An ethnographic study of implementation of evidence-based treatments in child mental health: first steps.
An ethnographic study of implementation of evidence-based treatments in child mental health: first steps.
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儿童心理健康循证治疗实施的人种学研究：第一步。
DOI：
10.1176/ps.2008.59.7.738
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
ResearchNetworkonYouthMentalHealth
中科院分区：
文献类型：
--
作者：
Palinkas,LawrenceA;Schoenwald,SonjaK;Hoagwood,Kimberly;Landsverk,John;Chorpita,BruceF;Weisz,JohnR;ResearchNetworkonYouthMentalHealth
为更好地了解儿童抑郁症、焦虑症和行为问题循证治疗的初始和长期意向，对临床医生使用循证治疗的初步和长期意向进行了调查。方法采用民族志观察法，对檀香山5家机构和波士顿6家机构的4名培训师、6名临床主管和52名临床医生进行了民族志观察和扩展半结构访谈，以了解临床治疗项目的治疗实施情况。使用扎根理论分析方法对实地笔记、访谈记录和会议记录进行分析。结果表明，实施治疗的长期意向有三种模式：保真使用治疗、放弃治疗、选择性或部分使用治疗。这些模式被认为与实施前的三个因素有关：治疗方案的初始培训和实践中的治疗使用之间的滞后时间，临床医生对项目的投入，以及临床医生与治疗的契合度。另外四个因素是三个决定因素的近期结果以及实施的第一步：临床医生在最初使用循证治疗后的第一印象，治疗使用的能力，临床医生和研究人员的适应性，以及临床医生与研究人员的互动。结论实施前因素与初始实施经验之间的互动，以及实施早期步骤中研究人员与临床医生之间的互动与持续治疗的意图有关。
ObjectiveThe experiences of clinicians in regard to initial and long-term intention to use evidence-based treatments were examined in order to better understand factors involved in implementation of innovative treatments.MethodsEthnographic methods of participant observation and extended semistructured interviews with four trainers, six clinical supervisors, and 52 clinicians at five agencies in Honolulu and six in Boston were used to understand treatment implementation in the Clinic Treatment Project, a randomized effectiveness trial of evidencebased treatments for depression, anxiety, and conduct problems of children. Grounded-theory analytic methods were used to analyze field notes, interview transcripts, and meeting minutes.ResultsThree patterns in regard to long-term intention to implement the treatments were evident: application of the treatments with fidelity, abandonment of the treatments, and selective or partial application. These patterns were perceived to be associated with three preimplementation factors: lag time between initial training in the treatment protocol and treatment use in practice, clinician engagement with the project, and clinician-treatment fit. Four additional factors were proximal outcomes of the three determinants as well as first steps of implementation: clinicians’ first impressions of the evidence-based treatments after initial use, competence in treatment use, clinician and researcher adaptability, and clinician-researcher interactions.ConclusionsInteractions between preimplementation factors and initial implementation experiences and between researchers and clinicians during the early implementation steps were related to intentions to sustain treatment.(Psychiatric Services 59: 738–746, 2008)
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精神卫生服务中护理连续性意义的人种学研究。
DOI：
10.1176/ps.50.3.395
发表时间：
1999
期刊：
Psychiatric services (Washington, D.C.)
影响因子：
--
作者：
Ware,NC;Tugenberg,T;Dickey,B;McHorney,CA
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McHorney,CA
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DOI：
10.1016/j.chc.2004.05.006
发表时间：
2004
期刊：
Child and adolescent psychiatric clinics of North America.
影响因子：
--
作者：
Weisz,JohnR;Hawley,KristinM;Doss,AmandaJensen
通讯作者：
Doss,AmandaJensen
影响因子：
12.7
作者：
Glasgow, RE;Lichtenstein, E;Marcus, AC
通讯作者：
Marcus, AC
影响因子：
1.7
作者：
S. Henggeler;Sonja K. Schoenwald;C. Borduin;Melisa D. Rowland;P. Cunningham
通讯作者：
P. Cunningham
无家可归、严重精神疾病和机构循环。
影响因子：
3.8
作者：
K. Hopper;J. Jost;Terri Hay;Susan Welber;G. Haugland
通讯作者：
G. Haugland