AshaRani P V, Tan Yeow Wee Brian, Samari Ellaisha, Wang Peizhi, Cetty Laxman, Satghare Pratika, Ho Jayne, Koh Shiyun Astelle, Zhong Yi Lee, Tang Charmaine, Verma Swapna, Subramaniam Mythily
Research Division, Institute of Mental Health, Singapore, Singapore.
Early Psychosis Intervention Programme, Department of Psychosis, Institute of Mental Health, Singapore, Singapore.
Front Psychiatry. 2022 Sep 20;13:952666. doi: 10.3389/fpsyt.2022.952666. eCollection 2022.
Needs define the capacity of a patient to benefit from health care services and a systematic assessment of needs allows planning and delivery of effective treatment to suit patients. This study aimed to understand the (a) needs felt by patients and those perceived by the care providers (CPs), (b) agreement between patients and CPs in the identified needs and (c) factors associated with unmet needs.
Participants ( = 215) were recruited through convenience sampling from the Early Psychosis Intervention Programme (EPIP). Data was captured from patients and CPs using the Camberwell Assessment of Needs Short Appraisal Schedule (CANSAS).
Patients and CPs identified an average of 4.06 and 3.84 needs, respectively. The highest number of unmet needs were identified for the social (50% of patients and CPs) and health domains (31.13% of patients' vs. 28.30% of CPs). Company, intimate relationships, psychotic symptoms, money, sexual expression and psychological distress, information and benefits were the unmet needs identified by patients, whereas company, intimate relationships, physical health, and daytime activities were identified by CPs. The concordance between patients and CPs was low with majority of the items scoring slight to fair agreement (Cohen's kappa = 0-0.4). Older age, depression, severe anxiety and having Obsessive-Compulsive Disorder (OCD) were positively associated with unmet needs in patients.
While there was an overall consensus on the total needs and met needs between patients and CPs, the level of agreement between the two groups on various items were low. Different perceptions regarding unmet needs were noted between the groups. A holistic approach that takes into account different facets of the needs of patients together with strategic planning to address unmet needs might improve treatment outcomes and satisfaction.
需求决定患者从医疗保健服务中获益的能力,对需求进行系统评估有助于规划和提供适合患者的有效治疗。本研究旨在了解:(a)患者感受到的需求以及护理提供者(CPs)察觉到的需求;(b)患者与CPs在所确定需求上的一致性;(c)与未满足需求相关的因素。
通过便利抽样从早期精神病干预项目(EPIP)中招募参与者(n = 215)。使用坎伯韦尔需求评估简短评定量表(CANSAS)从患者和CPs处收集数据。
患者和CPs分别平均确定了4.06项和3.84项需求。社会领域(患者和CPs均为50%)和健康领域(患者为31.13%,CPs为28.30%)的未满足需求数量最多。陪伴、亲密关系、精神病症状、金钱、性表达和心理困扰、信息及福利是患者确定的未满足需求,而陪伴、亲密关系、身体健康和日间活动是CPs确定的未满足需求。患者与CPs之间的一致性较低,大多数项目的评分仅为轻微至中等程度的一致(科恩kappa系数 = 0 - 0.4)。年龄较大、患有抑郁症、严重焦虑症和强迫症(OCD)与患者的未满足需求呈正相关。
虽然患者和CPs在总需求和已满足需求方面总体上达成了共识,但两组在各个项目上的一致程度较低。两组对未满足需求的看法存在差异。一种考虑患者需求不同方面的整体方法以及解决未满足需求的战略规划可能会改善治疗效果和满意度。