La Trobe Rural Health School, La Trobe University, P.O. Box 199, Bendigo, VIC, 3552, Australia.
Turning Point, Eastern Health, Melbourne, 3120, Australia.
BMC Med Inform Decis Mak. 2024 Nov 19;24(1):348. doi: 10.1186/s12911-024-02768-w.
Mental health presentations account for a considerable proportion of paramedic workload; however, the decision-making involved in managing these cases is poorly understood. This study aimed to explore how paramedics perceive their clinical decision-making when managing mental health presentations.
A qualitative descriptive study design was employed. Overall, 73 paramedics participated in semi structured interviews, and data were analyzed from transcribed interviews in NVivo.
Four themes emerged that reflected participants' perceptions: the assessment process, experience, the use of documents and standard procedures, and consultation with other healthcare providers. There were conflicting perceptions about the clinical decision-making process, with perception of role having a potential impact. The dual process theory of clinical decision-making, which includes both analytical and intuitive approaches, was evident in the decision-making process.
Incorporating dual process theory into education and training, which highlights the strengths and weaknesses of analytical and intuitive decision-making, may reduce clinical errors made by cognitive bias. To further support clinical decision-making, additional education and training are warranted to promote critical thinking and clarify the scope of practice and roles when attending to mental health-related presentations.
精神健康问题在急救人员的工作量中占相当大的比例；然而，对于这些病例的管理所涉及的决策过程仍不甚明了。本研究旨在探索急救人员在管理精神健康问题时如何看待他们的临床决策。
采用定性描述性研究设计。共有 73 名急救人员参与了半结构化访谈，对在 NVivo 中转录的访谈数据进行了分析。
出现了四个主题，反映了参与者的看法：评估过程、经验、文件和标准程序的使用以及与其他医疗保健提供者的协商。对于临床决策过程存在相互矛盾的看法，角色的看法可能会产生影响。临床决策的双重过程理论，包括分析和直觉方法，在决策过程中显而易见。
将双重过程理论纳入教育和培训中，突出分析和直觉决策的优缺点，可能会减少认知偏差导致的临床错误。为了进一步支持临床决策，需要进行额外的教育和培训，以促进批判性思维，并在处理与精神健康相关的问题时澄清实践范围和角色。
