Use of outcome measurements in clinical practice: How specific should one be?
| Autor: | Fabiana Engelsbel, Gabrielle Van Son, M. Annet Nugter, Jan Theunissen, Sylvana Robbers, Marleen L.M. Hermens |
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| Přispěvatelé: | APH - Mental Health, Psychiatry |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 050103 clinical psychology medicine.medical_specialty Psychotherapist Outcome measurements Measure (physics) Cohort Studies 03 medical and health sciences 0302 clinical medicine Outcome Assessment Health Care medicine Humans 0501 psychology and cognitive sciences Medical physics Psychiatric Status Rating Scales Depressive Disorder 05 social sciences Middle Aged Combined Modality Therapy humanities 030227 psychiatry Clinical Practice Psychotherapy Clinical Psychology Case-Control Studies Female Psychology |
| Zdroj: | Psychotherapy Research, 29(4), 432-444. Routledge Nugter, M A, Hermens, M L M, Robberts, S, Van Son, G, Theunissen, J & Engelsbel, F 2019, ' Use of outcome measurements in clinical practice : How specific should one be? ', Psychotherapy Research, vol. 29, no. 4, pp. 432-444 . https://doi.org/10.1080/10503307.2017.1408975 |
| ISSN: | 1468-4381 1050-3307 |
| DOI: | 10.1080/10503307.2017.1408975 |
| Popis: | Objective: Progress feedback is often measured with generic instruments that measure common symptoms and generic aspects of functioning. The current study aims to explore the relative usefulness of disorder-specific measures. We hypothesized that disorder-specific instruments reveal more improvement than generic instruments and that the addition of disorder-specific instruments results in better treatment outcomes. Method: We used a cohort of 3419 patients with a depression. As generic measures, we used the BSI or the symptoms distress subscale of the OQ-45. In 946 patients, a specific instrument, the IDS-SR, was added. We compared mean change scores and percentages of clinical significant change. In a matched case control design, we analyzed whether the additional use of the IDS-SR resulted in better treatment outcomes. Results: Mean change scores of both types of instruments were comparable. When comparing clinical significant change, agreement was moderate. We found better outcomes on the generic instruments when both a generic and a disorder-specific instrument were used. Conclusion: In individual treatment of depression, generic and disorder-specific instruments are not interchangeable. The additional use of disorder-specific instruments provides a more complete picture of the patient’s progress than the use of a generic instrument alone. Clinical or methodological significance of this article: In outcome management often rather generic instruments are used, that do not address the specific symptoms of the primary diagnosis of patients. In daily practice clinicians do not always use the feedback on treatment progress, when they perceive the feedback as not specific or relevant enough. The current study aims to explore the relative usefulness of measures that focus on symptoms that characterize the primary diagnosis of patients with a depression compared to the generic measures. We used a large cohort of existing data of patients of several mental health care organizations that share an application for outcome measurement. First, we compared outcomes of generic instruments and a disorder-specific instrument of a subsample of patients with a depressive disorder that completed both kinds of instruments. Next, we applied a matched case control design to control for differences between patients and analyzed whether the additional use of disorder-specific instruments predicted better outcomes. With this methodology, we tried to optimize both the methodological quality as well as the clinical significance of our research. |
| Databáze: | OpenAIRE |
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