摘要目的 探讨在综合医院内建立基于网络的精神卫生知识培训服务的可行性及效果.方法 在院内局域网上建立精神卫生服务网站,提供网络精神卫生继续教育和心理测量等.比较参加(继教组)与未参加继续教育(非继教组)临床医师的精神卫生知识掌握情况,以及发起精神科会诊的情况.结果 精神卫生服务网站运行5个月期间,有803名医务人员(其中临床医师447人)参加了院内精神卫生网络继续教育学习,643人(其中临床医师387人)通过了继续教育测试,共完成网络心理测量528份,诊疗指南及临床资讯等网页点击量为2 718人次.精神卫生知识测试合格率继教组(83.3％)高于非继教组(31.7％),差异有统计学意义(x2=32.77,P＜0.01).继教组请精神科会诊的主要症状有焦虑症状、抑郁或躁狂症状和谵妄.继教组与非继教组请精神科会诊的主要精神症状中,焦虑症状(18.7％ vs.9.7％)、医学不能解释症状(10.8％vs.4.1％)和谵妄(15.8％vs.26.9％)的比例,差异均有统计学意义(x2=4.80、4.59和5.16,P＜0.05).继教组与非继教组在会诊前使用网络心理测量的比例分别为33.8％和7.6％,差异有统计学意义(x2=30.04,P＜0.01).结论 在院内网站中开展精神卫生继续教育和心理测量等服务,可以增加临床医师的精神卫生知识,提高对焦虑、抑郁等轻型精神心理问题的识别能力.

abstractsObjective To evaluate the effectiveness of web-based mental health services.Methods Web-based mental health services were established in our hospital to offer continuing medical education on mental health and psychological assessments.The access of clinicians to psychiatric knowledge and consultation from psychiatry department was evaluated.Results A total of 803 medical staff took the continuing medical education,and 643 passed the examination.Five hundred and twenty-eight online psychological assessments were completed.The qualification rate of psychiatric examination was 83.3％ vs.31.7％ in educated and non-educated clinicians (x2=32.77,P＜0.01).The common consultation from psychiatry department of the educated group involved anxiety,depression/mania and delirium,of which anxiety and medically unexplained symptoms were comparatively higher while delirium was lower than the non-educated group (x2 values were 4.80,4.59 and 5.16,respectively; all P＜0.05).More use of online psychological assessments was found in the educated group (33.8％ vs.7.6％) before asking for a consultation from psychiatry department (x2=30.04,P＜0.01).Conclusions Online mental health continuing education and psychological assessment could improve psychiatric knowledge and recognition of anxiety and depression in clinicians.