Clinician perceptions of nomothetic and individualized patient-reported outcome measures in measurement-based care

摘要

Objective: Measurement-based care (MBC), which encompasses routine outcome monitoring (ROM) and measurement feedback systems (MFSs), is an evidence-based practice (EBP) supporting treatment personalization and clinical responsiveness. Despite MBC's effectiveness, clinicians report reservations regarding its utility, which may be a function of overreliance on nomothetic (i.e., standardized) measures. Although research suggests that individualized (i.e., idiographic) patient-reported outcome measures (I-PROMs) may have the potential to overcome these obstacles, little is known regarding clinicians' perceptions of different measurement approaches to MBC. Methods: This study examined clinicians' perceptions of the clinical utility, relevance to treatment planning, and practicality of nomothetic, individualized, and combined clinical feedback provided by a simulated MFS. Three hundred and twenty-nine clinicians were randomized to one of three conditions that presented a clinical vignette comprising: (a) nomothetic, (b) individualized, or (c) combined clinical feedback. Results: Participants' perceptions of the clinical feedback were not affected by the measurement approach. However, cognitive behavioral participants reported more positive perceptions of all aspects associated with the clinical feedback. Conclusion: These results were consistent with previous findings, suggesting that clinicians' theoretical orientation may have a significant impact on their perceptions of MBC, and should be considered when designing and implementing these systems.