Structured patient-clinician communication using DIALOG improves patient quality of life.

摘要

Question: Dcfes the DIALOG computer based dialogue between patient and clinician affect patients' quality of life, need for care and treatment satisfaction? Patients- 507 adults (18-65 years) with schizophrenia or related disorders who were part of the caseload of 134 key workers who.agreed to participate. Key workers had to have a professional qualification in mental health or a minimum of 1 year's professional experience in an out-patient setting. Setting: Community psychiatric services in urban and mixed urban-rural areas in Spain, The Netherlands, UK, Sweden, Germany and Switzerland; December 2002 to May 2005. Intervention: DIALOG plus usual care or usual care alone. DIALOG was a computer-mediated structured process facilitating clinician-patient communication about patient needs, delivered every 2 months for a year during meetings scheduled as part of usual care. Clinicians using DIALOG assessed patient satisfaction with eight life domains (mental health, physical health, friendships and relationship with partner, personal safety, accommodation, job and leisure) and three domains to do with their treatment (medication, psychological help, practical help). Items were rated by the patient on a scale of 1 (couldn't be worse) to 7 (couldn't be better). Patients were also able to say whether they wanted different or additional help in any of the domains. The DIALOG'S flexible interface allowed clinicians to view the domains alongside each other, to compare previous and current ratings for all domains, or to view a summary of changes in points since the last meeting. The focus was on changing interactions between patient and clinician so that' patient's views and ideas about what would improve their treatment became the central focus of the sessions.