Leisse Matthias, Kallert Thomas W
Saxonian State Ministry of Health and Social Affairs, Albertstrasse 10, D-01097 Dresden, Germany.
Psychiatry Res. 2003 Jun 15;118(3):223-33. doi: 10.1016/s0165-1781(03)00076-3.
This study aims to assess the extent of needs for mental health care of patients with schizophrenia living in different residential settings and to evaluate the quality of care in these types of complementary services recently established in the East German region of Dresden. Survey data from the first wave of a longitudinal study of five patient subgroups (N=244) living in (1) a psychiatric nursing home, (2) social therapeutic hostels, (3) sheltered community residential care, (4) at home in the family and (5) alone in one's own home are reported. Normative individual needs for care were assessed using the needs for care assessment (NCA). The patient groups show clear differences in the extent of needs for care, especially in the social NCA section. Patients in the psychiatric nursing home and in the social therapeutic hostels exhibit the highest numbers of areas of need. Positive psychotic symptoms, negative symptoms and neuroleptic side effects are the most prominent clinical areas of need in all subgroups. Patients are most frequently socially disabled in terms of managing household affairs, recreational activities and household chores. Deficits in the need status could be found in the NCA areas of 'negative symptoms,' 'recreational activities,' and 'communication.' The basic needs for mental health care of patients with schizophrenia are met in the established sheltered residential settings. Current deficiencies in providing psychological and educational interventions focusing on coping strategies and social skills training should be minimised in order to decrease the identified deficits in the need status.
本研究旨在评估生活在不同居住环境中的精神分裂症患者的心理健康护理需求程度,并评价德国东部德累斯顿地区近期设立的这类补充服务的护理质量。报告了对五个患者亚组(N = 244)进行的纵向研究第一波的调查数据,这些患者分别生活在:(1)精神病疗养院,(2)社会治疗宿舍,(3)社区庇护性住宿护理机构,(4)与家人同住在家中,(5)独自居住在自己家中。使用护理需求评估(NCA)来评估规范性个体护理需求。患者组在护理需求程度上存在明显差异,尤其是在社会NCA部分。精神病疗养院和社会治疗宿舍中的患者需求领域数量最多。阳性精神病性症状、阴性症状和抗精神病药物副作用是所有亚组中最突出的临床需求领域。患者在处理家务、娱乐活动和家务琐事方面最常出现社会功能障碍。在“阴性症状”、“娱乐活动”和“沟通”的NCA领域中发现了需求状态的不足。在既定的庇护性居住环境中,精神分裂症患者的基本心理健康护理需求得到了满足。应尽量减少目前在提供侧重于应对策略和社交技能培训的心理和教育干预方面的不足,以减少已确定的需求状态方面的缺陷。