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个人健康预算作为关爱社区内严重精神疾病的一种新康复模式:一项关于有益效果的意大利评估研究。

Personal Health Budget as a new rehabilitation model for severe mental illness within a caring community: An Italian evaluation study of beneficial effects.

作者信息

Pelizza Lorenzo, Leuci Emanuela, Landi Giulia, Maestri Davide, Paulillo Giuseppina, Ceroni Patrizia, Soncini Caterina, Daolio Maria Cristina, Quattrone Emanuela, Pellegrini Pietro

机构信息

Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy.

Department of Mental Health and Pathological Addiction, Azienda USL di Modena, Modena, Italy.

出版信息

Aust N Z J Psychiatry. 2021 Jun;55(6):602-612. doi: 10.1177/0004867420968918. Epub 2020 Oct 28.

Abstract

OBJECTIVE

Personal Health Budget has been provided to consumers with severe mental illness within a policy shift toward a person-tailored mental healthcare treatment based on individual unmet needs. Evidence of beneficial effects of Personal Health Budget is still scarce. The aim of this study was to provide preliminary data on clinical and social benefits of adding Personal Health Budget to a standard pharmacotherapy in patients with severe mental illness across a 24-month follow-up period.

METHODS

Participants ( = 137) were individuals with severe mental illness, aged 18-50 years, recruited in one of the adult mental health services of the Parma Department of Mental Health. They completed the Global Assessment of Functioning scale, the Health of the Nation Outcome Scale and the Brief Psychiatric Rating Scale. This age range was chosen to limit Personal Health Budget interventions to adults with a non-prolonged illness duration. Friedman's test for repeated measure was used to assess the longitudinal stability of functioning and clinical parameters. A linear regression analysis was also performed.

RESULTS

A significant decrease in all Global Assessment of Functioning scale, Health of the Nation Outcome Scale and Brief Psychiatric Rating Scale scores along the 24 months of follow-up was observed. Regression analysis results specifically showed a relevant association between a Personal Health Budget multiaxial intervention and the longitudinal reduction in Brief Psychiatric Rating Scale 'Negative Symptoms' and Health of the Nation Outcome Scale 'Social Problems' subscores.

CONCLUSION

Our findings support the useful implementation of a Health of the Nation Outcome Scale approach for severe mental illness patients within the Italian mental health service network.

摘要

目的

在朝着基于个体未满足需求的个性化精神卫生保健治疗的政策转变中,个人健康预算已提供给患有严重精神疾病的消费者。个人健康预算有益效果的证据仍然稀缺。本研究的目的是提供关于在24个月的随访期内,将个人健康预算添加到严重精神疾病患者的标准药物治疗中所产生的临床和社会效益的初步数据。

方法

参与者(n = 137)为年龄在18至50岁之间的严重精神疾病患者,从帕尔马心理健康部的成人心理健康服务机构之一招募。他们完成了功能总体评定量表、国民健康结果量表和简明精神病评定量表。选择这个年龄范围是为了将个人健康预算干预限制在病程未延长的成年人。采用Friedman重复测量检验来评估功能和临床参数的纵向稳定性。还进行了线性回归分析。

结果

在24个月的随访期内,观察到功能总体评定量表、国民健康结果量表和简明精神病评定量表的所有得分均显著下降。回归分析结果具体显示,个人健康预算多轴干预与简明精神病评定量表“阴性症状”和国民健康结果量表“社会问题”子得分的纵向降低之间存在显著关联。

结论

我们的研究结果支持在意大利心理健康服务网络内,对严重精神疾病患者采用国民健康结果量表方法的有益实施。

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