Hansson Lars, Sandlund Mikael, Bengtsson-Tops Anita, Bjarnason Olafur, Karlsson Hasse, Mackeprang Torben, Merinder Lars, Nilsson Liselotte, Sørgaard Knut, Vinding Hanne, Middelboe Thomas
Department of Clinical Neuroscience, Division of Psychiatry, Lund University, Sweden.
Nord J Psychiatry. 2003;57(1):5-11. doi: 10.1080/08039480310000194.
The relationship between needs for care and support and subjective quality of life was investigated in a cross-sectional multi-center study including 418 individuals with schizophrenia from 10 centers in Nordic countries. Needs in 22 domains were investigated by interviews with key workers and their patients using the Camberwell Assessment of Need scale, and quality of life by the Lancashire Quality of Life Profile. The results showed that key workers rated slightly more needs than patients. To have more unmet needs, as rated by both key workers and patients, were correlated to a worse overall subjective quality of life, while met needs showed no such association. A regression analysis, controlling for clinical and social characteristics of the patients, showed more unmet needs to be associated with a worse quality of life, accounting for 6% out of a total of 41% explained variance in subjective quality of life. Regression analyses of the relationship of unmet needs in specific life domains and overall quality of life showed that unmet needs in five domains as perceived by patients accounted for 17% of the explained variance in overall quality of life. More than half of this variance was related to an unmet need in the domain of social relationships. It is concluded that unmet needs are of specific importance in needs assessment and that attention must be paid to separate met needs for care and services from unmet needs, since the latter seem more important to consider in order to improve outcome of interventions with regard to quality of life. Specific attention should in this context also be paid to unmet needs concerning social relationships and problems with accommodation.
在一项横断面多中心研究中，对北欧国家10个中心的418名精神分裂症患者的护理和支持需求与主观生活质量之间的关系进行了调查。通过使用坎伯韦尔需求评估量表对关键工作人员及其患者进行访谈，调查了22个领域的需求，并通过兰开夏生活质量概况评估生活质量。结果显示，关键工作人员评定的需求略多于患者。关键工作人员和患者评定的未满足需求较多与总体主观生活质量较差相关，而满足的需求则无此关联。在控制患者临床和社会特征的回归分析中，未满足需求较多与生活质量较差相关，在主观生活质量总解释方差的41%中占6%。对特定生活领域未满足需求与总体生活质量关系的回归分析表明，患者感知的五个领域的未满足需求占总体生活质量解释方差的17%。这一方差的一半以上与社会关系领域的未满足需求有关。得出的结论是，未满足需求在需求评估中具有特殊重要性，必须注意将护理和服务的满足需求与未满足需求区分开来，因为为了改善干预措施在生活质量方面的结果，后者似乎更值得考虑。在这种情况下，还应特别关注社会关系方面的未满足需求和住宿问题。
