【摘要】 目的:"中国挪威联合精神卫生法律与伦理培训"是我国精神卫生法律和伦理建设的一次重要实践,本研究对其效果做出评估。方法:采用集中周期式培训模式、建立标准化培训模块(精神卫生法律知识、业务知识和应用案例),对40名省级重性精神疾病防治医疗技术负责人开展培训。采用自编问卷对40名培训对象在培训前后进行综合能力测评,以同期未接受培训的医疗技术负责人为对照做比较,通过演讲竞赛评价,比较培训组与对照组的法律及伦理教学能力。结果:培训后省级医疗技术负责人在法律知识、业务知识和应用水平三方面测评分数均提高(P<0.01),且评分显著高于对照组(P<0.01);他们在教学内容和方式上的法律与伦理教学能力评分也显著高于未接受培训的医疗技术负责人。结论:培训效果显著,可作为精神科医师的继续教育模式加以推广。更多还原

【Abstract】 Objective:The significance of legal and ethical construction in psychiatry was paid close attention in recent years.Academic institutions and psychiatric societies or associations in China began to develop strategies and programs to accelerate the development of Chinese Mental Health Law,standardize health practice of psychiatrists,protect patients’ rights and lead advocacy on medical ethics.However,evidence-based strategies were limited,and more work could be done to identify effective programs.This paper is to present a survey result of effectiveness evaluation of China-Norway Workshop on Mental Health Act and Ethics in Psychiatry which is an important implementation to promote education on mental health regulations and ethics.Methods:With key responsibilities of guiding psychiatrists to manage mental health practice in accordance with relevant laws and providing lifelong trainings for psychiatrists,Chinese Psychiatrist Association successfully built up collaboration with the Norwegian Medical Association,a training institution designated by World Psychiatry Association for legislation and medical ethics.Based on in-depth discussions and effective pilot trainings conducted in 2006 and 2007,a conceptual framework of collaboration was refined into training strategies.Most importantly,an international collaborative program "China-Norway Workshop on Mental Health Act and Ethics in Psychiatry" was developed.A staged training-of-trainer workshop was conducted to help Chinese psychiatrists to raise legal and ethical awareness,even clinical practice.The workshop was designed into three standardized training modules to(a) promote psychiatrists’ legal knowledge and medical ethics,(b) increase their professional knowledge,(c) improve good practice of mental health to protect both rights and interests of the patients and themselves in routine work,and(d) develop a trainer’ s group,consisting of qualified trainers from provincial psychiatric hospitals nationwide,that was competent to conduct trainings at provincial level.The workshop had three stages,one stage(12 training hours) for each year.A range of instructional techniques including slide presentation,video clips,role plays,case discussions and small group activities were adopted,which created an interactive training environment.An evaluation was needed to prove three hypotheses:(a) workshop participants would increase legal and professional knowledge and application competence post-training than pre-training,(b) workshop participants would show positive results three aspects aforesaid than a control group,(c) workshop participants would have stronger teaching competence than the control group.40 psychiatrists who were provincial head of medical intervention of psychosis participated in the workshop.A pretest-posttest experimental design with a self-developed questionnaire was used to monitor changes in knowledge of mental health regulations,expertise and application competence,and to compare with that of psychiatrists not exposed to the workshop.Whether psychiatrists receiving the workshop demonstrated stronger teaching ability than the control group was also examined by a lecture completion.Results:Significant elevated results were found in the following three aspects,namely mental health regulations,professional knowledge and application competence of psychiatrists who received the workshop on post-training(P<0.01).Compared to the control group who never exposed to the workshop,training participants did not show positive results on pre-training but significantly positive results in their comprehensive competence on post-training(P<0.01).As for the teaching ability of mental health regulations and ethical dilemmas,psychiatrists exposed to the workshop also got stronger results in contents(P<0.01) and teaching methods(P<0.01) as well as one essential factor in physical performance than the control group.Moreover,10 youth trainers were tested to be qualified and would be involved in follow-up workshops.Conclusion:These results support the effectiveness of the workshop in enhancing psychiatrists’ comprehensive quality on mental health regulations and ethics.The workshop may play a positive role in improving psychiatrists’ clinical practice and decreasing medical disputes.Furthermore,it could be promoted as a successful model of CME for psychiatrists.更多还原