Martin L, Hirdes J P, Morris J N, Montague P, Rabinowitz T, Fries B E
Lakehead University, 955 Oliver Road, Thunder Bay, Ontario P7B 5E1, Canada.
J Psychiatr Ment Health Nurs. 2009 Sep;16(7):646-53. doi: 10.1111/j.1365-2850.2009.01429.x.
For persons with mental illness and addictions, comprehensive assessment of their strengths, preferences and needs is central to person-centred care planning. In this study, the validity of the Mental Health Assessment Protocols (MHAPs) embedded in the Resident Assessment Instrument Mental Health instrument (the mandated assessment system for Ontario adult inpatient psychiatry) is examined, and triggering rates are compared in inpatient and community-based mental health settings. The sample is based on adults admitted to a psychiatric facility (n = 963) and to community mental health programmes (n = 1505) participating in the study. An international panel of mental health experts further evaluated study results. Among the 27 MHAPs, all but one had sensitivity rates above 80%, and the specificity was over 80% for 74% of the MHAPs. The expert panel found that the MHAPs worked well and could be used to support mental health care. The present study found that the MHAPs are valid measures, though more complex triggering algorithms capable of differentiating individuals based on outcomes were suggested to enhance their clinical relevance to care planning. Further, the use of compatible instrumentation in community-based mental health settings was promoted to enhance continuity of care.
对于患有精神疾病和成瘾问题的人来说,全面评估他们的优势、偏好和需求是以人为本的护理计划的核心。在本研究中,我们检验了嵌入居民评估工具心理健康量表(安大略省成人住院精神病学的法定评估系统)中的心理健康评估方案(MHAPs)的有效性,并比较了住院和社区心理健康环境中的触发率。样本基于参与研究的一家精神病院收治的成年人(n = 963)和社区心理健康项目的成年人(n = 1505)。一个国际心理健康专家小组进一步评估了研究结果。在27个MHAPs中,除一个外,所有的敏感度率均高于80%,74%的MHAPs的特异度超过80%。专家小组发现,MHAPs效果良好,可用于支持心理健康护理。本研究发现,MHAPs是有效的测量方法,不过有人建议采用更复杂的触发算法,以便根据结果区分个体,从而提高其与护理计划的临床相关性。此外,还提倡在社区心理健康环境中使用兼容的仪器,以加强护理的连续性。