van Ravenhorst M, Kasius M C, van Vliet C L M
Tijdschr Psychiatr. 2023;65(7):423-429.
Children and youth with an intellectual disability and psychiatric problems are a complex group. By identifying clients who require highly specialized mental health care at an early stage, it is expected that the provided care can be utilized more effectively, there will be less non-response and clients will more efficiently receive the most appropriate care.
To develop a decision tool which can identify clients who need highly specialized care at an early stage.
A review of the literature and qualitative research methods were used, including a Delphi study to get consensus on criteria that could be used as indicators for highly specialized care. These criteria were included in a decision tool, followed by validation of these criteria by testing them on the population of the Banjaard, a mental health care setting for young people with intellectual disability and psychiatric problems.
Ten criteria emerged from the Delphi method that were seen to be predictive of the need for highly specialized care. After applying these criteria to the Banjaard population, it appeared that three or more criteria reliably identified clients needing highly specialized care (sensitivity 76.5% and specificity 75.6%).
The decision tool developed in the current study is a reasonable instrument for identifying clients who could benefit from highly specialized mental health care.
患有智力残疾和精神问题的儿童及青少年是一个复杂的群体。通过在早期阶段识别出需要高度专业化心理健康护理的患者，有望更有效地利用所提供的护理，减少无反应情况，并且患者能更高效地获得最合适的护理。
开发一种能在早期阶段识别出需要高度专业化护理的患者的决策工具。
采用文献综述和定性研究方法，包括一项德尔菲研究，以就可作为高度专业化护理指标的标准达成共识。这些标准被纳入一个决策工具，随后通过在班贾德（一家为患有智力残疾和精神问题的年轻人提供心理健康护理的机构）的人群中进行测试来验证这些标准。
德尔菲法得出了10条标准，这些标准被认为可预测对高度专业化护理的需求。将这些标准应用于班贾德人群后，发现三条或更多标准能够可靠地识别出需要高度专业化护理的患者（敏感性为76.5%，特异性为75.6%）。
本研究中开发的决策工具是识别可能从高度专业化心理健康护理中受益的患者的一种合理工具。
