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实施指南的多层次障碍:在儿童和青少年精神病学中进行全国性的多专业横截面研究
Anna Helena Elisabeth Santesson1,2, Robert Holmberg3, Martin Bäckström3
1Department of Clinical Sciences, Faculty of Medicine, Lund University, BMC F12, Lund, 221 84, Sweden. anna.santesson@med.lu.se.
儿童和青少年心理健康临床医生对准则的采用持积极态度,但在患者护理和环境中存在障碍. 需要针对临床医生的知识和培训进行量身定制的实施策略,以有效地使用指南.
科学领域:
- 心理健康服务研究 心理健康服务研究
- 实施科学 实施科学
- 临床指南的采用 临床指南的采用
背景情况:
- 在医疗保健中,采用低于最佳的指导方针是一个持续的挑战.
- 在不同的背景和专业群体中,实施指南的障碍有很大差异.
- 儿童和青少年心理健康服务 (CAMHS) 面临着独特的挑战,多专业指导方针.
研究的目的:
- 检查CAMHS采用多专业抑郁症指南的障碍.
- 为了确定专业特定的差异在感知障碍的指导方针实施.
- 为提高CAMHS中准则采用的战略提供信息.
主要方法:
- 一项涉及瑞典440名CAMHS临床医生的全国性实施研究.
- 利用障碍物和促进者评估工具 (BFAI) 来评估所感知的障碍物.
- 采用ANOVA和千平方测试来分析不同职业之间的差异.
主要成果:
- 临床医生对指导方针的采用和个人采用能力表示乐观.
- 确定的主要障碍与患者因素,上下文问题以及临床医生的知识/培训有关.
- 在各个职业中观察到认知的显著差异,精神病医生是最积极的,顾问是最不积极的.
结论:
- 一般来说,CAMHS的临床医生对准则的采用持好态度.
- 实施策略应解决患者特定需求和背景障碍.
- 针对不同专业群体的实施努力,包括员工培训和参与,是成功的关键.
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