Institute of Psychology, University of Lausanne , Lausanne , Switzerland.
Community Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV) , Lausanne , Switzerland.
Front Public Health. 2016 Feb 17;4:22. doi: 10.3389/fpubh.2016.00022. eCollection 2016.
Needs assessment is recognized to be a key element of mental health care. Patients tend to present heterogeneous profiles of needs. However, there is no consensus in previous research about how patients' needs are organized. This study investigates both general and specific dimensions of patients' needs for care.
Patients' needs were assessed with ELADEB, an 18-domain self-report scale. The use of a self-assessment scale represents a unique way of obtaining patients' perceptions. A patient-centered psychiatric practice facilitates empowerment as it is based on the patients' personal motivations, needs, and wants. Four seventy-one patients' profiles were analyzed through exploratory factor analysis.
A four-factor bifactor model, including one general factor and three specific factors of needs, was most adequate. Specific factors were (a) "finances" and "administrative tasks"; (b) "transports," "public places," "self-care," "housework," and "food"; and (c) "family," "children," "intimate relationships," and "friendship."
As revealed by the general factor, patients expressing urgent needs in some domains are also more susceptible to report urgent needs in several other domains. This general factor relates to high versus low utilizers of public mental healthcare. Patients also present specific needs in life domains, which are organized in three dimensions: management, functional disabilities, and familial and interpersonal relationships. These dimensions relate to the different types of existing social support described in the literature.
需求评估被认为是精神卫生保健的关键要素。患者往往呈现出多样化的需求特征。然而，之前的研究对于患者需求如何组织并没有达成共识。本研究调查了患者对护理的一般和特定需求维度。
使用 ELADEB 自我报告量表评估患者的需求。自我评估量表的使用代表了一种获取患者感知的独特方式。以患者为中心的精神科实践促进了赋权，因为它基于患者的个人动机、需求和愿望。通过探索性因素分析对 471 名患者的特征进行了分析。
最适合的模型是一个包含一个一般因素和三个特定需求因素的四因素双因素模型。特定因素包括(a)“财务”和“行政任务”；(b)“交通”、“公共场所”、“自我护理”、“家务”和“食物”；和(c)“家庭”、“儿童”、“亲密关系”和“友谊”。
正如一般因素所揭示的那样，在某些领域表达紧急需求的患者也更容易报告其他几个领域的紧急需求。这个一般因素与公共精神卫生保健的高利用者和低利用者有关。患者在生活领域也存在特定需求，这些需求可以分为三个维度：管理、功能障碍以及家庭和人际关系。这些维度与文献中描述的不同类型的现有社会支持有关。
