Hatfield A B, Gearon J S, Coursey R D
Department of Human Development, University of Maryland, College Park, USA.
Psychiatr Serv. 1996 Aug;47(8):825-31. doi: 10.1176/ps.47.8.825.
Data from a 1993 survey of families in the National Alliance for the Mentally Ill (NAMI) were analyzed to examine services used by consumers and families' perceptions of the services' value. Data from 1993 and 1976 were compared to document changes.
A total of 3,099 families responded to a mailed questionnaire that was first used in a 1976 local survey of 89 NAMI members. Respondents indicated which of 11 services had been used by their ill relative in the past two years and rated the services as having "no," "some," or "considerable" value. Chi square tests examined relationships between service use and value and key variables.
In 1993 families reported nearly universal use of medications and rated them highest in value. More than 60 percent of the ill relatives had been hospitalized in the past two years, and hospitalization was rated second highest in value. Individual therapy, used by two-thirds of the consumers, also received high ratings. Community services were used by about a third of the consumers; these services were valued less highly than office-based services and medications. Respondents in 1976 reported less use of medication and residential services, more hospitalization, and more use of individual, group, and family therapies. In 1993 all services were valued more highly than in 1976.
The 1993 survey findings showed that more consumers used office-based services and hospitalization than community-based alternatives, and that families rated the former services more highly. Value ratings of community services rose significantly between 1976 and 1993.
对美国国家精神疾病联盟(NAMI)1993年的家庭调查数据进行分析,以研究消费者使用的服务以及家庭对这些服务价值的看法。将1993年和1976年的数据进行比较,以记录变化情况。
共有3099个家庭回复了一份邮寄问卷,该问卷最初用于1976年对89名NAMI成员进行的本地调查。受访者指出其患病亲属在过去两年中使用过11种服务中的哪些,并将这些服务评为具有“无”、“一些”或“相当大”的价值。卡方检验用于研究服务使用与价值以及关键变量之间的关系。
1993年,家庭报告称几乎普遍使用药物治疗,并将其评为价值最高的服务。超过60%的患病亲属在过去两年中曾住院治疗,住院治疗被评为价值第二高的服务。三分之二的消费者使用过个体治疗,其评价也很高。约三分之一的消费者使用过社区服务;这些服务的价值被认为低于基于办公室的服务和药物治疗。1976年的受访者报告称药物治疗和住院服务的使用较少,住院治疗较多,个体、团体和家庭治疗的使用较多。1993年,所有服务的价值评价都高于1976年。
1993年的调查结果表明,使用基于办公室的服务和住院治疗的消费者比使用基于社区的替代服务的消费者更多,并且家庭对前一种服务的评价更高。1976年至1993年间,社区服务的价值评价显著提高。