CLINICAL PSYCHOLOGY

临床心理学
  • 文章类型: Journal Article
    背景:儿童期不良经历(ACE)与青春期焦虑的发展有关。根据最近的研究,COVID-19大流行代表了一种与青少年焦虑相关的新型ACE。本研究调查了ACEs之间的关系,COVID-19和青少年焦虑。
    方法:使用社区样本进行了一项横断面研究,该样本来自东部阿提卡的五所高中的248名12至15岁(平均=13.50岁)的男孩和女孩。共使用四份问卷:(1)人口统计问卷,(2)儿童状态特质焦虑量表-STAIC,(3)不良童年经历量表,和(4)COVID-19影响量表。
    结果:结果表明,青春期ACEs总数与焦虑(特质和状态)之间存在中度关联(特质焦虑:ρ=0.37,p<0.001;状态焦虑:ρ=0.29,p<0.001)。女孩在特质焦虑(U=4353,p<0.001;平均差=5.5)和状态焦虑(U=5822.5,p=0.014;平均差=2)方面的得分均显着高于男孩。ACEs的数量与COVID-19的影响显著相关(β=0.025,p<0.001)。
    结论:这项研究强调了ACEs与青少年焦虑增加之间的显著联系,COVID-19大流行进一步加剧了这种情况。调查结果表明,女孩比男孩受到的影响更大。这些结果强调需要有针对性的心理健康干预措施,以加强应对机制,减轻压力,解决青少年的焦虑问题,特别是在大流行等全球危机期间。制定此类计划对于支持面临多种压力的年轻人的心理健康至关重要。
    BACKGROUND: Adverse Childhood Experiences (ACEs) are linked to the development of anxiety in adolescence. According to recent studies, the COVID-19 pandemic represents a novel ACE that is associated with anxiety among adolescents. This study investigates the relationship between ACEs, COVID-19, and anxiety in adolescents.
    METHODS: A cross-sectional study was conducted using a community sample of 248 boys and girls ages 12 to 15 years (mean = 13.50 years) from five high schools in Eastern Attica. A total of four questionnaires were used: (1) Demographic Questionnaire, (2) State-Trait Anxiety Inventory for Children-STAIC, (3) Adverse Childhood Experiences Scale, and (4) COVID-19 Impact Scale.
    RESULTS: The results demonstrated a moderate association between the total number of ACEs and anxiety (trait and state) in adolescence (trait anxiety: ρ = 0.37, p < 0.001; state anxiety: ρ = 0.29, p < 0.001). Girls scored significantly higher than boys on both trait anxiety (U = 4353, p < 0.001; mean difference = 5.5) and state anxiety (U = 5822.5, p = 0.014; mean difference = 2). The number of ACEs was found to be significantly related to the impact of COVID-19 (β = 0.025, p < 0.001).
    CONCLUSIONS: This study highlights the significant link between ACEs and increased anxiety in adolescents, which is further exacerbated by the COVID-19 pandemic. The findings indicate that girls are more affected than boys. These results emphasize the need for targeted mental health interventions to enhance coping mechanisms, reduce stress, and address anxiety in adolescents, particularly during global crises like the pandemic. Developing such programs is essential for supporting the mental well-being of youth facing multiple stressors.
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  • 文章类型: Journal Article
    为了解决预测对心理社会干预的心理反应的挑战,我们测试了基线基因表达谱可能提供超出基线心理测量的信息的可能性。基因组学策略利用转录因子活性的个体水平推断来预测孤独和情感的变化,以响应两种公认的冥想干预措施。最初的算法开发分析集中在三个先验定义的应激相关基因调控途径(CREB,GR,和NF-B),如从TELiS启动子为基础的生物信息学分析推断的基础(干预前)血液样本来自一项随机对照试验,比较基于同情心的冥想(CM,n=45)与正念冥想(MM,n=44)。较高的基线CREB活动(但不是GR或NF-B)预测从干预前后对孤独感(b=-0.24,p=0.016)和负面情绪(b=-0.23,p=0.017)的减少。但不是MM。第二个算法验证分析将相同的方法应用于另一个随机对照试验,比较CM(n=42)与MM(n=38)和健康教育控制条件(n=41)。同样,较高的基线CREB活动预测干预前后孤独感的降低(b=-0.24,p=0.029)和生活满意度的提高(b=0.21,p=0.046)。在两项研究中,基线CREB活性与基线心理测量无关联。结果增加了干预前基因表达谱可能反映影响对不同心理社会干预的心理反应的非意识心理生物学状态的可能性。从而帮助个性化干预选择。
    To address the challenge of predicting psychological response to a psychosocial intervention we tested the possibility that baseline gene expression profiles might provide information above and beyond baseline psychometric measures. The genomics strategy utilized individual level inferences of transcription factor activity to predict changes in loneliness and affect in response to two well-established meditation interventions. Initial algorithm development analyses focused on three a-priori defined stress-related gene regulation pathways (CREB, GR, and NF-ĸB) as inferred from TELiS promoter-based bioinformatic analysis of basal (pre-intervention) blood samples from a randomized-controlled trial comparing a compassion-based meditation (CM, n = 45) with mindfulness meditation (MM, n = 44). Greater baseline CREB activity (but not GR or NF-ĸB) predicted greater reductions from pre- to post-intervention in loneliness (b = -0.24, p = 0.016) and negative emotions (b = -0.23, p = 0.017) for CM, but not for MM. A second algorithm validation analysis applied the same approach to another randomized controlled trial comparing CM (n = 42) with MM (n = 38) and a health education control condition (n = 41). Similarly, greater baseline CREB activity predicted greater pre- to post-intervention decreases in loneliness (b = -0.24, p = 0.029) and greater increases in satisfaction with life (b = 0.21, p = 0.046) for the CM condition only. Baseline CREB activity was not associated with baseline psychometric measures in either study. Results raise the possibility that pre-intervention gene expression profiles may reflect non-conscious psychobiological states that affect psychological responses to distinct psychosocial interventions, and thereby help personalize intervention selection.
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  • 文章类型: Journal Article
    发作性偏头痛(EM)是全球第二大最普遍的神经系统疾病,比所有其他神经系统疾病的总和造成更多的残疾。偏头痛发展的触发因素包括,压力,情感负担,低血糖水平,烟草,略餐,焦虑和抑郁的感觉。偏头痛影响儿童和成人,女性的发病率是男性的三倍。
    这项研究的目的是评估EM患者的心理状况以及EM患者的负面情绪之间的关系,疼痛管理中的自我效能测量分析。
    我们在60名年龄在18-55岁(平均年龄33.8;SD±10.4)的EM门诊患者中进行了一项观察性研究。
    所有患者均已在L\'Aquila的SanSalvatore医院的头痛中心注册。评估包括五个标准化的心理自我评估,调查相关的情绪维度和疼痛自我效能感,以及两份评估偏头痛相关残疾的问卷。进行了负面情绪的网络分析,以评估哪些情绪特征和关系在疼痛应对和管理中起着至关重要的作用。
    我们的研究结果表明,偏头痛显著损害患者日常生活中的生活质量。超过一半的患者报告说经历了严重的残疾,负面情绪显着影响他们在偏头痛发作期间应对疼痛和维持生产力的能力。烦躁的变量(烦躁,人际关系的怨恨,和投降)与情绪调节能力的困难以及尽管经历疼痛但仍从事目标导向行为的能力有关。调节情绪和管理烦躁不安的能力与疼痛自我效能感呈正相关,而积极的心理健康与个体在经历疼痛的情况下进行活动的信心相关。
    负面情绪与积极的心理健康呈负相关,并且与尽管经历偏头痛但进行日常活动的能力降低有关。这表明心理干预可以改善心理健康,并可能超过单独的药物干预在偏头痛管理中的作用。一个综合的,以患者为中心的方法可能是解决和减轻偏头痛负担的有效范例,降低医疗成本。
    UNASSIGNED: Episodic migraine (EM) is the second most prevalent neurological disorder worldwide and is responsible for more disability than all other neurological disorders combined. Triggers for the development of migraine include, stress, emotional burden, low blood sugar levels, tobacco, skipped meals, anxious and depressive feelings. Migraine affects both children and adults, occurring three times more frequently in women than in men.
    UNASSIGNED: The aim of this study was to evaluate the psychological profile of EM patients and the relationship among negative emotions in EM patients, analyzing self-efficacy measures in pain management.
    UNASSIGNED: We performed an observational study in 60 outpatients aged 18-55 years (mean age 33.8; SD ±10.4) with EM.
    UNASSIGNED: All patients have been enrolled at the Headache Center of the San Salvatore Hospital of L\'Aquila. The assessment comprised five standardized psychological self-assessments investigating relevant emotional dimensions and pain self-efficacy, along with two questionnaires assessing migraine-related disability. A network analysis of negative emotions was performed to evaluate which emotional traits and relationships play a crucial role in pain coping and management.
    UNASSIGNED: Our findings indicate that migraine significantly impairs the quality of life of patients in their daily lives. Over half of the patients reported experiencing severe disability, with negative emotions significantly influencing their ability to cope with pain and maintain productivity during migraine attacks. Dysphoric variables (irritability, interpersonal resentment, and surrender) were correlated with difficulties in emotion regulation ability and with the capacity of engaging in goal-directed behaviors despite experiencing pain. The ability to regulate one\'s emotions and manage dysphoria were positively correlated with pain self-efficacy, whereas positive mental health was associated with individuals\' confidence in performing activities despite experiencing pain.
    UNASSIGNED: Negative emotions had a negative correlation with positive mental health and were linked to a lower capacity to carry out daily activities despite experiencing migraine pain. This suggests that psychological interventions could improve mental health and potentially surpassing the effects of pharmacological interventions alone in migraine management. An integrated, patient-centered approach may represent an effective paradigm to address and reduce the burden of migraine, leading to a reduction in healthcare costs.
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  • 文章类型: Journal Article
    背景:银屑病是一种慢性炎症性皮肤病,其表现超出了视觉表现,包括心理方面。牛皮癣患者的一些精神障碍或人格特质也得到了强调,比如对生活的消极或有问题的态度,冲动或回避行为,对生活的满意度较低。我们的横断面研究的目的是探索成人依恋之间的关联,气质,和银屑病患者的生活质量。
    方法:使用依恋风格问卷(ASQ)评估75例银屑病患者的样本,以研究成人依恋,孟菲斯的气质评价,比萨,和圣地亚哥自动问卷(TEMPS-A)研究气质特征,和皮肤病生活质量指数(DLQI)研究皮肤病对患者生活的影响。
    结果:抑郁,环胸腺,发现易怒的性情与需要批准和关注ASQ的关系子量表显着正相关。女性皮肤病对患者生活影响的严重程度高于男性。此外,发现需要ASQ的批准子量表具有统计学上的显著影响.皮肤病严重程度对患者生活的影响与需要批准之间的正相关具有统计学意义,女性比男性更强。
    结论:更好地理解精神合并症对银屑病的影响,反之亦然,这将使参与银屑病治疗的皮肤科医生认识到这些问题,并与心理学家和精神科医生合作帮助这些患者承担更大的责任。
    BACKGROUND: Psoriasis is a chronic inflammatory skin disease with manifestations that go beyond the visual manifestation, and include psychological aspects. Some mental disorders or personality traits in psoriasis patients have also been highlighted, such as a negative or problematic attitude towards life, impulsive or avoidant behavior, and lower satisfaction with life. The aim of our cross-sectional study was to explore the associations between adult attachment, temperament, and quality of life of patients with psoriasis.
    METHODS: A sample of 75 patients with psoriasis was evaluated with the Attachment Style Questionnaire (ASQ) to study adult attachment, the Temperament Evaluation of Memphis, Pisa, and San Diego Auto-questionnaire (TEMPS-A) to study temperament traits, and the Dermatology Life Quality Index (DLQI) to study the impact of dermatological diseases on patients\' lives.
    RESULTS: Depressive, cyclothymic, and irritable temperaments were found to be significantly positively associated with a need for approval and preoccupation with relationships subscales of the ASQ. The severity of skin disease effect on the patient\'s life was higher in women than in men. Moreover, a statistically significant effect of the need for approval subscale of the ASQ was found. The positive correlation between the severity of skin disease effect on the patient\'s life with a need for approval was statistically significant and stronger in women than in men.
    CONCLUSIONS: A better understanding of the impact of mental comorbidities on psoriasis and vice versa places an ever-greater responsibility on dermatologists involved in the management of psoriasis to recognize these problems and collaborate with psychologists and psychiatrists to help these patients.
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  • 文章类型: Journal Article
    背景:本研究旨在分析情绪耗竭在抑郁纵向关联关系中的调节作用,焦虑,以及在COVID-19大流行期间协助临终癌症患者的医护人员的压力。
    方法:一项纵向研究,涉及122名医护人员的最终样本(61.5%为女性,平均年龄=39.09±11.04岁)。这些参与者完成了Maslach倦怠量表(MBI)和抑郁焦虑压力量表-21(DASS-21)。
    结果:相关分析结果显示,情绪耗竭与抑郁的T1和T2测量值相关,焦虑,和压力。适度分析的结果表明,情绪耗竭调节了连续抑郁和焦虑之间的关系。每个适度模型都解释了抑郁和焦虑的大约一半的方差。当考虑压力时,结果未显示对情绪衰竭的调节作用.
    结论:总体而言,这项研究的结果强调,随着时间的推移,情绪疲惫可以缓解抑郁和焦虑。在帮助终末期癌症患者的医护人员中促进心理心理健康的心理干预措施应仔细考虑这些发现。
    BACKGROUND: This study aimed to analyze the moderating role of emotional exhaustion in the relationships between longitudinal associations of depression, anxiety, and stress among healthcare workers assisting end-of-life cancer patients during the COVID-19 pandemic.
    METHODS: A longitudinal study involving a final sample of 122 healthcare workers (61.5% females, mean age = 39.09 ± 11.04 years) was conducted. These participants completed the Maslach Burnout Inventory (MBI) and the Depression Anxiety Stress Scales-21 (DASS-21).
    RESULTS: Results of correlation analysis showed that emotional exhaustion was correlated with both T1 and T2 measures of depression, anxiety, and stress. Results of the moderation analysis indicated that emotional exhaustion moderated the relationships between consecutive measures of depression and anxiety. Each of the moderation models explained about half of the variance for depression and anxiety. When considering stress, results did not show a moderating role for emotional exhaustion.
    CONCLUSIONS: Overall, the results of this study highlight that emotional exhaustion moderated depression and anxiety over time. Psychological interventions to promote psychological mental health among healthcare workers assisting patients with end-stage cancer should carefully consider these findings.
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  • 文章类型: Case Reports
    恶意行为的特点是故意捏造和/或夸大症状以获得次要利益,在医疗机构中构成诊断挑战。在这份报告中,我们介绍了一名15岁的男性,有精神病史,他试图自杀以逃避法律判决,随后与另一名患者发生口吃。尽管最初担心脑震荡,进一步的评估显示,恶意是潜在的动机。这个案例突出了识别青少年恶意行为的重要性,这要求采取谨慎的方法和彻底的评估,以将其与真正的疾病区分开来。及早发现恶意行为可以优化资源分配,并确保为有真正医疗需求的患者提供适当的护理。
    Malingering is characterized by the deliberate fabrication and/or exaggeration of symptoms for secondary gain, posing a diagnostic challenge in healthcare settings. In this report, we present a 15-year-old male with a history of psychiatric disorders who attempted suicide to avoid legal sentencing, subsequently developing a stutter following an altercation with another patient. Despite initial concern for a concussion, further evaluation revealed malingering as the underlying motive. This case highlights the importance of identifying malingering in adolescents, which calls for a careful approach and thorough assessment for it to be distinguished from an authentic illness. Early identification of malingering optimizes resource allocation and ensures appropriate care for patients who have genuine medical needs.
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  • 文章类型: Journal Article
    目的:我们旨在揭示美国临床心理学研究的热点和发展趋势。
    方法:利用文献计量分析,我们研究了2010年至2022年在美国WebofScience数据库中发表的临床心理学论文,采用引文分析,内容分析,作者分析,和期刊分析。
    结果:我们的分析表明,临床心理学研究显着增加,特别是在2019年COVID-19大流行的催化下。这种激增在针对PTSD等精神障碍的研究中尤为明显,焦虑,和自杀行为,以及与家庭冲突等问题相关的心理创伤,虐待老人,集体创伤。此外,研究不同人群有明显的转变,包括性别和种族少数,母亲们,和青少年。治疗方法,例如基于正念的实践和人工智能辅助技术,也得到了突出。
    结论:这项研究代表了美国临床心理学领域的首次大规模文献计量学分析。我们的研究结果表明,COVID-19大流行凸显了研究与重大事件相关的心理问题的重要性。此外,研究人员越来越关注少数群体。这种趋势,随着大数据和人工智能等新技术的使用,指导未来的临床心理学研究。
    这篇综述的作品表明,临床心理学的变化,尤其是后COVID-19。大流行后增加的研究强调解决家庭冲突等社会问题引起的心理创伤,虐待老人,集体创伤。在研究中,向包容性的积极转变是显而易见的,关注不同的群体,如性别少数群体,少数民族,母亲们,和青少年。此外,对创伤后应激障碍等精神障碍的关注,焦虑,大流行期间的自杀行为强调需要量身定制的干预措施和支持系统。探索基于正念的实践和人工智能辅助技术等创新方法,展示了该领域在心理健康干预方面的适应性。
    OBJECTIVE: We aim to uncover the hot topics and development trends in clinical psychology research in the United States.
    METHODS: Utilizing bibliometric analysis, we examined clinical psychology papers published in the United States from 2010 to 2022 in the Web of Science database, employing citation analysis, content analysis, author analysis, and journal analysis.
    RESULTS: Our analysis revealed a significant increase in clinical psychology research, notably catalyzed by the 2019 COVID-19 pandemic. This surge was particularly evident in studies addressing mental disorders such as PTSD, anxiety, and suicidal behaviors, as well as psychological trauma related to issues like family conflict, elder abuse, and collective trauma. Furthermore, there was a distinct shift towards studying diverse populations, including gender and racial minorities, mothers, and adolescents. Therapeutic approaches, such as mindfulness-based practices and AI-assisted technologies, also gained prominence.
    CONCLUSIONS: This study represents the first large-scale bibliometric analysis in the field of clinical psychology in the United States. Our findings suggest that the COVID-19 pandemic highlights the importance of studying psychological issues linked to major events. Also, researchers are increasingly focusing on minority groups. This trend, along with the use of new technologies like big data and artificial intelligence, guides future research in clinical psychology.
    UNASSIGNED: The works in this review suggest that the changing landscape of clinical psychology, especially post-COVID-19. The increased research post-pandemic emphasizes addressing psychological trauma arising from societal issues like family conflicts, elder abuse, and collective trauma. A positive shift towards inclusivity is evident in research, focusing on diverse groups like gender minorities, racial minorities, mothers, and adolescents. Additionally, the amplified focus on mental disorders like PTSD, anxiety, and suicidal behaviors during the pandemic stresses the need for tailored interventions and support systems. Exploring innovative methods such as mindfulness-based practices and AI-assisted technologies showcases the field\'s adaptability in mental health interventions.
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  • 文章类型: Journal Article
    背景:1型糖尿病(T1DM)是一种严重的慢性病,影响了许多人。与T1DM相关的物理问题的讨论遍及文献,然而,关于心理后果的讨论较少。心理健康困难,在这个人群中存在述情障碍和不确定性,已知对发病有害,T1DM的维持和恶化。本研究旨在评估这些现象在T1DM患者中的存在。
    方法:将105名受T1DM影响的年龄在11至17岁(M:13.88;SD:2.16)的参与者纳入样本。为了评估心理健康困难的存在,SAFA量表(抑郁症,焦虑和躯体症状)与TAS-20和IUS-12一起包含在方案中,它们评估了运动障碍和对样本中不确定性的不耐受的存在和作用,分别。
    结果:A关于焦虑的存在,样本中发现了抑郁和躯体症状。心理健康问题似乎一直存在于样本中,经常克服病态的问题。述情障碍和不确定性也很常见,强调其在T1DM中的作用。
    结论:在患有糖尿病的青少年样本中,活跃的心理健康困难以及高的述情障碍和对不确定感的不耐受率普遍存在。
    BACKGROUND: Type 1 Diabetes Mellitus (T1DM) represents a serious chronic condition affecting a wide number of people. Discussion of the physical issues associated with T1DM pervades the literature, however, there is less discussion of the psychological consequences. Mental health difficulties, alexithymia and uncertainty are present in this population, and known to be harmful for the onset, maintenance and worsening of T1DM. This study aimed to evaluate the presence of these phenomena in people with T1DM.
    METHODS: 105 participants aged between 11 and 17 years old (M: 13.88; SD: 2.16) affected by T1DM were included in the sample. To assess the presence of mental health difficulties, SAFA scales (Depression, Anxiety and Somatic symptoms) were included in the protocol together with TAS-20 and IUS-12, which evaluate the presence and role of alexithymia and intolerance to uncertainty in the sample, respectively.
    RESULTS: A concerning presence of anxiety, depression and somatic symptoms was found in the sample. Mental health difficulties appeared to be consistently present in the sample, often overcoming pathological thesholds. Alexithymia and uncertainty were also common, highlighting their role in T1DM.
    CONCLUSIONS: Active mental health difficulties together with high rates of alexithymia and intolerance to uncertainty were prevalent in the sample of adolescents with diabetes.
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  • 文章类型: Journal Article
    本文研究了1930年代至1960年代美国一群松散联系的女性心理学家和医生对婴儿进行的电影摄影观察研究。今天基本上被遗忘了,这些从业者实现了详细的和精心计划的关于婴儿行为在各种环境中的研究项目-从实验室到婴儿诊所。尽管他们的研究与知名作品进行了对话,比如约翰·鲍比关于依恋的研究和勒内·斯皮茨关于机构婴儿的电影,他们在仔细研究婴儿的个体特征和对当代“病态母亲”概念的批判态度方面有所不同。在密切关注几位研究人员的工作中,包括但不限于儿科医生MargaretFries(1898-1987),临床心理学家SibylleEscalona(1915-96)和她的团队成员-儿童精神病学家MaryLeitch(1914-?)和前卫摄影师EllenAuerbach(1906-2004)-和心理学家AnnelieseKorner(1918-2010),我认为,他们的电影作品为20世纪中叶的婴儿研究和儿童精神病学提供了更细微的启示,并为性别的替代阅读开辟了一条道路,精神分析,和当时的科学观察。
    This article examines cinematographic observational studies of infants conducted by a loosely connected group of female psychologists and physicians in the USA from the 1930s to the 1960s. Largely forgotten today, these practitioners realized detailed and carefully planned research projects about infant behavior in a variety of settings-from the laboratory to the well-baby clinic. Although their studies were in conversation with better-known works, such as John Bowlby\'s research on attachment and René Spitz\'s films on institutionalized infants, they differed in a close examination of individual characteristics of babies and a critical attitude toward contemporary notions of \'pathological mothering\'. In closely following the work of several researchers, including but not limited to pediatrician Margaret Fries (1898-1987), the clinical psychologist Sibylle Escalona (1915-96) and her team members-child psychiatrist Mary Leitch (1914-?) and avant-garde photographer Ellen Auerbach (1906-2004)-and psychologist Anneliese Korner (1918-2010), I argue that their cinematographic works shed a more nuanced light on the landscape of infant research and child psychiatry in the mid 20th century, and open a way for alternative readings of gender, psychoanalysis, and scientific observation at that time.
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  • 文章类型: Journal Article
    在越来越多的国家,患者可以访问他们的完整在线临床记录,包括临床医生写的叙述性报告(后者,称为“开放说明”)。即使在有成熟患者在线记录访问的国家,获得心理治疗笔记不是强制性的。迄今为止,没有研究探讨心理治疗对学员开放笔记的看法。
    本研究旨在探讨瑞士心理治疗学员对患者“接触心理治疗师”的自由文本摘要的看法。
    我们对201名心理治疗学员进行了一项基于网络的混合方法调查,以探讨他们对患者的熟悉程度和对心理治疗实践的影响以及为患者提供在线访问心理治疗笔记的看法。采用描述性统计分析42项调查,定性描述性分析用于检查对四个开放式问题的书面答复。
    72名(35.8%)学员完成了调查。定量结果显示,人们对公开笔记的看法参差不齐。75%的人同意,总的来说,公开笔记是个好主意,94.1%的人同意开放笔记教育应该是心理治疗培训的一部分。当考虑对患者和心理治疗的影响时,出现了四个主题:(a)对治疗的负面影响;(b)对治疗的正面影响;(c)对患者的影响;(d)文档.学生确定了与工作量增加有关的问题,伤害心理治疗关系,记录质量受损。他们还确定了许多潜在的好处,包括更好的患者沟通和知情同意过程。在描述对不同治疗类型的影响时,学生们认为,开放笔记可能会有不同的影响取决于心理治疗方法。
    分享心理治疗笔记不是常规的,但可能会扩大。这项混合方法研究提供了对心理治疗学员关于公开笔记对患者护理和心理治疗实践的影响的观点的及时见解。
    UNASSIGNED: In a growing number of countries, patients are offered access to their full online clinical records, including the narrative reports written by clinicians (the latter, referred to as \"open notes\"). Even in countries with mature patient online record access, access to psychotherapy notes is not mandatory. To date, no research has explored the views of psychotherapy trainees about open notes.
    UNASSIGNED: This study aimed to explore the opinions of psychotherapy trainees in Switzerland about patients\' access to psychotherapists\' free-text summaries.
    UNASSIGNED: We administered a web-based mixed methods survey to 201 psychotherapy trainees to explore their familiarity with and opinions about the impact on patients and psychotherapy practice of offering patients online access to their psychotherapy notes. Descriptive statistics were used to analyze the 42-item survey, and qualitative descriptive analysis was employed to examine written responses to four open-ended questions.
    UNASSIGNED: Seventy-two (35.8%) trainees completed the survey. Quantitative results revealed mixed views about open notes. 75% agreed that, in general open notes were a good idea, and 94.1% agreed that education about open notes should be part of psychotherapy training. When considering impact on patients and psychotherapy, four themes emerged: (a) negative impact on therapy; (b) positive impact on therapy; (c) impact on patients; and (d) documentation. Students identified concerns related to increase in workload, harm to the psychotherapeutic relationship, and compromised quality of records. They also identified many potential benefits including better patient communication and informed consent processes. In describing impact on different therapy types, students believed that open notes might have differential impact depending on the psychotherapy approaches.
    UNASSIGNED: Sharing psychotherapy notes is not routine but is likely to expand. This mixed methods study provides timely insights into the views of psychotherapy trainees regarding the impact of open notes on patient care and psychotherapy practice.
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