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抑郁症的电休克治疗(ECT)转诊研讨会:评估患者与消除污名化

Electroconvulsive Therapy (ECT) Referral Workshop for Depression: Assessing Patients and Addressing Stigma.

作者信息

Haynes Wayles, Miller Jeremy, Weidner Payton, Abbott Christopher

机构信息

Assistant Professor, Department of Psychiatry and Behavioral Health, University of New Mexico School of Medicine.

Associate Professor and Chief, Geriatric Psychiatry Division, Department of Psychiatry and Behavioral Health, University of New Mexico School of Medicine.

出版信息

MedEdPORTAL. 2025 Feb 11;21:11497. doi: 10.15766/mep_2374-8265.11497. eCollection 2025.

Abstract

INTRODUCTION

Electroconvulsive therapy (ECT) is an important somatic treatment in psychiatry with well-defined indications, strong evidence for a quick response, and established efficacy. Despite the benefits of ECT, it is underutilized and inequitably accessed by patients in the United States. Patient and provider lack of knowledge, misinformation, and negative attitudes perpetuated by bias and stigma towards ECT can be significant barriers to patients receiving ECT.

METHODS

We created a workshop to address these issues with Kern's six-step approach, using the affective context learning theory as a conceptual framework. Based on a literature review and ECT physician researcher expertise, we taught the 90-minute workshop to 50 psychiatry and other behavioral health trainees to assess patients for ECT referral and address stigma and bias towards ECT. The workshop was delivered in person at four separate sessions to a total of 50 trainees and included pre- and postworkshop assessments of workshop efficacy.

RESULTS

Results of a paired-samples test of participants' responses pre- and postworkshop showed statistically significant growth on most learning objectives. Comments from the qualitative feedback indicated a majority-positive participant response to the engaging and effective workshop design and presentation. Participants' self-assessment found at least a 50% normalized gain for all learning objectives.

DISCUSSION

This workshop is an effective contribution to ECT educational scholarship that can build trainee confidence in assessing patients with depression for ECT referral and addressing ECT stigma in clinical care.

摘要

引言

电休克治疗(ECT)是精神病学中一种重要的躯体治疗方法,其适应症明确,有充分证据表明疗效迅速且确切。尽管ECT有诸多益处,但在美国,它未得到充分利用,患者获取该治疗的机会也不平等。患者和医疗服务提供者缺乏相关知识、存在错误信息,以及因对ECT的偏见和污名化而产生的消极态度,都可能成为患者接受ECT治疗的重大障碍。

方法

我们采用克恩的六步法,以情感情境学习理论为概念框架,创建了一个研讨会来解决这些问题。基于文献综述和ECT医生研究人员的专业知识,我们为50名精神病学及其他行为健康专业的实习生举办了一场90分钟的研讨会,以评估患者是否适合转介接受ECT治疗,并消除对ECT的污名化和偏见。该研讨会分四次现场授课,共有50名实习生参加,并对研讨会的效果进行了课前和课后评估。

结果

对参与者课前和课后回答的配对样本检验结果显示,在大多数学习目标上都有统计学意义上的显著进步。定性反馈中的评论表明,大多数参与者对引人入胜且有效的研讨会设计和呈现给予了积极回应。参与者的自我评估发现,所有学习目标的标准化增益至少为50%。

讨论

本次研讨会对ECT教育学术研究做出了有效贡献,能够增强实习生在评估抑郁症患者是否适合转介接受ECT治疗以及在临床护理中消除对ECT的污名化方面的信心。

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