Electroconvulsive Treatment-More Than Electricity? An Odyssey of Facilities
Electroconvulsive Treatment-More Than Electricity? An Odyssey of Facilities
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DOI：
10.1097/yct.0b013e3181a2f23e
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发表时间：
2009-12-01
期刊：
影响因子：
2.5
通讯作者：
Berg, John E.
中科院分区：
文献类型：
--
作者：
Berg, John E.
目的：为了调查电休克治疗（ECT）的做法，今天是在一个比较的方式在不同的医院在几个continents.Materials和Methods：在访问ECT设施的14家医院在3大洲，进行了比较，和负责的卫生专业人员进行了采访，使用半结构化的指南。强调的是，本文是不是一个结构良好的研究的结果，但在观察到缺乏同质性facility.Results：总共超过18,000修改ECT会议，每年在14家医院的反思。公众和监管机构对ECT的意见强烈影响了对患者进行ECT的可能性。在访问的大多数设施中，ECT的适应症比抑郁症的病例更广泛。精神科医生在所有的机构都做电休克治疗。除我院外，所有医院均由麻醉师实施麻醉。2家（或3家）机构未使用吸嘴，但理由与使用吸嘴的机构相同。没有机构提供未经修改的ECT。在癫痫发作期间坚持对患者的判断是不必要的，在12的14 facility.Conclusions：在严重的精神疾病，使用ECT的做法似乎也有其优点，在其他情况下与衰弱的疾病比单极和双相抑郁症。电休克疗法可以由合格的或有专门证书的护士进行，但麻醉应该是麻醉师的工作。有些机构认为吸嘴是多余的装置。可以省略癫痫发作期间对患者的保持。参观的一些设施每年为大量患者提供ECT。它们在ECT的实践中存在差异，可以作为比较研究的重点。尽管观察到的差异，以及可以改变的程序，以修改的方式给予ECT有效地减轻了患者的痛苦。
Objective: To investigate whether the practice of electroconvulsive treatment (ECT) today is done in a comparable way in different hospitals on several continents.Materials and Methods: During visits to the ECT facilities of 14 hospitals on 3 continents, comparisons were made, and responsible health professionals were interviewed using a semistructured guide. It is emphasized that the present article is not the result of a well-structured research, but of reflections after observing a lack of homogeneity among facilities.Results: A total of more than 18,000 modified ECT sessions were given per year in the 14 hospitals. The opinion of the public and regulatory bodies on ECT strongly influences the possibility of giving ECT to patients. Indications for ECT are wider than the cases of depression in most facilities visited. A psychiatrist gives ECT in all but I facility. Anesthesia is given by an anesthesiologist in all but I facility. A mouthpiece was not used in 2 (or 3) facilities, although the rationale was the same as in facilities using mouthpieces. No facility gave unmodified ECT. Holding on to the patient during seizures was judged unnecessary in 12 of 14 facilities.Conclusions: in severe mental illness, the practice of using ECT seems to have its merit also in cases with debilitating illnesses other than unipolar and bipolar depression. Giving ECT may be done by qualified or specially certified nurses, but the giving of anesthesia should be the realm of the anesthesiologist. Mouthpieces are judged by some facilities to be a superfluous device. The holding of patients during seizure can be omitted. Some of the facilities visited give ECT to a huge number of patients each year. They differ in the practice of ECT and could be the focus of comparative research. Despite the differences observed, and procedures that could be altered, giving ECT in a modified way effectively relieves suffering in the patients.