TY - JOUR AU - Aref-Adib, Golnar AU - Landy, Gabriella AU - Eskinazi, Michelle AU - Sommerlad, Andrew AU - Morant, Nicola AU - Johnson, Sonia AU - Graham, Richard AU - Osborn, David AU - Pitman, Alexandra PY - 2020 DA - 20/7/29 TI -评估精神病患者的数字风险:混合方法研究精神病学学员的经验、观点和理解乔- JMIR表示“状态”健康SP - e19008六世- 7 - 7 KW -风险评估KW -互联网KW -自杀KW -有自伤行为KW -心理健康KW -精神病学家KW -混合方法KW -手机AB -背景:数字技术的使用可以帮助人们获取信息,对他们的心理健康问题提供支持,但它也可以暴露风险,如欺凌或prosuicide网站。在一般的精神病学风险评估中考虑与互联网相关的风险行为(数字风险)可能很重要，但没有研究探索精神科医生对此的实践或可接受性。目的:本研究旨在探讨精神科培训生对精神科数字风险的经验、看法和理解。我们预测，在儿童和青少年心理健康服务工作的受训人员中，临床医生的意识将是最高的。方法:我们对参加英国地区培训生会议的精神病学培训生进行了横断面调查，以调查他们如何例行评估患者的互联网使用和相关的伤害风险，以及他们评估这些风险的经验和信心。我们开展了焦点小组，进一步探讨学员对数字风险评估的理解和体验。定量资料采用描述性统计和卡方检验。采用专题分析来确定定性数据集中的关键专题。结果:横断面调查由312名精神病学学员中的113人完成(回复率36.2%)，来自不同的亚专科和经验水平。 Half of the trainees (57/113, 50.4%) reported treating patients exposed to digital risk, particularly trainees subspecializing in child and adolescent psychiatry (17/22, 77% vs 40/91, 44%;P=.02). However, 67.3% (76/113) reported not feeling competent to assess digital risk. Child and adolescent psychiatrists were more likely than others to ask patients routinely about specific digital risk domains, including reckless web-based behavior (18/20, 90% vs 54/82, 66%; P=.03), prosuicide websites (20/21, 95% vs 57/81, 70%; P=.01), and online sexual behavior (17/21, 81% vs 44/81, 54%; P=.02). Although 84.1% (95/113) of the participants reported using a proforma to record general risk assessment, only 5% (5/95) of these participants prompted an assessment of internet use. Only 9.7% (11/113) of the trainees had received digital risk training, and 73.5% (83/113) reported that they would value this. Our thematic analysis of transcripts from 3 focus groups (comprising 11 trainees) identified 2 main themes: barriers to assessment and management of digital risk, and the double-edged sword of web use. Barriers reported included the novelty and complexity of the internet, a lack of confidence and guidance in addressing internet use directly, and ongoing tension between assessment and privacy. Conclusions: Although it is common for psychiatrists to encounter patients subject to digital risk, trainee psychiatrists lack competence and confidence in their assessment. Training in digital risk and the inclusion of prompts in standardized risk proformas would promote good clinical practice and prevent a potential blind spot in general risk assessment. SN - 2368-7959 UR - http://mental.www.mybigtv.com/2020/7/e19008/ UR - https://doi.org/10.2196/19008 UR - http://www.ncbi.nlm.nih.gov/pubmed/32726288 DO - 10.2196/19008 ID - info:doi/10.2196/19008 ER -