Bernardo Miquel, de Dios Consuelo, Pérez Víctor, Ignacio Emilio, Serrano Manuel, Vieta Eduard, Mira José Joaquín, Guilabert Mercedes, Roca Miquel
Unidad de Esquizofrenia, Hospital Clínic, Universitat de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Salud Mental (Cibersam), Barcelona, España.
Servicio de Psiquiatría, Hospital Universitario La Paz, Facultad de Medicina, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IDiPaz), Centro de Investigación Biomédica en Red de Salud Mental (Cibersam), Madrid, España.
Rev Psiquiatr Salud Ment (Engl Ed). 2018 Apr-Jun;11(2):66-75. doi: 10.1016/j.rpsm.2017.09.002. Epub 2018 Jan 6.
To define a set of indicators for mental health care, monitoring quality assurance in schizophrenia, depression and bipolar disorders in Spain.
Qualitative research. Consensus-based study involving 6 psychiatrists on the steering committee and a panel of 43 psychiatrists working in several health services in Spain. An initial proposal of 44 indicators for depression, 42 for schizophrenia and 58 for bipolar disorder was elaborated after reviewing the literature. This proposal was analysed by experts using the Delphi technique. The valuation of these indicators in successive rounds allowed those with less degree of consensus to be discarded. Feasibility, sensitivity and clinical relevance were considered. The study was carried out between July 2015 and March 2016.
Seventy indicators were defined by consensus: 17 for major depression, 16 for schizophrenia, 17 for bipolar disorder and 20 common to all three pathologies. These indicators included measures related to adequacy, patient safety, exacerbation, mechanical restraint, suicidal behaviour, psychoeducation, adherence, mortality and physical health.
This set of indicators allows quality monitoring in the treatment of patients with schizophrenia, depression or bipolar disorder. Mental health care authorities and professionals can use this proposal for developing a balanced scorecard adjusted to their priorities and welfare objectives.
确定一套用于西班牙精神分裂症、抑郁症和双相情感障碍心理健康护理及监测质量保证的指标。
定性研究。基于共识的研究，涉及指导委员会的6名精神科医生以及在西班牙多个卫生服务机构工作的43名精神科医生组成的小组。在查阅文献后，拟定了一份针对抑郁症的44项指标、针对精神分裂症的42项指标和针对双相情感障碍的58项指标的初步提案。专家们采用德尔菲技术对该提案进行了分析。在连续几轮中对这些指标进行评估，从而摒弃了那些共识度较低的指标。考虑了可行性、敏感性和临床相关性。该研究于2015年7月至2016年3月进行。
经共识确定了70项指标：重度抑郁症17项，精神分裂症16项，双相情感障碍17项，以及这三种病症共有的20项。这些指标包括与充分性、患者安全、病情加重、机械约束、自杀行为、心理教育、依从性、死亡率和身体健康相关的措施。
这套指标有助于对精神分裂症、抑郁症或双相情感障碍患者的治疗进行质量监测。心理健康护理当局和专业人员可利用该提案制定符合其优先事项和福利目标的平衡计分卡。
