护士参与的临床决策支持系统在抑郁症管理中应用的范围综述

doi:10.3761/j.issn.0254-1769.2024.19.018

摘要/Abstract

摘要：

目的对国内外护士参与的临床决策支持系统（clinical decision support system，CDSS）在抑郁症中应用的相关研究进行范围综述。方法计算机检索PubMed、Web of Science、Scopus、CINAHL、PsycINFO、Embase、Cochrane Library、中国知网、万方数据库、维普中文科技期刊数据库，检索时限为建库至2024年3月。筛选有关护士参与的CDSS在抑郁症中应用的相关研究，基于范围综述的研究框架分析研究的基本特征、CDSS的功能和特征、应用可行性及效果等。结果最终纳入16篇英文文献，涉及13个CDSS。护士参与的CDSS能够改善患者的抑郁程度，但其在抑郁症管理中的应用以筛查为主，鲜有CDSS能够根据患者的心理社会因素提出个性化的抑郁症管理方案。结论护士参与的CDSS能够促进抑郁症的筛查，改善患者的抑郁程度，但其功能有限，未能提出个性化的抑郁症管理方案。未来的研究可基于电子病历系统开发CDSS以促进护士对抑郁症的筛查，并进一步为CDSS搭建智能管理模块，以便为抑郁症患者提供智慧化、个性化的管理方案。

关键词: 临床决策支持系统, 抑郁症, 护理, 范围综述

Abstract:

Objective To review the research on the application of clinical decision support system（CDSS） involving nurses in depression both domestically and internationally. Methods 10 Chinese and English databases including PubMed，Web of Science，Scopus，CINAHL，PsycINFO，Embase，Cochrane Library，CNKI，Wanfang Database，and VIP were searched until March，2024. The eligible literature of the application of CDSS involving nurses in depression was selected to analyze the basic characteristics of studies，the functions，characteristics，feasibility，and effectiveness of CDSS. Results Finally，16 English articles involving 13 CDSS were included. This study found that nurses participating in CDSS can improve the degree of depression in patients，but its application in depression management is mainly for screening，and few CDSS can propose personalized depression management programs based on the psychological and social factors of patients. Conclusion The CDSS involving nurses can promote the screening of depression and improve depression in patients，but it fails to propose a personalized depression management program. Future research can develop CDSS based on electronic medical record systems to facilitate nurses’ screening for depression and further develop an intelligent management module for CDSS to provide intelligent and personalized management solutions for patients with depression.

Key words: Clinical Decision Support System, Depression, Nursing Care, Scoping Review

吕萍萍, 卢芳燕, 郑力, 谢洪琼, 王华芬. 护士参与的临床决策支持系统在抑郁症管理中应用的范围综述[J]. 中华护理杂志, 2024, 59(19): 2427-2432.

LÜ Pingping, LU Fangyan, ZHENG Li, XIE Hongqiong, WANG Huafen. A scope review of the application of Clinical Decision Support Systems involving nurses in depression management[J]. Chinese Journal of Nursing, 2024, 59(19): 2427-2432.

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参考文献 28

[1]	World Health Organization. Depression and other common mental disorders[EB/OL].(2017-01-03)[2024-01-31]. https://www.who.int/publications/i/item/depression-global-health-estimates.
[2]	Daundasekara SS, Beauchamp JES, Hernandez DC. Parenting stress mediates the longitudinal effect of maternal depression on child anxiety/depressive symptoms[J]. J Affect Disord, 2021, 295:33-39.
[3]	Williams SZ, Chung GS, Muennig PA. Undiagnosed depression:a community diagnosis[J]. SSM Popul Health, 2017, 3:633-638. DOI PMID
[4]	American Psychiatric Association. Diagnostic and statistical ma-nual of mental disorders:dsm-5TM[M]. 5th ed. Arlington,VA,US: American Psychiatric Publishing,Inc, 2013.
[5]	杨宇辉, 李素姣, 喻洪流, 等. 临床决策支持系统研究进展[J]. 生物医学工程学进展, 2021, 42(4):203-207.
	Yang YH, Li SJ, Yu HL, et al. Research progress of clinical decision support system[J]. Prog Biomed Eng, 2021, 42(4):203-207.
[6]	Bellón JA, Rodríguez-Morejón A, Conejo-Cerón S, et al. A per-sonalized intervention to prevent depression in primary care based on risk predictive algorithms and decision support systems:protocol of the e-predict D study[J]. Front Psychiatry, 2023, 14:1163800.
[7]	Popescu C, Golden G, Benrimoh D, et al. Evaluating the clinical feasibility of an artificial intelligence-powered,web-based clini-cal decision support system for the treatment of depression in adults:longitudinal feasibility study[J]. JMIR Form Res, 2021, 5(10):e31862.
[8]	Harrison P, Carr E, Goldsmith K, et al. Antidepressant Advisor (ADeSS):a decision support system for antidepressant treatment for depression in UK primary care:a feasibility study[J]. BMJ Open, 2023, 13(3):e060516.
[9]	Benrimoh D, Tanguay-Sela M, Perlman K, et al. Using a simula-tion centre to evaluate preliminary acceptability and impact of an artificial intelligence-powered clinical decision support system for depression treatment on the physician-patient interaction[J]. BJPsych Open, 2021, 7(1):e22. DOI PMID
[10]	Arksey H, O’Malley L. Scoping studies:towards a methodolo-gical framework[J]. Int J Soc Res Methodol, 2005, 8(1):19-32.
[11]	Fletcher S, Spittal MJ, Chondros P, et al. Clinical efficacy of a Decision Support Tool(Link-me) to guide intensity of mental health care in primary practice:a pragmatic stratified rando-mised controlled trial[J]. Lancet Psych, 2021, 8(3):202-214.
[12]	Cannon DS, Allen SN. A comparison of the effects of com-puter and manual reminders on compliance with a mental health clinical practice guideline[J]. J Am Med Inform Assoc, 2000, 7(2):196-203. PMID
[13]	Sherman SE, Chapman A, Garcia D, et al. Improving recogni-tion of depression in primary care:a study of evidence-based quality improvement[J]. Jt Comm J Qual Saf, 2004, 30(2):80-88. PMID
[14]	Choi J. Development and evaluation of a computer-interpre-table guideline for depression screening and initial mana-gement in primary care[D]. Columbia: Columbia University, 2006.
[15]	John R, Buschman P, Chaszar M, et al. Development and eva-luation of a PDA-based decision support system for pediatric depression screening[J]. Stud Health Technol Inform, 2007, 129(Pt 2):1382-1386.
[16]	Schnall R, Currie LM, Jia HM, et al. Predictors of depression screening rates of nurses receiving a personal digital assistant-based reminder to screen[J]. J Urban Health, 2010, 87(4):703-712. DOI PMID
[17]	Trivedi MH, Daly EJ, Kern JK, et al. Barriers to implementa-tion of a computerized decision support system for depres-sion:an observational report on lessons learned in “real world” clinical settings[J]. BMC Med Inform Decis Mak, 2009, 9:6.
[18]	Pyne JM, Fortney JC, Curran GM, et al. Effectiveness of colla-borative care for depression in human immunodeficiency virus clinics[J]. Arch Intern Med, 2011, 171(1):23-31.
[19]	Gill JM, Chen YX, Grimes A, et al. Using electronic health record-based tools to screen for bipolar disorder in primary care patients with depression[J]. J Am Board Fam Med, 2012, 25(3):283-290. DOI PMID
[20]	Loeb D, Sieja A, Corral J, et al. Evaluation of the role of train-ing in the implementation of a depression screening and treatment protocol in 2 academic outpatient internal medicine clinics utilizing the electronic medical record[J]. Am J Med Qual, 2015, 30(4):359-366.
[21]	Wu S, Vidyanti I, Liu P, et al. Patient-centered technological assessment and monitoring of depression for low-income patients[J]. J Ambul Care Manage, 2014, 37(2):138-147. DOI PMID
[22]	di Capua P, Wu B, Sednew R, et al. Complexity in redesign-ing depression care:comparing intention versus implementa-tion of an automated depression screening and monitoring program[J]. Popul Health Manag, 2016, 19(5):349-356. DOI PMID
[23]	Ramirez M, Wu S, Jin HM, et al. Automated remote monitoring of depression:acceptance among low-income patients in diabetes disease management[J]. JMIR Ment Health, 2016, 3(1):e6.
[24]	Wu S, Ell K, Jin HM, et al. Comparative effectiveness of a tech-nology-facilitated depression care management model in safety-net primary care patients with type 2 diabetes:6-month outcomes of a large clinical trial[J]. J Med Internet Res, 2018, 20(4):e147.
[25]	Patel VL, Halpern M, Nagaraj V, et al. Information processing by community health nurses using mobile health(mHealth) tools for early identification of suicide and depression risks in Fiji Islands[J]. BMJ Health Care Inform, 2021, 28(1):e100342.
[26]	Fletcher S, Chondros P, Densley K, et al. Matching depression management to severity prognosis in primary care:results of the Target-D randomised controlled trial[J]. Br J Gen Pract, 2021, 71(703):e85-e94.
[27]	张静, 梁士楚, 陈忠兰. 护理领域中临床实践指南依从性的研究进展[J]. 中华护理杂志, 2023, 58(6):758-763. DOI URL
	Zhang J, Liang SC, Chen ZL. The adherence of clinical practice guidelines in nursing fields:where things stand[J]. Chin J Nurs, 2023, 58(6):758-763.
[28]	陈越, 皮红英, 宋杰, 等. 临床决策支持系统在脑卒中患者护理中的应用进展[J]. 中华护理杂志, 2019, 54(12):1898-1901. DOI URL
	Chen Y, Pi HY, Song J, et al. Research progress on clinical decision support system for stroke nursing[J]. Chin J Nurs, 2019, 54(12):1898-1901.