Dickey B, Wagenaar H, Stewart A
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Med Care. 1996 Feb;34(2):112-6. doi: 10.1097/00005650-199602000-00003.
Changes in the delivery of mental health care have prompted interest in using generic health status measures to test the effect of system change on those receiving treatment. Of special concern are those with serious and persistent mental illness who may be neglected when cost containment efforts reduce the availability of treatment services. This population may be affected by these changes, which might go undetected if investigators use scales that measure only pathology and not the full spectrum of well-being. The purpose of this study was to test the feasibility of using self-report health status measures with this population, to describe the psychometric properties of the scales, and to report the health status scores of a random sample of the Medicaid psychiatrically disabled population. We found that the four health status scales had adequate psychometric properties, that score variability was high, the distributions normal, and that patterns of association with more traditional clinical measures were of the expected size and direction. One scale, General Health Perceptions, had reliability and item-to-score correlation below acceptable levels.
精神卫生保健服务的变化引发了人们对使用通用健康状况测量方法来测试系统变化对接受治疗者影响的兴趣。特别令人担忧的是那些患有严重持续性精神疾病的人，在成本控制措施导致治疗服务可及性降低时，他们可能会被忽视。这一人群可能会受到这些变化的影响，如果研究人员使用仅测量病理学而非全面幸福感的量表，这些影响可能无法被发现。本研究的目的是测试对这一人群使用自我报告健康状况测量方法的可行性，描述量表的心理测量特性，并报告医疗补助计划中精神残疾人群随机样本的健康状况得分。我们发现，这四个健康状况量表具有足够的心理测量特性，得分变异性高，分布呈正态，且与更传统临床测量方法的关联模式在预期的大小和方向上。其中一个量表，即总体健康感知量表，其信度和项目与得分的相关性低于可接受水平。
