精神分裂症认知行为治疗技术专家共识的德尔菲法 研究
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Expert consensus on cognitive behavioral therapy for schizophrenia: A Delphi study
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    摘要:

    目的 采用德尔菲法调查国内精神分裂症认知行为治疗(CBT)技术的应用现状,进一步 规范国内精神分裂症CBT技术。方法 在文献复习、专家论证会基础上制订专家咨询表,经过两轮专 家咨询,对各项技术成分从可操作性、使用频率、对治疗效果的贡献及来访者的可接受性4 个不同维度 进行综合评价,根据各项技术综合秩次大小进行排序;采用描述性统计分析的方法对专家基本情况、专 家意见集中程度及协调程度进行分析,并评价专家咨询的可靠性。结果 (1)参与本研究的23 位专家平 均权威系数为0.84,专家积极系数均为100%。(2)经过两轮咨询,在四个维度上评分的变异系数> 0.30 的技术明显减少,全部技术的协调系数在0.4~0.5。(3)综合4 个维度的权重,根据各项技术成分综合秩 次大小排出46 项技术的顺序,前35 位的技术成分除行为激活、声音日记外在各个维度上均达成专家共 识,排序为36~46 位的主要是针对阴性症状的治疗技术专家意见存在一定程度分歧。结论 本研究的 专家积极程度高,权威性高,结果可靠;专家意见的协调程度较好;经过两轮咨询,综合4 个不同维度确 定了46 项技术的权重。

    Abstract:

    Objective To investigate the domestic application of cognitive behavioral therapy (CBT) for schizophrenia by Delphi method, in order to further standardize CBT for schizophrenia in China. Methods Expert consultant questionnaire was formulated on the basis of literature review and experts discussion. After two rounds of expert consultation, the technical components were evaluated comprehensively from four different dimensions: operability, frequency of use, contribution to therapeutic effect and acceptability of visitors, sorted according to the comprehensive technical rank. Descriptive statistical analysis was used to analyze the basic information of experts, the degree of concentration and coordination of experts' opinion. Reliability of the study was appraised by analyzing initiative and authority of experts. Results The average authority coefficient of the 23 experts was 0.84, and the initiative coefficient was 100%. After two rounds' of expert consultation, the techniques with variation coefficient over 0.30 in four dimensions were reduced significantly. The overall coordination coefficient of the four dimensions ranged from 0.4 to 0.5. 46 technique components were sorted according to integrated rank size. The top 35 technical components reach expert consensus in all dimensions except behavioral activation and voice diary. There was a certain degree of disagreement for the techniques ranking from 36 to 46 in treating negative symptoms. Conclusions The experts exert high enthusiasm into the study and have a high authority level. The result of the study is reliable. The coordination of the experts' opinions is high. The weights of techniques are determined and the rank of 46 technique components is achieved through two rounds of expert consultation.

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付兆燕 李占江 郭志华 李平 马云.精神分裂症认知行为治疗技术专家共识的德尔菲法 研究[J].神经疾病与精神卫生,2018,18(8):
DOI :10.3969/j. issn.1009-6574.2018.08.010.

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  • 在线发布日期: 2018-10-29