Individual unmet needs for care: are they sensitive as outcome criterion for the effectiveness of mental health services interventions?
| Autor: | Rosemarie McCabe, Kerstin Wolters, Tommy Björkman, Lars Hansson, Francisco Torres-Gonzales, Christoph Lauber, Hans Joachim Salize, Rafael Martínez-Leal, Donna Wright, Rob H. S. van den Brink, Stefan Priebe, Durk Wiersma, Wulf Rössler, Jens Bullenkamp |
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| Přispěvatelé: | University of Zurich, Wiersma, D |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Health (social science) MRC NEEDS Social Psychology Epidemiology Psychological intervention 610 Medicine & health Context (language use) 10056 Clinic for Clinical and Social Psychiatry Zurich West (former) ILLNESS Efficiency Organizational PATIENT 2738 Psychiatry and Mental Health Quality of life (healthcare) QUALITY-OF-LIFE PEOPLE Outcome Assessment Health Care community mental health care Humans Medicine routine outcome assessment SCHIZOPHRENIC-PATIENTS Psychiatry Randomized Controlled Trials as Topic 3207 Social Psychology Health Services Needs and Demand EPIDEMIOLOGICALLY REPRESENTATIVE SAMPLE business.industry Public health Social environment Middle Aged Mental health Community Mental Health Services Europe schizophrenia COMMUNITY Psychiatry and Mental health need for care RELIABILITY Community health Needs assessment Female CAMBERWELL ASSESSMENT 3306 Health (social science) business 2713 Epidemiology |
| Zdroj: | Social Psychiatry and Psychiatric Epidemiology, 44(4), 317-324. SPRINGER HEIDELBERG |
| DOI: | 10.5167/uzh-11970 |
| Popis: | Background Mental health interventions should demonstrate an effect on patients' functioning as well as his/her needs, in particular on unmet needs whose assessment depends on the perspective of either the patient or the clinician. However, individual met and unmet needs appear to change over time, qualitatively and quantitatively, raising questions about their sensitivity to change and about the association between level of needs and treatment. Methods Data on baseline and follow-up need assessment in community mental health services in four European countries in the context of a cluster randomised trial on a novel mental health service intervention were used, which involved 102 clinicians with key worker roles and 320 patients with schizophrenia or related psychotic disorders. Need assessment was performed with the Camberwell assessment of needs short appraisal schedule (CANSAS) among patients as well as clinicians. Focus is the sensitivity to change in unmet needs over time as well as the concordance between patient and clinician ratings and their relationship with treatment condition. Results At follow-up 294 patients (92%) had a full need assessment, while clinician rated needs were available for 302 patients (94%). Generally, the total number of met needs remained quite stable, but unmet needs decreased significantly over time, according to patients as well as to clinicians. Sensitivity to change of unmet needs is quite high: about two third of all unmet needs made a transition to no or met need, and more than half of all unmet needs at follow-up were new. Agreement between patient and clinician on unmet needs at baseline as well as follow-up was rather low, without any indication of a specific treatment effect. Conclusions Individual unmet needs appear to be quite sensitive to change over time but as yet less suitable as outcome criterion of treatment or specific interventions. |
| Databáze: | OpenAIRE |
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