van Bebber Jan, Meijer Rob R, Wigman Johana Tw, Sytema Sjoerd, Wunderink Lex
Interdisciplinary Center for Psychopathology and Emotion Regulation, University Center for Psychopathology, University Medical Center Groningen, Groningen, Netherlands.
Department of Psychometrics and Statistics, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Groningen, Netherlands.
JMIR Ment Health. 2018 May 28;5(2):e41. doi: 10.2196/mental.9488.
Adequate recognition of mental health problems is a prerequisite for successful treatment. Although most people tend to consult their general practitioner (GP) when they first experience mental health problems, GPs are not very well equipped to screen for various forms of psychopathology to help them determine clients' need for treatment.
In this paper, the development and characteristics of CATja, a computerized adaptive test battery built to facilitate triage in primary care settings, are described, and first results of its implementation are reported.
CATja was developed in close collaboration with GPs and mental health assistants (MHAs). During implementation, MHAs were requested to appraise clients' rankings (N=91) on the domains to be tested and to indicate the treatment level they deemed most appropriate for clients before test administration. We compared the agreement between domain score appraisals and domain score computed by CATja and the agreement between initial (before test administration) treatment level advice and final treatment level advice.
Agreements (Cohen kappas) between MHAs' appraisals of clients' scores and clients' scores computed by CATja were mostly between .40 and .50 (Cohen kappas=.10-.20), and the agreement between "initial" treatment levels and the final treatment level advised was .65 (Cohen kappa=.55).
Using CATja, caregivers can efficiently generate summaries of their clients' mental well-being on which decisions about treatment type and care level may be based. Further validation research is needed.
充分认识心理健康问题是成功治疗的前提条件。尽管大多数人在首次出现心理健康问题时往往会咨询他们的全科医生(GP),但全科医生在筛查各种形式的精神病理学方面的能力并不强,难以帮助他们确定客户的治疗需求。
本文描述了CATja的开发过程和特点,CATja是一种为便于初级保健机构进行分诊而构建的计算机化自适应测试组合,并报告了其实施的初步结果。
CATja是与全科医生和心理健康助理(MHA)密切合作开发的。在实施过程中,要求心理健康助理在测试实施前评估客户在待测试领域的排名(N = 91),并指出他们认为最适合客户的治疗水平。我们比较了领域分数评估与CATja计算的领域分数之间的一致性,以及初始(测试实施前)治疗水平建议与最终治疗水平建议之间的一致性。
心理健康助理对客户分数的评估与CATja计算的客户分数之间的一致性(科恩卡帕系数)大多在0.40至0.50之间(科恩卡帕系数 = 0.10 - 0.20),“初始”治疗水平与建议的最终治疗水平之间的一致性为0.65(科恩卡帕系数 = 0.55)。
使用CATja,护理人员可以有效地生成客户心理健康的总结,据此可以做出关于治疗类型和护理水平的决策。还需要进一步的验证研究。