Jeyasingam Neil
School of Medicine, Sydney University, New South Wales, Australia.
School of Medicine, Western Sydney University, New South Wales, Australia.
J Patient Exp. 2018 Mar;5(1):21-25. doi: 10.1177/2374373517719752. Epub 2017 Jul 17.
Measurement of patient outcomes is an integral part of mental health service evaluation, as well as guiding clinical practice to ensure best outcomes for patients. Moreover, carers have long held a need for a voice in care outcomes. Despite there existing numerous tools for quantifying patient functioning based on clinician assessments or self-reports, there is a serious paucity of tools available for the carers of patients to appraise their functioning. This tool, developed for use in a community aged care psychiatric service, involves 4 sections-a global impression of patient progress, a scorable checklist of patient functioning in multiple domains, a qualitative section for identifying the most pressing concerns from the carer's perspective, and an open-ended feedback on treatment to date. In this pilot study, the Carer Appraisal Scale was found to have a fair correlation with the Health of Nation Outcomes Scale for over 65. This tool has potential for use in community aged care psychiatric services, as it provides a framework for communication of concerns, assists in prioritizing care, and adds value to clinician treatment plans, as well as providing another dimension to assessment of the patient while empowering carers in care participation. Practical implications of its use, limitations, and potential for modifications are also discussed.
患者结局的测量是心理健康服务评估不可或缺的一部分，同时也为临床实践提供指导，以确保患者获得最佳结局。此外，长期以来，护理人员一直希望在护理结局方面拥有发言权。尽管存在众多基于临床医生评估或自我报告来量化患者功能的工具，但供患者护理人员评估其功能的工具却严重匮乏。这个为社区老年护理精神科服务开发的工具包含4个部分——对患者进展的总体印象、患者在多个领域功能的可评分清单、从护理人员角度识别最紧迫问题的定性部分以及对迄今为止治疗的开放式反馈。在这项试点研究中，发现护理人员评估量表与65岁以上人群的国家健康结局量表具有一定相关性。该工具在社区老年护理精神科服务中有应用潜力，因为它提供了一个表达关切的沟通框架，有助于确定护理重点，为临床医生的治疗计划增添价值，同时在增强护理人员参与护理的能力时，为患者评估提供了另一个维度。还讨论了其使用的实际意义、局限性和修改潜力。
