Migliorini Christine, Fossey Ellie, Harvey Carol
Department of Psychiatry, Psychosocial Research Centre, The University of Melbourne, Melbourne, VIC, Australia.
NorthWest Area Mental Health Service, NorthWestern Mental Health, Coburg, VIC, Australia.
Front Psychiatry. 2022 Sep 9;13:1013919. doi: 10.3389/fpsyt.2022.1013919. eCollection 2022.
Person-centered care is a collaborative approach to health care. To provide effective, person-centered care to people living with severe mental illness, it is necessary to understand how people view their own needs. The Perceived Need for Care Questionnaire (PNCQ) was used in the Australian National Survey of High Impact Psychosis (SHIP) to deepen understanding and evaluate, at a population level, the needs of Australian adults living with psychotic illness. SHIP participants were 1,825 adults, aged 18-65 years, living with psychotic illness and in contact with public specialized mental health services across Australia in 2010. The survey package included demographic and clinical items, and various scales including the PNCQ appraising a comprehensive range of life domains. Logistic regressions measured the impact that various demographic, clinical and psychosocial independent variables (e.g., loneliness, health-related quality of life, disability, accommodation type) had on the likelihood of inadequately met PNCQ domain-related need. Over two-thirds of people living with psychosis reported at least two areas of unmet need for care despite most being in contact with mental health services. Work or using one's time and socializing, counseling, and self-care domains had the largest proportion of inadequately met needs (range between 49 and 57%). Feelings of loneliness and/or social isolation were significantly associated with unmet needs across all PNCQ domains, except for financial needs. Health-related quality of life was significantly associated with unmet needs across all domains, except for housing needs. Disability was significantly associated with unmet social, occupation (work or time use), housing and medication-related needs. Consumers view their needs for care as unmet across many life areas despite being in contact with mental health services. Loneliness, unmet psychosocial needs, and health-related quality of life appear strongly interconnected and warrant greater attention in the delivery of person-centered care for people living with psychosis. Support to address social, work or time use and housing related needs among people living with psychosis appears less well targeted toward those with disability. Results underscore the link between quality of life, recovery and needs. These inter-relationships should be considered in mental health services research and evaluation.
以患者为中心的护理是一种医疗保健的协作方法。为了向患有严重精神疾病的人提供有效且以患者为中心的护理，有必要了解人们如何看待自己的需求。在澳大利亚全国高影响力精神病调查（SHIP）中使用了护理需求感知问卷（PNCQ），以在人群层面加深对患有精神病性疾病的澳大利亚成年人的需求的理解并进行评估。SHIP的参与者为1825名年龄在18至65岁之间、患有精神病性疾病且在2010年与澳大利亚各地的公共专业心理健康服务机构有接触的成年人。调查包包括人口统计学和临床项目，以及各种量表，包括评估广泛生活领域的PNCQ。逻辑回归测量了各种人口统计学、临床和社会心理自变量（如孤独感、与健康相关的生活质量、残疾、住宿类型）对PNCQ领域相关需求未得到充分满足的可能性的影响。尽管大多数患有精神病的人与心理健康服务机构有接触，但超过三分之二的人报告至少有两个护理需求未得到满足的领域。工作或利用时间、社交、咨询和自我护理领域未得到充分满足的需求比例最大（在49%至57%之间）。孤独感和/或社会隔离感与除财务需求外的所有PNCQ领域未得到满足的需求显著相关。与健康相关的生活质量与除住房需求外的所有领域未得到满足的需求显著相关。残疾与未得到满足的社会、职业（工作或时间利用）、住房和药物相关需求显著相关。尽管与心理健康服务机构有接触，但消费者认为他们在许多生活领域的护理需求未得到满足。孤独感、未得到满足的社会心理需求以及与健康相关的生活质量似乎紧密相连，在为患有精神病的人提供以患者为中心的护理时需要给予更多关注。针对患有精神病的人解决社会、工作或时间利用以及住房相关需求的支持，似乎对残疾人士的针对性较差。结果强调了生活质量、康复和需求之间的联系。在心理健康服务研究和评估中应考虑这些相互关系。
