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精神科医疗服务提供者在开具精神药物时参与共同决策的意愿。

Psychiatric Providers' Willingness to Participate in Shared Decision Making When Prescribing Psychotropics.

作者信息

Ali Saadia, Smith Tawny L, Mican Lisa, Brown Carolyn

机构信息

Houston Methodist Hospital, Houston, TX, USA.

The University of Texas at Austin, TX, USA.

出版信息

J Pharm Technol. 2015 Oct;31(5):212-218. doi: 10.1177/8755122515578288. Epub 2015 Apr 6.

Abstract

Patients with mental health disorders experience difficulty in selecting treatments. With a paternalistic approach, patients are not offered an opportunity to provide input. Shared decision making (SDM) occurs when providers and patients collaborate on informed treatment decisions. Research on psychiatric providers' perceptions toward SDM is limited. This pilot study aimed to determine psychiatric providers' willingness to engage in SDM and factors that influence willingness. This cross-sectional, self-report study measured willingness, attitude, experiences, and barriers related to SDM as well as demographic/practice characteristics. A survey was e-mailed to psychiatric providers at 3 psychiatric institutions. Out of 80 providers e-mailed, 29 (36.3%) responded. Providers had a favorable attitude toward SDM (3.26 ± 0.24, range = 1-4) and a high willingness to use SDM (3.43 ± 0.50, range = 1-4). The most common SDM methods were discussions (96.6%) and written material (89.7%). Common perceived barriers included limited patient capacity (86.2%) and limited time with patient (62.1%). Current SDM users (3.46 ± 0.51) had a higher willingness to engage in SDM than noncurrent users (3.00 ± 0.00), = 4.63, df = 25.0, < .001. Attitude and willingness were positively related ( = .62, < .001). Attitude did not vary based on demographic/practice characteristics. Willingness to use SDM was positively related to a favorable attitude toward SDM. Larger, geographically diverse, randomized controlled trials need to be conducted to evaluate the willingness of psychiatric providers to conduct SDM.

摘要

患有精神健康障碍的患者在选择治疗方法时会遇到困难。采用家长式方法时,患者没有机会提供意见。当医疗服务提供者和患者就明智的治疗决策进行协作时,就会出现共同决策(SDM)。关于精神科医疗服务提供者对共同决策的看法的研究有限。这项试点研究旨在确定精神科医疗服务提供者参与共同决策的意愿以及影响意愿的因素。这项横断面自我报告研究测量了与共同决策相关的意愿、态度、经历和障碍以及人口统计学/实践特征。通过电子邮件向3家精神科机构的精神科医疗服务提供者发送了一份调查问卷。在通过电子邮件发送问卷的80名医疗服务提供者中,有29名(36.3%)回复。医疗服务提供者对共同决策持积极态度(3.26±0.24,范围为1 - 4),并且使用共同决策的意愿很高(3.43±0.50,范围为1 - 4)。最常见的共同决策方法是讨论(96.6%)和书面材料(89.7%)。常见的感知障碍包括患者能力有限(86.2%)和与患者相处时间有限(62.1%)。当前使用共同决策的用户(3.46±0.51)比非当前用户(3.00±0.00)参与共同决策的意愿更高,t = 4.63,自由度 = 25.0,p <.001。态度和意愿呈正相关(r =.62,p <.001)。态度不会因人口统计学/实践特征而有所不同。使用共同决策的意愿与对共同决策的积极态度呈正相关。需要进行更大规模、地域多样的随机对照试验,以评估精神科医疗服务提供者进行共同决策的意愿。

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