Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Điều trị trẻ em hay hội chứng: Ngữ cảnh có quan trọng cho quyết định điều trị đối với thanh thiếu niên có hành vi chống đối?
Tóm tắt
Bằng cách sử dụng thiết kế giữa các đối tượng 3 × 3 với một trường hợp thực nghiệm mô tả thanh thiếu niên da màu, da trắng và gốc Tây Ban Nha trong một cuộc khảo sát gửi qua bưu điện tới 1540 nhà tâm lý học, bác sĩ tâm thần và nhân viên xã hội có kinh nghiệm, các tác giả đã xem xét liệu các nhà lâm sàng có thay đổi đánh giá về điều trị cho thanh thiếu niên có hành vi chống đối dựa trên ngữ cảnh xã hội của triệu chứng (ví dụ: hoàn cảnh sống) và chủng tộc hoặc dân tộc của thanh thiếu niên hay không, ngay cả trong trường hợp thanh thiếu niên hoàn toàn giống nhau về các triệu chứng hành vi. Các mô tả này chứa đựng các hành vi đáp ứng tiêu chí của DSM-IV về rối loạn hành vi, nhưng có thông tin ngữ cảnh gợi ý sự rối loạn nội bộ (ID) hoặc phản ứng bình thường đối với một môi trường khó khăn (tức là, phản ứng môi trường [ER]). So sánh được thực hiện giữa chỉ triệu chứng (SO). Các đánh giá về hiệu quả của 14 phương pháp điều trị cho thanh thiếu niên có hành vi chống đối đã được xem xét. Tần suất và điểm trung vị của mức độ hiệu quả nhận thức (1–9, Likert) đã được so sánh trong các phân tích bivariate, phân tầng ngữ cảnh và chủng tộc hoặc dân tộc của thanh thiếu niên. Ngữ cảnh hành vi có sự liên quan đáng kể với sự khác biệt trong các đánh giá hiệu quả ở 13 trên 14 phương pháp điều trị. Trong các ngữ cảnh ID và ER, các nhà lâm sàng đã đánh giá ba phương pháp điều trị khác nhau là hiệu quả (điểm trung vị ≥ 7 trên 9). Trong điều kiện SO, các nhà lâm sàng lựa chọn ít hơn, đánh giá sáu phương pháp là hiệu quả. Trong ngữ cảnh ID, thuốc tâm thần, liệu pháp gia đình theo hệ thống và chăm sóc nội trú được đánh giá hiệu quả hơn cho thanh thiếu niên da trắng so với thanh thiếu niên da đen hoặc gốc Tây Ban Nha. Nghiên cứu thực hành dựa trên bằng chứng có thể bị cản trở bởi sự chú ý không đầy đủ đến ngữ cảnh xã hội của các triệu chứng hành vi. Ngữ cảnh có thể kích hoạt những giả định về chủng tộc tiềm ẩn về hiệu quả điều trị. Ý nghĩa là cần cải thiện đào tạo lâm sàng để nâng cao chất lượng dịch vụ và nghiên cứu lâm sàng trong tương lai.
Từ khóa
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