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工具带中的又一工具:一项定性访谈研究,调查患者和临床医生对将心理测量学纳入肠道-脑互动障碍常规检测的看法。

One More Tool in the Tool Belt: A Qualitative Interview Study Investigating Patient and Clinician Opinions on the Integration of Psychometrics Into Routine Testing for Disorders of Gut-Brain Interaction.

作者信息

Law Mikaela, Bartlett Esme, Sebaratnam Gabrielle, Pickering Isabella, Simpson Katie, Keane Celia, Daker Charlotte, Gharibans Armen, O'Grady Greg, Andrews Christopher N, Calder Stefan

机构信息

Department of Surgery, The University of Auckland, Auckland, NZL.

Department of Science, Alimetry Ltd., Auckland, NZL.

出版信息

Cureus. 2024 Aug 18;16(8):e67155. doi: 10.7759/cureus.67155. eCollection 2024 Aug.

Abstract

Introduction Disorders of gut-brain interaction (DGBIs) encompass a common group of disorders characterised by chronic gastrointestinal symptoms. Psychological comorbidities are common in patients with DGBIs and are linked with poorer patient outcomes. Consequently, assessing and managing mental wellbeing may lead to improvements in symptoms and quality of life. Methods This study aimed to explore patients' and clinicians' opinions on integrating psychometrics into routine DGBI testing. Semi-structured interviews were conducted with 16 patients with gastroduodenal DGBI and 19 clinicians who see and treat these patients. Interviews were analysed using inductive, reflexive thematic analysis. Results Three key clinician themes were developed: (1) psychology as part of holistic care, emphasising the importance of a multidisciplinary approach; (2) the value of psychometrics in clinical practice, highlighting their potential for screening and expanding management; and (3) navigating barriers to utilising psychometrics, addressing the need for standardisation to maintain the therapeutic relationship. Four key patient themes were developed: (1) the utility of psychometrics in clinical care, reflecting the perceived benefits; (2) openness to psychological management, indicating patients' willingness to explore psychological treatments; (3) concerns with psychological integration, addressing potential stigma and fear of labelling; and (4) the significance of clinician factors, emphasising the importance of clinician bedside manner, knowledge and collaboration. Conclusions These themes demonstrate that patients and clinicians see value in integrating psychometrics into routine DGBI testing. Despite potential barriers, psychometrics advance patient and clinician understanding and facilitate multidisciplinary management. Recommendations for navigating challenges were provided, and considering these, patients and clinicians supported the use of psychometrics as screening tools for patients with DGBIs.

摘要

引言 肠-脑互动障碍(DGBIs)是一组常见的以慢性胃肠道症状为特征的疾病。心理共病在DGBIs患者中很常见,并且与较差的患者预后相关。因此,评估和管理心理健康可能会改善症状和生活质量。方法 本研究旨在探讨患者和临床医生对于将心理测量学纳入常规DGBI检测的看法。对16例胃十二指肠DGBI患者和19名诊治这些患者的临床医生进行了半结构化访谈。采用归纳性、反思性主题分析法对访谈进行分析。结果 形成了三个关键的临床医生主题:(1)心理学作为整体护理的一部分,强调多学科方法的重要性;(2)心理测量学在临床实践中的价值,突出其在筛查和拓展管理方面的潜力;(3)应对使用心理测量学的障碍,解决标准化需求以维持治疗关系。形成了四个关键的患者主题:(1)心理测量学在临床护理中的效用,反映出感知到的益处;(2)对心理管理持开放态度,表明患者愿意探索心理治疗;(3)对心理整合的担忧,涉及潜在的污名化和对贴标签的恐惧;(4)临床医生因素的重要性,强调临床医生的床边态度、知识和协作的重要性。结论 这些主题表明,患者和临床医生认为将心理测量学纳入常规DGBI检测具有价值。尽管存在潜在障碍,但心理测量学增进了患者和临床医生的理解,并促进了多学科管理。提供了应对挑战的建议,考虑到这些建议,患者和临床医生支持将心理测量学用作DGBIs患者的筛查工具。

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