1Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
Int J Soc Psychiatry. 2013 Nov;59(7):663-70. doi: 10.1177/0020764012450996. Epub 2012 Aug 17.
Continuity of care has been demonstrated to be important for service users and carer groups have voiced major concerns over disruptions of care. We aimed to assess the experienced continuity of care in carers of patients with both psychotic and non-psychotic disorders and explore its association with carer characteristics and psychological well-being.
Friends and relatives caring for two groups of service users in the care of community mental health teams (CMHTs), 69 with psychotic and 38 with non-psychotic disorders, were assessed annually at three and two time points, respectively. CONTINUES, a measure specifically designed to assess continuity of care for carers themselves, was utilized along with assessments of psychological well-being and caregiving.
One hundred and seven carers participated. They reported moderately low continuity of care. Only 22 had had a carer's assessment and just under a third recorded psychological distress on the GHQ. For those caring for people with psychotic disorders, reported continuity was higher if the carer was male, employed, lived with the user and had had a carer's assessment; for those caring for people with non-psychotic disorders, it was higher if the carer was from the service user's immediate family, lived with them and had had a carer's assessment.
The vast majority of the carers had not had a carer's assessment provided by the CMHT despite this being a clear national priority and being an intervention with obvious potential to increase carers' reported low levels of continuity of care. Improving continuity of contact with carers may have an important part to play in the overall improvement of care in this patient group and deserves greater attention.
连续性护理已被证明对服务使用者很重要,照顾者群体对护理中断表示了重大关注。我们旨在评估精神病和非精神病患者照顾者的护理连续性体验,并探讨其与照顾者特征和心理健康的关系。
在社区精神卫生团队(CMHT)的护理下,分别对 69 名患有精神病和 38 名非精神病的服务使用者的朋友和亲属进行评估,每年在三个和两个时间点进行评估。CONTINUES 是专门为评估照顾者自身护理连续性而设计的一种措施,与心理健康和照顾评估一起使用。
共有 107 名照顾者参与。他们报告的护理连续性中等偏低。只有 22 人接受过照顾者评估,近三分之一的人在 GHQ 上记录了心理困扰。对于照顾精神病患者的人,如果照顾者是男性、有工作、与使用者同住并接受过照顾者评估,报告的连续性更高;对于照顾非精神病患者的人,如果照顾者是服务使用者的直系亲属、与他们同住并接受过照顾者评估,报告的连续性更高。
尽管这是国家的优先事项,而且这是一种干预措施,显然有可能提高照顾者报告的低连续性护理水平,但绝大多数照顾者并未接受 CMHT 提供的照顾者评估。改善与照顾者的联系连续性可能在改善该患者群体的整体护理方面发挥重要作用,值得更多关注。