evidence-based practices

循证实践
  • 文章类型: Journal Article
    会议计划是实施循证实践(EBP)的核心活动,然而,尚不清楚公共心理健康机构是否为治疗师提供会议计划的支持。这项由两部分组成的研究与费城公共心理健康系统的EBP领导人合作,采用了混合方法来检查治疗师的会议计划实践和偏好。在研究1中,61名公共心理健康治疗师完成了一项在线调查,以确定会议计划障碍和促进者,目前的做法,和期望的规划支持。在研究2中,九位将会议计划工具列为研究1中的首选支持的治疗师参加了两个焦点小组,以详细说明他们的调查回应,并就三个会议计划工具原型提供反馈。研究1调查受访者列举了会议计划的多层次障碍和促进者。在封闭式和开放式回应中,分别通过内容分析和描述性分析,治疗师描述想要更多的时间,案件量较低,会议计划的财政激励措施,以及额外的临床资源和培训指导,同行,和主管支持会议计划。研究2焦点小组参与者,他们的回答使用内容分析进行了分析,重申需要这些多层次的支持,并表示需要一个免费的“一站式”会议计划工具数据库,易于搜索,并且可根据不同的临床需求进行修改。审查的所有三个会议计划工具原型都是可以接受的;两个也被认为是可行和适当的。对EBP实施过程中研究不足的方面的调查表明,需要多层次的会话计划支持。
    Session planning is a core activity for implementing evidence-based practices (EBPs), yet it is unknown whether public mental health settings provide the support for therapists to session plan. This two-part study conducted in collaboration with EBP leaders in Philadelphia\'s public mental health system deployed mixed methods to examine therapists\' session planning practices and preferences. In Study 1, 61 public mental health therapists completed an online survey to identify session planning barriers and facilitators, current practices, and desired planning supports. In Study 2, nine therapists who ranked a session planning tool as a top choice support in Study 1 participated in two focus groups to elaborate on their survey responses and provide feedback on three session planning tool prototypes. Study 1 survey respondents cited multi-level barriers and facilitators to session planning. In both closed- and open-ended responses, analyzed descriptively and via content analysis respectively, therapists described wanting more time, lower caseloads, financial incentives for session planning, and additional clinical resources and guidance from trainings, peers, and supervisors to support session planning. Study 2 focus group participants, whose responses were analyzed using content analysis, reiterated the need for these multi-level supports and expressed the need for a \"one-stop\" database of session planning tools that would be free, easily searchable, and modifiable for varied clinical needs. All three session planning tool prototypes reviewed were acceptable; two were also considered feasible and appropriate. This investigation of an under-studied aspect of the EBP implementation process reveals the need for multi-level session planning supports.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    诸如国家自闭症证据与实践信息交换所之类的组织已经为自闭症患者传播了有关循证实践(EBP)的报告,以告知实践。然而,一些从业者通常比EBP更频繁地采用未经验证的干预措施,表明存在研究到实践的差距。当前的评论调查了针对自闭症小学学生的社交交流结果的单案例研究的程度,包括了可能影响EBP在实践中采用和实施的变量的详细信息。结果表明,在采用和实施EBP时,有助于决策的变量报告有限。有限的报告可能会对摄取和保真度产生负面影响,因此,学生成果。建议提高研究人员对EBP关键组成部分的报告,以促进从业人员的采用和实施。
    Organizations such as the National Clearinghouse on Autism Evidence and Practice have disseminated reports on evidence-based practices (EBPs) for individuals with autism to inform practice. However, some practitioners routinely employ unvalidated interventions more frequently than EBPs, signaling the presence of a research-to-practice gap. The current review investigated the degree to which single-case research studies with social communication outcomes for elementary-aged students with autism included details on variables that may impact the adoption and implementation of EBPs in practice. The results suggest limited reporting of variables that aid decision-making in the adoption and implementation of EBPs. Limited reporting can negatively impact uptake and fidelity and, therefore, student outcomes. Suggestions are made to improve researchers\' reporting of the critical components of EBPs that will facilitate adoption and implementation by practitioners.
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  • 文章类型: Journal Article
    科学诚信是循证实践(EBP)的基础,也是音乐疗法(MT)研究和临床实践中必不可少的。在国家自闭症中心(NAC)和国家自闭症证据与实践信息交换所(NCAEP)如何分析研究的背景下,研究人员对音乐治疗师(MT)与自闭症谱系个体采用的方法和干预措施进行了综合审查。研究人员确定了880个符合初始搜索标准的数据库记录(即,自闭症谱系障碍,自闭症,PDD-NOS,MT,和音乐干预);在筛查重复后,仍有36项研究,主题相关性,并遵守纳入标准。纳入的研究发表在1964年至2021年之间,以英语,在免费的开放获取期刊上,全球;同行评审;由MT进行;经验定量,定性,或混合方法设计;基于干预;并为自闭症谱系的参与者提供单独的数据。内容和定量分析确定了科学完整性方面的缺陷以及所审查研究中的以下差距:运动技能和位置(NAC定义的干预目标),基于计算机和歌曲创作和作曲(MT技术),以及音乐指导图像的健康和Bonny方法(临床方法);在使用MT技术和方法的NAC干预中,没有明显的模式。对5点科学绩效评级的分析得出平均2.78评级。NAC和NCAEP术语的比较(即,MT研究人员如何报告自变量)表明八个标题提到了特定的非音乐干预措施,19提到MT,14包括基于音乐的技术描述符,两个提到了非音乐干预和MT。研究人员提供有关包含身份的语言的指南,科学诚信,以及对自闭症谱系个体的MT干预研究中EBP的清晰度。
    Scientific integrity is fundamental to evidence-based practice (EBP) and essential in music therapy (MT) research and clinical practice. Researchers conducted an integrative review of approaches and interventions employed by music therapists (MTs) with individuals on the autism spectrum in the context of how studies are analyzed by the National Autism Center (NAC) and National Clearinghouse on Autism Evidence and Practice (NCAEP). Researchers identified 880 database records meeting initial search criteria (i.e., autism spectrum disorder, autism, PDD-NOS, MT, and music interventions); 36 studies remained after screening for duplication, topic relevance, and adherence to inclusion criteria. Included studies were published between 1964 and 2021, in English language, in free open-access journals, worldwide; peer reviewed; conducted by MTs; empirical quantitative, qualitative, or mixed-methods design; intervention-based; and presented separate data for participants on the autism spectrum. Content and quantitative analyses identified deficits in scientific integrity and the following gaps in studies reviewed: Motor Skills and Placement (NAC-defined intervention targets), Computer-based and Songwriting and Composition (MT techniques), and Wellness and Bonny Method of Guided Imagery in Music (clinical approaches); no patterns were evident among NAC Interventions with MT techniques and approaches. Analysis of 5-point Scientific Merit Ratings yielded a mean 2.78 rating. A comparison of NAC and NCAEP terminology (i.e., how MT researchers report independent variables) indicated eight titles mention specific non-music interventions, 19 mention MT, 14 include music-based technique descriptors, and two mention both non-music interventions and MT. Researchers offer guidelines regarding identity-inclusive language, scientific integrity, and clarity of EBPs within MT intervention research with individuals on the autism spectrum.
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  • 文章类型: Journal Article
    这项调查研究调查了164名在职特殊教育教师在美国跨分类教师准备计划中对培训策略的看法,以发展系统教学中的知识和技能,为有广泛支持需求的学生提供循证实践。评估了基于课堂和基于现场的培训策略,以及教师对各种培训策略的贡献和重要性的看法。卡方检验结果,皮尔逊相关性,多变量协方差分析,和协方差分析的重复测量表明,教师在退出课程和教导残疾学生后,感到准备实施系统的指导,培训策略的感知有效性与教师经验有关。教师在大学教室和基于现场的环境中感知建模和接收绩效反馈,以促进他们在系统教学中的知识和技能发展。我们从对实践和未来研究的意义方面介绍了结果。
    This survey study examined 164 in-service special education teachers\' perceptions of training strategies in their cross categorical teacher preparation program in the United Sates for developing knowledge and skills in systematic instruction, an evidence-based practice for students with extensive support needs. Both classroom-based and field-based training strategies were evaluated along with teachers\' perceptions of the contribution and importance of the various training strategies. Results from Chi-square tests, Pearson correlations, multivariate analysis of covariance, and repeated measures of analysis of covariance indicated that teachers felt prepared to implement systematic instruction after exiting their program and after teaching students with disabilities, and the perceived effectiveness of training strategies was related to teacher experience. Teachers perceived modeling and receiving performance feedback in both university classrooms and field-based settings to contribute to their knowledge and skill development in systematic instruction. We present the results in terms of implications for practice and future research.
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  • 文章类型: Journal Article
    目的本研究旨在评估实施增强的产前遗传检查表的效果,以指导提供者在初次产前检查时对胎儿非整倍体检测的筛查和诊断选择的讨论。方法采用回顾性质量改进(QI)项目,大,城市学术医疗中心。该项目的实施是有前景的;然而,在实施QI计划3个月后对数据进行回顾性检查.如果患者小于24周孕龄,在初次产科(OB)就诊时进行了子宫内动态妊娠,则将其包括在内。在初次OB就诊时年龄小于18岁的患者被排除在外。使用统计软件R对结果进行分析。卡方检验用于检查干预前后组之间在人口统计学和临床特征方面的比例差异,并记录了遗传咨询讨论。结果最终队列共纳入416例患者。根据文档衡量,诊断性产前基因检测的讨论率从干预前的54%增加到干预后的72%(p<0.001)。在对高龄产妇的亚组分析中,诊断性产前基因检测的讨论率从干预前的53%上升到干预后的83%(p=0.003),初次产前检查时的遗传学咨询转诊率显着从干预前的4%增加到干预后的38%(p<0.001)。结论使用增强的产前遗传检查表导致对诊断胎儿非整倍体测试的讨论增加,并增加了转诊到遗传学咨询的比率。
    Aim This study aims to assess the effect of implementing an enhanced prenatal genetic checklist to guide the provider\'s discussion on both screening and diagnostic options for fetal aneuploidy testing at the initial prenatal visit. Methods A retrospective quality improvement (QI) project was performed at a single, large, urban academic medical center. The implementation of this project was prospective; however, data was examined retrospectively after the QI initiative was implemented for three months. Patients were included if they were less than 24 weeks gestational age with a live intrauterine gestation at their initial obstetric (OB) visit. Patients less than 18 years old at the initial OB visit were excluded. The results were analyzed using the statistical software R. Chi-squared tests were used to examine proportional differences between the pre- and post-intervention groups with respect to demographic and clinical characteristics and documented genetic counseling discussions. Results A total of 416 patients were included in the final cohort. As measured by documentation, the rate of discussion of diagnostic prenatal genetic testing increased significantly from the pre-intervention proportion of 54% to the post-intervention proportion of 72% (p < 0.001). In the subgroup analysis of patients with advanced maternal age, the rate of discussion of diagnostic prenatal genetic testing increased significantly from the pre-intervention proportion of 53% to the post-intervention proportion of 83% (p = 0.003), and the rate of genetics counseling referrals made at the initial prenatal visit increased significantly from 4% pre-intervention to 38% post-intervention (p < 0.001). Conclusions The use of an enhanced prenatal genetic checklist led to increased discussion of diagnostic fetal aneuploidy testing and increased rates of referral to genetics counseling.
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  • 文章类型: Journal Article
    随着对姑息治疗的需求不断增加,在人口变化和医疗进步的推动下,由于研究有限,循证实践面临障碍。复杂的患者状况和道德考虑挑战传统的方法,而缺乏全面的临床试验阻碍了创新的干预措施。赋予从业者研究技能和建立姑息治疗研究网络是旨在弥合这些差距的努力。重要的是要强调,这些举措集体渴望加强循证实践,确保为面临严重疾病的个人提供优质护理。
    Amid the increasing demand for palliative care, driven by demographic shifts and medical progress, evidence-based practices face obstacles due to limited research. Complex patient conditions and ethical considerations challenge traditional methodologies, while the absence of comprehensive clinical trials hinders innovative interventions. Empowering practitioners with research skills and establishing a palliative care research network are efforts aimed at bridging these gaps. It is important to emphasise that these initiatives collectively aspire to enhance evidence-based practices, ensuring quality care for individuals facing severe illnesses.
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  • 文章类型: Journal Article
    退伍军人事务部成立了调整咨询服务(RCS),以满足现役军人的精神健康需求,退伍军人,和他们的家人。需要多样化的治疗技能来服务于这种复杂的人群。为了评估培训需求,国家混合方法需求评估,包括对RCS辅导员的调查和辅导员之间的焦点小组,RCS教育培训师,进行了国家领导。调查结果显示(n=681),RCS辅导员对道德伤害培训最感兴趣,接受和承诺疗法,和军事性创伤(MST)。所需的培训与所服务的人群一致。焦点小组的主题表明需要进行基础培训,以便所有RCS顾问都能熟练治疗MST,道德伤害,和创伤后障碍,精通照顾夫妻。此外,辅导员希望根据个别辅导员的需求量身定制高级培训。RCS顾问确定了多种培训,以帮助他们对待他们所服务的人。
    The Department of Veteran Affairs established Readjustment Counseling Service (RCS) to meet the mental health needs of active-duty service members, veterans, and their families. A diverse therapeutic skill set is needed to serve this complex population. To assess training needs, a national mixed-methods needs assessment consisting of a survey for RCS counselors and focus groups among counselors, RCS educational trainers, and national leadership was conducted. Survey results (n = 681) showed that RCS counselors were most interested in trainings on moral injury, acceptance and commitment therapy, and military sexual trauma (MST). Desired trainings aligned with populations served. Themes from focus groups revealed the need for foundational trainings so that all RCS counselors are adept in treating MST, moral injury, and posttraumatic disorder and proficient in caring for couples. Additionally, counselors desired advanced trainings tailored to individual counselors\' needs. RCS counselors identified multiple trainings to help them treat those they serve.
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  • 文章类型: Journal Article
    研究表明,视频建模对于培训成人服务提供商对自闭症儿童实施循证实践是有效的。这项研究检查了视频建模训练(VMT)对同伴介导的社交互动(PMSI)的神经典型青少年表现的影响,简化行为实践的10步程序,在和成年演员的角色扮演中。跨参与者的多探针设计评估了VMT对五个神经典型青少年PMSI递送的影响。所有参与者都表现出立即增加和向VMT后的四名自闭症青少年普遍递送PMSI。在同伴介导的环境中进行评估时,另外两名自闭症青年的社交互动也得到了改善,作为社会有效性的衡量标准,VMT之前和之后。
    Research has shown video modeling to be effective for training adult service providers to administer evidence-based practices to children with autism. This study examined the effects of video modeling training (VMT) on neurotypical adolescents\' performance of peer mediated social interaction (PMSI), a 10-step procedure of simplified behavioral practices, during roleplay with an adult actor. A multiple probe design across participants evaluated the effects of VMT on delivery of PMSI by five neurotypical adolescents. All participants demonstrated immediate increases and generalized delivery of PMSI to four adolescents with autism following VMT. Social interaction for two additional youths with autism also improved when evaluated within a peer mediated setting, as a measure of social validity, before and after VMT.
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