Psychiatrists' Adoption of Schizophrenia Guidelines

精神科医生采用精神分裂症指南

• 批准号: 6624048
• 负责人: DONALD Michael STEINWACHS
• 金额: $ 35.2万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-05-16 至 2005-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6624048
• 关键词: adult human (21+); behavioral /social science research tag; clinical research; continuing education; decision making; health care personnel education; health care quality; health care service evaluation; human subject; judgment; learning; patient care management; patient care personnel attitude; perception; population survey; preference; psychiatric patient care; psychiatrist; questionnaires; schizophrenia

There is substantial evidence that quality of care for schizophrenia falls short of evidence-based standards derived from the clinical research literature. Studies of non-adherence to guidelines for other conditions have found lack of knowledge, disagreement with the evidence, lack of confidence in ability to implement guidelines effectively, and perceived organizational barriers to their implementation. Reasons for the gap between practice and evidence are not known for schizophrenia. This study will address these issues through a survey of psychiatrists providing direct patient. The aims are: 1) To identify sources of information used by psychiatrists to learn about advances in diagnosis and treatment of psychiatric disorders, 2) To assess the extent of agreement with and adherence to evidence-based guidelines developed in the schizophrenia PORT project, 3) To examine characteristics of psychiatrists, their practices and the external environment associated with readiness to adopt evidence-based guidelines, and 4) To assess the willingness of psychiatrists to participate in educational opportunities to advance their knowledge about and ability to implement guidelines, and their preferences among alternative educational formats. The survey sample will be all psychiatrists in the state of Maryland who are providing direct patient care. Based on survey responses, psychiatrists will be classified by learning style (what methods and resources they are most likely to respond to), readiness to adopt guideline-based practices (following Prochaska and DiClemente's readiness to change model), and clinical interest in schizophrenia. Among those treating or having an interest in schizophrenia, willingness to participate in practice assessments will be determined, as will perceived need for practice tools to overcome barriers to implementation of guideline-based patient care. The findings of this research will be used to design educational intervention trials in Maryland to improve the care of patients with schizophrenia.

有大量证据表明，精神分裂症的护理质量没有达到来自临床研究文献的循证标准。对不遵守其他条件指导方针的研究发现，缺乏知识、与证据不一致、对有效执行指导方针的能力缺乏信心，以及对实施指导方针存在组织障碍。对于精神分裂症，实践和证据之间存在差距的原因尚不清楚。这项研究将通过对提供直接病人的精神科医生的调查来解决这些问题。其目的是：1)确定精神病学家用来了解精神疾病诊断和治疗进展的信息来源；2)评估精神分裂症港项目中制定的循证指南的一致程度和遵守程度；3)检查精神病学家的特点、他们的做法以及与是否愿意采用循证指南相关的外部环境；以及4)评估精神病学家是否愿意参加教育机会，以增进他们对指南的了解和执行指南的能力，以及他们对替代教育形式的偏好。调查样本将是马里兰州所有提供直接病人护理的精神病学家。根据调查结果，精神病学家将按照学习风格(他们最有可能对哪些方法和资源做出反应)、是否准备好采用基于指南的实践(遵循普罗查斯卡和迪克莱门特的改变模式的准备)以及对精神分裂症的临床兴趣进行分类。在那些治疗精神分裂症或对精神分裂症感兴趣的人中，将确定是否愿意参加实践评估，以及是否需要实践工具来克服实施以指南为基础的患者护理的障碍。这项研究的结果将被用于在马里兰州设计教育干预试验，以改善对精神分裂症患者的护理。