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共决和抑郁治疗建议的实施。

Shared decision-making and the implementation of treatment recommendations for depression.

机构信息

Black Dog Institute, University of New South Wales, Hospital Rd, Randwick, NSW, 2031, Australia.

Black Dog Institute, University of New South Wales, Hospital Rd, Randwick, NSW, 2031, Australia; School of Psychiatry, University of New South Wales, High St, Kensington, NSW, 2052, Australia.

出版信息

Patient Educ Couns. 2021 Aug;104(8):2119-2121. doi: 10.1016/j.pec.2021.01.025. Epub 2021 Jan 23.

Abstract

OBJECTIVE

This study aimed to examine the relationship between shared decision-making (SDM) and the implementation of treatment recommendations amongst outpatients at a specialist Depression Clinic.

METHODS

A total of 110 adult outpatients in a specialist Depression Clinic in Sydney, Australia, completed an online survey examining their experiences of shared decision-making (SDM) during their psychiatrist consultation and the extent to which they later implemented Depression Clinic treatment recommendations.

RESULTS

The odds of implementing treatment recommendations were over four times higher in patients who reported a high level of SDM in their consultation, compared to those who reported a low level of SDM. Further, three elements of patient-rated SDM were significantly associated with an increased likelihood of implementing depression treatment recommendations. These three elements were: i) being given the opportunity to ask questions or voice concerns; ii) being asked about any problems or side effects from previous treatments; and iii) being involved in deciding their treatment plan.

CONCLUSIONS

SDM was significantly associated with an increased likelihood of implementing psychiatrists' treatment recommendations at a specialist Depression Clinic.

PRACTICE IMPLICATIONS

We recommend that clinicians be informed of the potential benefits of SDM and adopt SDM when developing treatment plans with patients living with depression.

摘要

目的

本研究旨在探讨共享决策(SDM)与在专科抑郁诊所的门诊患者中实施治疗建议之间的关系。

方法

在澳大利亚悉尼的一家专科抑郁诊所中,共有 110 名成年门诊患者完成了一项在线调查,调查了他们在精神科医生就诊期间的共享决策(SDM)体验,以及他们随后实施抑郁诊所治疗建议的程度。

结果

与报告 SDM 水平较低的患者相比,报告 SDM 水平较高的患者实施治疗建议的可能性高出四倍以上。此外,患者自评 SDM 的三个要素与增加实施抑郁治疗建议的可能性显著相关。这三个要素是:i)有机会提问或表达担忧;ii)询问之前治疗的任何问题或副作用;iii)参与决定他们的治疗计划。

结论

SDM 与在专科抑郁诊所实施精神科医生治疗建议的可能性增加显著相关。

实践意义

我们建议临床医生了解 SDM 的潜在益处,并在与患有抑郁症的患者制定治疗计划时采用 SDM。

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