Nonspecific Effects in Psychoeducational Intervention Research
Nonspecific Effects in Psychoeducational Intervention Research
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DOI：
10.1177/0193945909338488
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发表时间：
2009-12-01
影响因子：
1.8
通讯作者：
Ward, Sandra E.
中科院分区：
文献类型：
--
作者：
Donovan, Heidi S.;Kwekkeboom, Kristine L.;Ward, Sandra E.
随机临床试验支持广泛的心理教育干预措施的有效性。然而，这些干预措施改善结果的机制并不总是明确的。有时，干预措施中理论上指定的因素已被证明对患者的治疗结果有特定的影响。但也有人认为，干预理论中未确定的其他因素（例如，“非特异性”因素，如患者期望和治疗性患者-临床医生联盟）具有强大的非特异性效应，可以解释大部分（如果不是全部）观察到的心理教育干预效果。本文描述了这场辩论中的重要概念，并讨论了区分心理教育护理干预的特定效果和非特定效果的关键问题。使用四个例子来说明在临床干预试验中识别和控制非特异性效应的潜在方法。
Randomized clinical trials support the efficacy of a wide range of psychoeducational interventions. However, the mechanisms through which these interventions improve outcomes are not always clear. At times, the theoretically specified factors within interventions have been shown to have specific effects on patient outcomes. But it has also been argued that other factors not identified in the intervention theory (e.g., "nonspecific" factors such as patient expectations and therapeutic patient-clinician alliances) have powerful nonspecific effects that account for most, if not all, of the observed efficacy of psychoeducational interventions. This article describes important concepts in this debate and discusses key issues in distinguishing between specific and nonspecific effects of psychoeducational nursing interventions. Four examples are used to illustrate potential methods of identifying and controlling for nonspecific effects in clinical intervention trials.