Training to enhance psychiatrist communication with patients with psychosis (TEMPO): cluster randomised controlled trial.

Autor:	McCabe R; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK r.mccabe@exeter.ac.uk., John P; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK., Dooley J; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK., Healey P; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK., Cushing A; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK., Kingdon D; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK., Bremner S; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK., Priebe S; Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Jazyk:	angličtina
Zdroj:	The British journal of psychiatry : the journal of mental science [Br J Psychiatry] 2016 Dec; Vol. 209 (6), pp. 517-524. Date of Electronic Publication: 2016 Jul 21.
DOI:	10.1192/bjp.bp.115.179499
Abstrakt:	Background: A better therapeutic relationship predicts better outcomes. However, there is no trial-based evidence on how to improve therapeutic relationships in psychosis. Aims: To test the effectiveness of communication training for psychiatrists on improving shared understanding and the therapeutic relationship (trial registration: ISRCTN94846422). Method: In a cluster randomised controlled trial in the UK, 21 psychiatrists were randomised. Ninety-seven (51% of those approached) out-patients with schizophrenia/schizoaffective disorder were recruited, and 64 (66% of the sample recruited at baseline) were followed up after 5 months. The intervention group received four group and one individualised session. The primary outcome, rated blind, was psychiatrist effort in establishing shared understanding (self-repair). Secondary outcome was the therapeutic relationship. Results: Psychiatrists receiving the intervention used 44% more self-repair than the control group (adjusted difference in means 6.4, 95% CI 1.46-11.33, P<0.011, a large effect) adjusting for baseline self-repair. Psychiatrists rated the therapeutic relationship more positively (adjusted difference in means 0.20, 95% CI 0.03-0.37, P = 0.022, a medium effect), as did patients (adjusted difference in means 0.21, 95% CI 0.01-0.41, P = 0.043, a medium effect). Conclusions: Shared understanding can be successfully targeted in training and improves relationships in treating psychosis. (© The Royal College of Psychiatrists 2016.)
Databáze:	MEDLINE
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