精神科医生对迟发性运动障碍的认知及临床实践状况调查  

Psychiatrists' knowledge and clinical practice in tardive dyskinesia

作　　者：孙振晓[1] 孙宇新[2] 于相芬[1] 

机构地区：[1]临沂市精神卫生中心精神科,山东临沂276005 [2]山东大学医学院,山东济南250012

出　　处：《临床荟萃》2018年第3期214-216,220,共4页Clinical Focus

摘　　要：目的探讨精神科医生对迟发性运动障碍(TD)的认知及临床实践状况。方法应用自行设计的TD知识及态度问卷对106名临沂市精神科医生进行调查。结果精神科医生对TD临床表现项目掌握情况最好(86.79%),发病机制项目掌握情况最差(56.60%)。市级精神科医生对TD基础知识的掌握情况好于县区级精神科医生(P<0.01)。98.11%的精神科医生认为有必要进行TD诊断和治疗的培训,81.13%的医生接受过TD诊断和治疗的培训,其中,仅62.79%的医生接受过正规课程培训,34.92%的医生对TD的诊断和治疗没有信心。91.51%的医生认为在应用抗精神病药物前,应与患者及家属讨论TD发生的危险性,但仅76.42%的医生在临床实践中常规执行。98.11%的医生认为在应用抗精神病药物期间,应监测异常不自主运动,但仅74.52%的医生常规监测,53.77%的医生作监测结果记录。65.10%的医生认为TD是造成医疗纠纷及诉讼的原因之一,76.41%的医生认为没有患者的同意,抗精神病药物不得长期超适应证使用。结论应加强对精神科医生TD知识的培训,在临床工作中,应严格执行知情告知并常规监测TD的发生。Objective To explore the psychiatrists' knowledge and clinical practice in tardive dyskinesia(TD).Methods Investigations were conducted with a self-made questionnaire of psychiatrists' knowledge and attitude in tardive dyskinesia in 106 psychiatrists.Results The psychiatrists' basic knowledge in TD was not enough comprehensive from clinical manifestations(86.79%)to pathogenesis(56.60%).The municipal psychiatrists' basic knowledge in TD was better than the county level psychiatrists(P <0.01).A total of 98.11% of psychiatrists agreed that there should be a training in diagnosis and treating of TD,a total of 81.13% of psychiatrists had a training in diagnosis and treating of TD,a total of 62.79% of psychiatrists had accepted a training of formal course.A total of 34.92% of psychiatrists were not in confidence about diagnosis and treating of TD.Totally,91.51% of psychiatrists approved that psychiatrists should discuss the risk of TD before prescribing antipsychotics,however,76.42% of psychiatrists routinely discussed the risk of TD before prescribing antipsychotics.Totally,98.11% of psychiatrists approved that psychiatrists should monitor abnormal movements in patients with antipsychotics,however,74.52% of psychiatrists routinely monitored abnormal involuntary movements and 53.77% of psychiatrists routinely documented the outcome of monitoring.Totally,65.10% of psychiatrists approved that TD should be a cause for medical disputes and litigation,however,76.41% of psychiatrists approved that antipsychotics should not be prescribed for a long-term time with unlicensed indications without the patient's consent.Conclusion Psychiatrists should strengthen the training of knowledge of TD,and strictly provide information to patients in the risk of TD and routinely monitor in clinical work.

关 键 词：运动障碍 认知 精神科医生 

分 类 号：R745.1[医药卫生—神经病学与精神病学]