Abstract

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.

摘要

目标：基于测量的护理 (MBC)，包括常规结果监测 (ROM) 和测量反馈系统 (MFS)，是一种支持治疗个性化和临床反应的循证实践 (EBP)。尽管 MBC 有效，但临床医生报告对其效用持保留态度，这可能是过度依赖标准（即标准化）措施的结果。尽管研究表明个体化（即具体的）患者报告结果测量 (I-PROM) 可能有可能克服这些障碍，但对于临床医生对 MBC 不同测量方法的看法知之甚少。方法：本研究检查了临床医生对模拟 MFS 提供的临床实用性、与治疗计划的相关性以及单论、个性化和组合临床反馈的实用性的看法。329 名临床医生被随机分配到呈现临床小插曲的三种情况之一，包括：(a) nomothetic，(b) 个体化，或 (c) 联合临床反馈。结果：参与者对临床反馈的看法不受测量方法的影响。然而，认知行为参与者报告了对与临床反馈相关的所有方面的更积极的看法。结论：这些结果与之前的研究结果一致，表明临床医生的理论取向可能会对他们对 MBC 的看法产生重大影响，在设计和实施这些系统时应予以考虑。