Handerer Fritz, Kinderman Peter, Nevard Imogen, Tai Sara
Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom.
Institute of Primary Care & Mental Health, University of Liverpool, Liverpool, United Kingdom.
Front Psychiatry. 2024 May 20;15:1377751. doi: 10.3389/fpsyt.2024.1377751. eCollection 2024.
There is growing consensus that consideration of the Social Determinants of Mental Health should be at the centre of mental health care provision. To facilitate this, a validated means to assess mental health service users' social contextual information is arguably needed. We therefore developed a questionnaire to assess the Social Determinants of Mental Health in clinical practice.
Our guideline-informed development consisted of three steps; i) construct and purpose definition, ii) initial item generation based on the literature, similar questionnaires, and a selection of the ICD-10, iii) evaluation, revision, and content validation of the questionnaire. Initially we developed 249 items that were reduced, revised, and validated in several stages to 73 items. Content validation of the questionnaire was achieved through surveys and focus groups including mental health care service users and professionals.
The surveys and focus groups indicated the need for a standardised assessment of adverse social factors and highlighted that the benefits of such an assessment would be a more holistic approach to identifying and addressing fundamental factors involved in the development of mental health difficulties. Importantly, this study also revealed how any assessment of the Social Determinants of Mental Health must prioritise the assessed person having a central role in the process and control over their own data. The focus groups identified contradicting recommendations regarding the most suitable context to administer the questionnaire.
The resulting questionnaire can be considered to be theoretically robust and partially validated. Future research is discussed.
越来越多的人达成共识，即对心理健康的社会决定因素的考量应处于心理健康护理服务的核心位置。为促成此事，或许需要一种经过验证的方法来评估心理健康服务使用者的社会背景信息。因此，我们开发了一份问卷，用于在临床实践中评估心理健康的社会决定因素。
我们基于指南的开发包括三个步骤；i）构建与目的定义，ii）基于文献、类似问卷以及国际疾病分类第十版（ICD - 10）的部分内容初步生成条目，iii）对问卷进行评估、修订和内容验证。最初我们开发了249个条目，经过几个阶段的删减、修订和验证后，最终确定为73个条目。通过包括心理健康护理服务使用者和专业人员在内的调查及焦点小组实现了问卷的内容验证。
调查和焦点小组表明需要对不良社会因素进行标准化评估，并强调这种评估的好处在于能以更全面的方法来识别和解决心理健康问题发展过程中涉及的基本因素。重要的是，本研究还揭示了对心理健康社会决定因素的任何评估都必须优先考虑被评估者在该过程中发挥核心作用并对其自身数据具有控制权。焦点小组就问卷最适合的施测情境提出了相互矛盾的建议。
最终形成的问卷在理论上可被认为是稳健的且经过了部分验证。文中还讨论了未来的研究方向。
