. From baseline to 12-months, mean familiarity ratings of clinicians in the intervention group increased from 3.0 to 3.4 on scale of 1 (not at all) to 5 (extremely); mean ratings for the control group were 3.2 at both assessments. Clinicians generally viewed the CPG practices favorably, rating them as likely to benefit their clients. The results suggest that Internet-based resources may aid more comprehensive efforts to disseminate CPGs, but increasing clinician engagement will be important.

摘要

为现役军人和退伍军人提供创伤后应激障碍(PTSD)的最佳实践护理是临床医生的首要任务。基于互联网的 PTSD 临床医生交流(PTSD Clinicians Exchange)干预措施旨在协助传播支持退伍军人事务部(VA)-国防部(DoD)创伤后应激管理临床实践指南(CPG)中推荐的关键实践的临床相关信息和资源。我们进行了一项随机对照试验,以检验 Clinicians Exchange 干预措施在增加对 26 项 CPG 相关和新兴实践的熟悉程度和感知益处方面的有效性。该干预措施包括持续访问一个互联网资源,该资源提供最佳实践资源、自我管理倦怠以及每周两次的电子邮件提醒,突出显示选定的实践。心理健康临床医生(N = 605)从三个服务部门(VA、DoD、社区)招募;32.7%的参与者访问了互联网干预网站以查看资源。与仅接受新闻通讯的对照组相比,接受干预的个体对实践的熟悉程度评分显著提高,d = 0.27,p =.005。从基线到 12 个月,干预组的临床医生熟悉程度评分从 1(一点也不)到 5(非常)的量表上从 3.0 增加到 3.4;对照组的平均评分在两次评估中均为 3.2。临床医生普遍对 CPG 实践持肯定态度,认为这些实践可能使他们的患者受益。结果表明,基于互联网的资源可能有助于更全面地传播 CPG,但增加临床医生的参与将是重要的。

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