Plasencia Maribel, Chen Patricia V, Hundt Natalie E, Kunik Mark E, Giardina Traber D, Christie Israel C, Sansgiry Shubhada, Fletcher Terri L
Michael E. DeBakey VA Medical Center, VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, (MEDVAMC 152), 2002 Holcombe Blvd, Houston, TX, 77030, USA.
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
J Clin Psychol Med Settings. 2025 Jun;32(2):253-265. doi: 10.1007/s10880-024-10060-2. Epub 2024 Dec 15.
Clinical practice guidelines indicate treatments for specific anxiety diagnoses. Misdiagnosing specific anxiety disorders as unspecified anxiety may prevent patients from receiving appropriate care. Provider knowledge and attitudes may influence diagnostic practices. This study evaluated provider knowledge of diagnostic criteria for anxiety disorders and attitudes toward diagnostic processes and the relevance of diagnosis to patients' treatment. This qualitative analysis of interviews included 32 Veterans Health Administration providers in Primary Care Behavioral Health and Specialty Mental Health. Interview guides were created using a framework that outlines barriers regarding provider knowledge, attitudes, and behaviors as they pertain to following clinical practice guidelines. Most providers described themselves as familiar with diagnostic criteria for anxiety disorders and discussed consulting the Diagnostic and Statistical Manual of Mental Disorders if unsure about criteria. Providers were divided on the relevance of diagnostic specificity to a patient's treatment plan and outcomes. In the Veterans Health Administration, providers across different settings, roles, and tendency toward assigning specific diagnosis disagree on the relevance of diagnostic specificity for a patient's treatment and outcomes. Future research should seek to understand this divide and evaluate methods for optimizing a patient's likelihood of receiving a proper, accurate diagnosis.
临床实践指南指明了针对特定焦虑症诊断的治疗方法。将特定焦虑症误诊为未特定的焦虑症可能会使患者无法获得恰当的治疗。医疗服务提供者的知识和态度可能会影响诊断行为。本研究评估了医疗服务提供者对焦虑症诊断标准的了解、对诊断过程的态度以及诊断与患者治疗的相关性。这项对访谈的定性分析纳入了32名退伍军人健康管理局初级保健行为健康和专科心理健康领域的医疗服务提供者。访谈指南是使用一个框架创建的,该框架概述了医疗服务提供者在遵循临床实践指南方面在知识、态度和行为上的障碍。大多数医疗服务提供者称自己熟悉焦虑症的诊断标准,并表示如果对标准不确定会查阅《精神疾病诊断与统计手册》。医疗服务提供者在诊断特异性与患者治疗计划及结果的相关性问题上存在分歧。在退伍军人健康管理局,不同科室、角色以及对进行特定诊断倾向不同的医疗服务提供者在诊断特异性与患者治疗及结果的相关性问题上存在分歧。未来的研究应设法了解这种分歧,并评估优化患者获得正确、准确诊断可能性的方法。