TY - JOUR AU - van der Krieke, Lian AU - Emerencia, Ando C AU - Boonstra, Nynke AU - Wunderink, Lex AU - de Jonge, Peter AU - Sytema, Sjoerd PY - 2013 DA - 2013/10/07 TI -支持精神病患者共享决策的基于web的工具:随机对照试验和过程评估JO - J Med Internet Res SP - e216 VL - 15 IS - 10kw -精神病，精神分裂症KW -计算机KW -计算机辅助决策KW -共享决策KW -可行性研究，随机临床试验AB -背景:精神健康政策制定者鼓励开发电子决策辅助工具，以增加患者参与医疗决策。需要有证据来确定这些辅助决策在临床实践中是否有帮助，以及它们是否会增加患者的参与和更好的结果。目的:本研究报告了一项随机对照试验的结果和基于web的干预过程评估，以促进精神病患者的共享决策。方法:研究在荷兰的一家精神健康机构进行。患者来自2个精神病患者门诊小组(N=250)。在干预条件下(n=124)，为患者提供了一个帐户，以访问基于web的信息和决策工具，该工具旨在支持患者获得其需求的概述和由其精神卫生保健组织提供的适当治疗方案。病人可以自己(在家里的电脑上或在服务的电脑上)使用基于网络的工具，也可以在助手的支持下使用。对照组患者照例治疗(n=126)。样本中有一半的患者是首次精神病发作的患者; the other half were patients with a chronic psychosis. Primary outcome was patient-perceived involvement in medical decision making, measured with the Combined Outcome Measure for Risk Communication and Treatment Decision-making Effectiveness (COMRADE). Process evaluation consisted of questionnaire-based surveys, open interviews, and researcher observation. Results: In all, 73 patients completed the follow-up measurement and were included in the final analysis (response rate 29.2%). More than one-third (48/124, 38.7%) of the patients who were provided access to the Web-based decision aid used it, and most used its full functionality. No differences were found between the intervention and control conditions on perceived involvement in medical decision making (COMRADE satisfaction with communication: F1,68=0.422, P=.52; COMRADE confidence in decision: F1,67=0.086, P=.77). In addition, results of the process evaluation suggest that the intervention did not optimally fit in with routine practice of the participating teams. Conclusions: The development of electronic decision aids to facilitate shared medical decision making is encouraged and many people with a psychotic disorder can work with them. This holds for both first-episode patients and long-term care patients, although the latter group might need more assistance. However, results of this paper could not support the assumption that the use of electronic decision aids increases patient involvement in medical decision making. This may be because of weak implementation of the study protocol and a low response rate. Trial Registration: Dutch Trial Register (NTR) trial number: 10340; http://www.trialregister.nl/trialreg/admin/rctsearch.asp?Term=10340 (Archived by WebCite at http://www.webcitation.org/6Jj5umAeS). SN - 14388871 UR - //www.mybigtv.com/2013/10/e216/ UR - https://doi.org/10.2196/jmir.2851 UR - http://www.ncbi.nlm.nih.gov/pubmed/24100091 DO - 10.2196/jmir.2851 ID - info:doi/10.2196/jmir.2851 ER -