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荷兰和澳大利亚的心理健康护理需求认知及护理障碍。

Perceived need for mental health care and barriers to care in the Netherlands and Australia.

机构信息

Netherlands Institute for Health Services Research, Utrecht, The Netherlands.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2011 Oct;46(10):1033-44. doi: 10.1007/s00127-010-0266-3. Epub 2010 Aug 5.

Abstract

PURPOSE

This study of Australian and Dutch people with anxiety or depressive disorder aims to examine people's perceived needs and barriers to care, and to identify possible similarities and differences.

METHODS

Data from the Australian National Survey of Mental Health and Well-Being and the Netherlands Study of Depression and Anxiety were combined into one data set. The Perceived Need for Care Questionnaire was taken in both studies. Logistic regression analyses were performed to check if similarities or differences between Australia and the Netherlands could be observed.

RESULTS

In both countries, a large proportion had unfulfilled needs and self-reliance was the most frequently named barrier to receive care. People from the Australian sample (N = 372) were more likely to perceive a need for medication (OR 1.8; 95% CI 1.3-2.5), counselling (OR 1.4; 95% CI 1.0-2.0) and practical support (OR 1.8; 95% CI 1.2-2.7), and people's overall needs in Australia were more often fully met compared with those of the Dutch sample (N = 610). Australians were more often pessimistic about the helpfulness of medication (OR 3.8; 95% CI 1.4-10.7) and skills training (OR 3.0; 95% CI 1.1-8.2) and reported more often financial barriers for not having received (enough) information (OR 2.4; 95% CI 1.1-5.5) or counselling (OR 5.9; 95% CI 2.9-11.9).

CONCLUSIONS

In both countries, the vast majority of mental health care needs are not fulfilled. Solutions could be found in improving professionals' skills or better collaboration. Possible explanations for the found differences in perceived need and barriers to care are discussed; these illustrate the value of examining perceived need across nations and suggest substantial commonalities of experience across the two countries.

摘要

目的

本研究旨在调查澳大利亚和荷兰患有焦虑或抑郁障碍人群的需求和就诊障碍,以评估中两国人群的就诊障碍和需求是否存在相似性和差异。

方法

将澳大利亚国家精神健康与幸福感调查和荷兰抑郁焦虑研究的数据合并为一个数据集,在两个研究中都采用了感知需求护理问卷。采用逻辑回归分析来检查澳大利亚和荷兰之间是否可以观察到相似或差异。

结果

在两个国家,都有很大比例的人群存在未满足的需求,而自我依赖是寻求护理最常见的障碍。与荷兰样本(N=610)相比,澳大利亚样本(N=372)的人群更有可能认为需要药物治疗(OR 1.8;95% CI 1.3-2.5)、心理咨询(OR 1.4;95% CI 1.0-2.0)和实际支持(OR 1.8;95% CI 1.2-2.7),并且澳大利亚人群的整体需求更常得到满足。澳大利亚人对药物治疗(OR 3.8;95% CI 1.4-10.7)和技能培训(OR 3.0;95% CI 1.1-8.2)的有效性持更为悲观的态度,也更常因经济原因未获得(足够)信息(OR 2.4;95% CI 1.1-5.5)或心理咨询(OR 5.9;95% CI 2.9-11.9)而报告就诊障碍。

结论

在两个国家中,绝大多数的精神卫生保健需求都未得到满足。解决方法可能是提高专业人员的技能或更好的合作。对感知需求和就诊障碍差异的可能解释进行了讨论;这些差异说明了在国家之间检查感知需求的价值,并表明两国之间存在着实质性的共同经验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bddb/3173635/4e100e42555e/127_2010_266_Fig1_HTML.jpg

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