| Background Using the theoretical framework of Bio-Psycho-Social Medical Model for reference,the project team tried to establish a simple and feasible the Integrated Diagnosis and Treatment Model of Physiological-Psychosocial-Ethics which based on domestic and foreign research results,expert opinions and clinical practice experience,and the model was verified the clinical effectiveness in cardiology department.Objective We want to revise the compiled assessment and indicators manual and the established procedure of the Integrated Diagnosis and Treatment Model to make it applicable to psychiatry,and we will verify the reliability and validity of them through clinical research.Methods In the first research,we sampled 143 patients with mental disorders and 286 subjects without mental disorders and the history of related medical disorders in various communities,hospitals and other places.We used the revised Assessment and Indicators Manual of the Integrated Diagnosis and Treatment Model to assess their mental symptoms,personality disorder tendency,coping style and social situation,and we verified the reliability and the validity.In the second research,we selected psychiatric inpatients from two hospitals as subjects,one of which did be the intervention group(62 people),using the integrated diagnosis and treatment model,and the other was the control group(67 people),using the conventional diagnosis and treatment model.By analyzing the psychosocial symptoms of the two groups at discharge and follow-up,we verified the feasibility and clinical effectiveness of the model.Results From the first research,the Cronbach’s α coefficients of each subscale in the evaluation manual are 0.818,0.728,0.701,0.722.The consistency reliability of scorers are 0.987,0.914,0.926,0.952 with significant correlation coefficient(P<0.01).The scores of all factors in the patients group are higher than those in the normal group with significant difference(P<0.01).From the second research,the scores of all factors of psychiatric symptoms in both groups were significantly lower than those before diagnosis and treatment(P<0.05).However,the scores of depression,irritability,anxiety,somatization,suicidal tendency,total score of psychiatric symptoms,mania and obsessive-compulsive factors of the intervention group were lower than those in the control group,and the difference was significant(the t values are 2.60,2.84,2.86,2.75,2.80,4.83,2.11,2.10,P<0.05).The scores of the total satisfaction of diagnosis and treatment service,the detailed inquiry of disease condition,the detailed inquiry of etiology,the explanation of disease knowledge,the explanation of diagnosis and treatment plan,the communication of diagnosis and treatment plan,the satisfaction of diagnosis and treatment effect,the awareness of diagnosis and treatment cost and the explanation of prognosis precautions of the intervention group were lower than those of the control group,and the difference was significant(the t values are 2.14,2.68,2.13,3.24,3.32,2.74,2.29,2.75,P<0.05).During follow-up,the scores of coping style and interpersonal relationship factors of the intervention group were lower than those before diagnosis and treatment,and the difference was significant(the t values are 4.47,3.49,P<0.01).The scores of coping style,interpersonal relationship and drug compliance factors of the intervention group were lower than those in the control group,and the difference was significant(the t values are 2.13,2.52,2.18,P<0.05).Conclusion The Assessment and Indicators Manual of the Integrated Diagnosis and Treatment Model has good reliability and validity,and it can be used to assess the psychosocial status of patients with mental disorders.The Integrative diagnosis and treatment model can alleviate the mental symptoms of patients,improve social function,improve medication compliance,and it is conducive to rehabilitation and prognosis.The Integrative diagnosis and treatment model is helpful to improve patientsatisfaction and to promote harmonious doctor-patient relationship. |
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