Janine DeSimone, MSN, PMHNP-BC, Johns Hopkins University, Baltimore, MD, USA; Stony Brook University, Stony Brook, NY, USA.
Bryan R. Hansen, PhD, RN, APRN-CNS, ACNS-BC, Johns Hopkins University, Baltimore, MD, USA.
J Am Psychiatr Nurses Assoc. 2024 Apr;30(2):279-287. doi: 10.1177/10783903231177707. Epub 2023 Jun 1.
The quality of mental health treatment has not progressed to the same extent as physical health treatment. Suboptimal mental health outcomes may be attributed to the lack of a systematic approach to tracking and measuring patient progress. In psychiatry, Measurement-Based Care (MBC) offers an objective, systematic approach to monitor clinical progress, evaluate treatment efficacy, and inform clinical decisions, yet remains seldom used in daily practice.
To identify the clinical impact of using MBC in psychiatry.
Using the Johns Hopkins Nursing Evidence-Based Practice Model as a guideline, this integrative review focused on the research query, "What is the clinical impact of Measurement-Based Care when treating patients with mental illness?"
A total of nine articles met the inclusion criteria for this integrative review. The articles ranged from 2008 to 2021. The following themes were identified from the analysis of these articles: (1) the clinical impact of MBC, (2) provider attitudes about MBC, and (3) barriers to MBC implementation.
MBC, augmenting usual standard care, provides an objective, systematic approach using quantifiable data to monitor symptom severity and treatment effectiveness. This review highlights the clinical benefits of MBC, including increased remission rates, lower risk of relapse, improved medication adherence, and strengthening the therapeutic alliance. Although this review provides an overview of the benefits of MBC in psychiatry, there remains a substantial practice gap warranting further investigation. Strategies must be developed to address barriers at the individual and organizational levels which impede the successful adoption of MBC.
心理健康治疗的质量并没有像身体健康治疗那样取得同样的进展。心理健康效果不佳可能归因于缺乏跟踪和衡量患者进展的系统方法。在精神病学中，基于测量的护理 (MBC) 提供了一种客观、系统的方法来监测临床进展、评估治疗效果并为临床决策提供信息，但在日常实践中仍很少使用。
确定在精神病学中使用 MBC 的临床影响。
使用约翰霍普金斯护理循证实践模型作为指南，本次综合回顾重点关注研究查询，“在治疗患有精神疾病的患者时，使用基于测量的护理有何临床影响？”
共有九篇文章符合本次综合回顾的纳入标准。这些文章的时间范围从 2008 年到 2021 年。从对这些文章的分析中确定了以下主题：(1)MBC 的临床影响，(2)提供者对 MBC 的态度，以及 (3)MBC 实施的障碍。
MBC 增强了常规标准护理，提供了一种使用可量化数据客观、系统的方法来监测症状严重程度和治疗效果。本综述强调了 MBC 的临床益处，包括更高的缓解率、更低的复发风险、提高药物依从性和加强治疗联盟。尽管本综述概述了 MBC 在精神病学中的益处，但仍存在很大的实践差距，需要进一步调查。必须制定策略来解决个人和组织层面阻碍 MBC 成功采用的障碍。
