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日本人群中强化个案管理筛查表的开发与评估

Development and evaluation of Intensive Case Management Screening Sheet in the Japanese population.

作者信息

Suzuki Kota, Yamaguchi Sosei, Kawasoe Yasunari, Nayuki Kazumi, Aoki Tsutomu, Hasegawa Naomi, Fujii Chiyo

机构信息

1Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry (NCNP), 4-1-1, Ogawahigashi, Kodaira, Tokyo Japan.

2Asahi General Hospital, I 1326, Asahi, Chiba Japan.

出版信息

Int J Ment Health Syst. 2019 Apr 5;13:22. doi: 10.1186/s13033-019-0278-7. eCollection 2019.

Abstract

BACKGROUND

In Japan, the mental health system has been shifting from hospitalization-based to community-based care; some organizations have gradually begun providing intensive case management (ICM) services. We developed an Intensive Case Management Screening Sheet (ICMSS) to screen for the need for ICM in people with mental illness.

METHODS

The aim of this study was to examine the psychometric properties and discriminative ability of ICMSS. Subjects consisted of 911 people with mental illness. The ICMSS score was rated by a professional such as a nurse, social worker, or occupational therapist.

RESULTS

Exploratory factor analysis showed a one-factor structure with 14 items. The factor structure was supported by confirmatory factor analysis (comparative fit index, 0.98; Tucker-Lewis index, 0.97; root mean square error test of close fit, 0.05). In the receiver operating characteristic analysis for discriminating between users and non-users of ICM services, the area under the curve (AUC) for ICMSS was significantly larger than for Global Assessment of Functioning and Personal and Social Performance Scale, indicating better discriminative ability. However, the AUC for ICMSS was moderate. Thus, we suggest that the need for ICM services is determined by quantitative assessment (i.e., ICMSS) and clinical judgment.

CONCLUSION

ICMSS is a brief tool for mental health professionals that will be useful in routine clinical practice. We expect that ICMSS will be used as a measure that reflects the views of professionals from various disciplines in Japanese institutions.

摘要

背景

在日本,心理健康系统已从以住院治疗为主转变为以社区护理为主;一些组织已逐渐开始提供强化个案管理(ICM)服务。我们开发了一份强化个案管理筛查表(ICMSS),用于筛查精神疾病患者对ICM的需求。

方法

本研究的目的是检验ICMSS的心理测量特性和区分能力。研究对象包括911名精神疾病患者。ICMSS得分由护士、社会工作者或职业治疗师等专业人员评定。

结果

探索性因素分析显示该量表具有一个包含14个条目的单因素结构。验证性因素分析支持了该因素结构(比较拟合指数为0.98;塔克-刘易斯指数为0.97;近似拟合均方根误差为0.05)。在用于区分ICM服务使用者和非使用者的受试者工作特征分析中,ICMSS的曲线下面积(AUC)显著大于功能总体评估量表和个人与社会表现量表,表明其区分能力更好。然而,ICMSS的AUC处于中等水平。因此,我们建议通过定量评估(即ICMSS)和临床判断来确定对ICM服务的需求。

结论

ICMSS是一种供心理健康专业人员使用的简短工具,在日常临床实践中会很有用。我们预计ICMSS将作为一种反映日本机构中各学科专业人员观点的测量工具加以使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c654/6449981/f130b10260ae/13033_2019_278_Fig1_HTML.jpg

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