Acessibilidade / Reportar erro

Factors associated with unmet needs in individuals with schizophrenia in Chile

Fatores associados com as necessidades não satisfeitas em indivíduos com esquizofrenia no Chile

Abstracts

OBJECTIVE: To evaluate the possible associations between different sociodemographic, clinical, and healthcare factors and the number of unmet needs among people being treated for schizophrenia. METHODS: The sample was made up of 141 subjects who were being treated at eight mental health service networks throughout Chile. Unmet need was assessed with the Camberwell Assessment of Need, which was specifically created for people with severe mental disorders. A multiple linear regression analysis was also applied. RESULTS: It was found a direct association with clinical variables: score in the Positive and Negative Syndrome Scale, global functioning at diagnosis, and change in global functioning at diagnosis from diagnosis to interview. However, sociodemographic (ethnicity, education level, and number of people who live with subject) and other clinical variables (age at diagnosis, and annual rate of relapse) were indirectly associated with unmet needs. CONCLUSIONS: Our results can be applied in order to coordinate and improve the effectiveness of mental health services in Chile.

schizophrenia; needs assessment; mental health services


OBJETIVO: Avaliar as possíveis associações entre diversos fatores sociodemográficos, clínicos e de cuidado à saúde e o número de necessidades não atendidas entre pessoas que estão sendo tratadas devido à esquizofrenia. MÉTODOS: A amostra foi composta por 141 indivíduos que estavam sendo tratados em oito redes de serviço de saúde mental por todo o Chile. A necessidade não atendida foi avaliada pela Camberwell Assessment of Need, que foi especificamente criada para pessoas com distúrbios mentais graves. Também foi aplicada uma análise de regressão linear múltipla. RESULTADOS: Encontrou-se associação direta com variáveis clínicas: escore na Positive and Negative Syndrome Scale, funcionamento global ao diagnóstico e mudança no funcionamento global ao diagnóstico desde o diagnóstico à entrevista. Entretanto, variáveis sociodemográficas (etnia, nível educacional e número de pessoas que moram com o indivíduo) e clínicas (idade no momento do diagnóstico e taxa anual de recidiva) foram indiretamente associadas com as necessidades não atendidas. CONCLUSÕES: Os presentes resultados podem ser aplicados para coordenar e aprimorar a eficácia dos serviços de saúde mental no Chile.

esquizofrenia; determinação de necessidades de cuidados de saúde; serviços de saúde mental


  • 1
    Torres González F, Rosales Varo C, Moreno Küstner B, Jiménez Estévez JF. Evaluación de las necesidades de los enfermos mentales. In: Bulbena Vilarrasa A, Berrios G, Fernández de Larrinoa P, editors. Medición clínica en psiquiatría y psicología. Barcelona, Spain: Masson; 2000. p. 545-54.
  • 2
    Wing JK, Cooper JE, Sartorius N. The measurement and classification of psychiatric symptoms. London, UK: Cambridge University Press; 1974.
  • 3
    Ochoa S, Haro JM, Autonell J, Pendàs F, Teba F, Màrquez M et al. Met and unmet needs of schizophrenia patients in a Spanish sample. Schizophr Bull. 2003;29(2):201-10.
  • 4
    Rosales Varo C, Torres González F, Luna del Castillo J, Baca Baldomero E, Martínez Montes G. Evaluación de necesidades de personas con enfermedad esquizofrénica (CAN). Actas Esp Psiquiatr. 2002;30:182-8.
  • 5
    Moreno Küstner B, Jimenez Estévez JF, Godoy García JF, Torres González F. Assessment of needs for care of a schizophrenic patient simple from the Granada South Mental Health Care Area. Actas Esp Psiquiatr. 2003;31(6):325-30.
  • 6
    Macpherson R, Varah M, Summerfield L, Foy Ch, Slade M. Staff and patient assessments of need in a epidemiologically representative sample of patients with psychosis. Soc Psychiatry Psychiatr Epidemiol. 2003;38(11):662-7.
  • 7
    Kallert TW, Leisse M, Winiecki P. Needs for care of chronic schizophrenic patients in long-term community treatment. Soc Psychiatry Psychiatr Epidemiol. 2004;39(5):386-96.
  • 8
    Wiersma D. Needs of people with severe mental illness. Acta Psychiatr Scand Suppl. 2006;113(Suppl. 429):115-9.
  • 9
    Ochoa S, Usall J, Haro JM, Araya S, Autonell J, Busquets E, et al. Estudio comparativo de las necesidades de pacientes con esquizofrenia en función del género. Actas Esp Psiquiatr. 2005;29:165-71.
  • 10
    Becker T, Knapp M, Knudsen HC, Schene A, Tansella M, Thornicroft G, et al. The EPSILON study of schizophrenia in five European countries. Design and methodology for standardizing outcome measures and comparing patterns of care and service costs. Br J Psychiatry. 1999;175:514-21.
  • 11
    Meijer K, Schene A, Koeter M, Knudsen HC, Becker T, Thornicroft G, et al. Needs for care of patients with schizophrenia and the consequences for their informal caregivers: results from the EPSILON multi centre study on schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2004;39(4):251-8.
  • 12
    Lasalvia A, Bonetto C, Malchiodi F, Salvi G, Parabiaghi A, Tansella M, et al. Listening to patients' needs to improve their subjective quality of life. Psychol Med. 2005;35(11):1655-65.
  • 13
    Slade M, Leese M, Cahill S, Thornicroft G, Kuipers E. Patient-rated mental health needs and quality of life improvement. Br J Psychiatry. 2005;187:256-61.
  • 14
    Thornicroft G, Strathdee G, Phelan M, Holloway F, Wykes T, Dunn G, et al. Rationale and design. PRiSM Psychosis Study 1. Br J Psychiatry. 1998;173:363-70.
  • 15
    Thornicroft G, Wykes T, Holloway F, Johnson S, Szmukler G. From efficacy to effectiveness in community mental health services. PRISM Psychosis Study 10. Br J Psychiatry. 1998;173:423-7.
  • 16
    Leese M, Johnson S, Slade M, Parkman S, Kelly F, Phelan M, et al. User perspective on needs and satisfaction with mental health services. PRISM Psychosis Study. Br J Psychiatry. 1998;173:409-15.
  • 17
    Arvidsson H. Met and unmet needs of severely mentally ill persons. The Psychiatric Care Reform in Sweden. Soc Psychiatry Psychiatr Epidemiol. 2003;38(7):373-9.
  • 18
    Goldman HH, Skodol AE, Lave TR. Revising axis V for DSM-IV: a review of measurement of social functioning. Am J Psychiatry. 1992;149(9):1148-56.
  • 19
    Páez D. Suceso vital, soporte social, recursos e identidades sociales como factores explicativos de la depresión y ansiedad. In: Páez D, eds. Salud Mental y Factores Psicosociales. España: Editorial Fundamentos; 1982. p. 83-127.
  • 20
    Alvarado R, Asún D, Alfaro A, Vega A, Toledo MI, Serrano F, et al. Comparación de variables psico-sociales entre un grupo con trastornos emocionales y uno control. Rev Psiquiatría. 1992;9:1141-52.
  • 21
    Alvarado R, Vera A. La Escala de Balance Afectivo y su relación con algunas variables psicosociales. Rev Psiquiatría. 1995;12:174-8.
  • 22
    Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13:261-76.
  • 23
    Peralta Martín V, Cuesta Zorita MJ. Validation of positive and negative symptom scale (PANSS) in a sample of Spanish schizophrenic patients. Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1994;22(4):171-7.
  • 24
    Slade M, Loftus L, Phelan M, Thornicroft G, Wykes T. The Camberwell Assessment of Need. London: Gaskell; 1999.
  • 25
    Phelan M, Slade M, Thornicroft G, Dunn G, Holloway F, Wykes T, et al. The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness. Br J Psychiatry. 1995;167(5):589-95.
  • 26
    Rosales Varo C, Torres González F, Luna Del Castillo J, Jiménez Estévez J, Martínez Montes G. Reliability of the Spanish version of the Camberwell Assessment of Needs (CAN). Actas Esp Psiquiatr. 2002;30(2):99-104.
  • 27
    Jiménez Estévez JF, Moreno Küstner B, Torres González F, Luna del Castillo JD, Phelan M. Evaluación de necesidades en enfermos mentales crónicos: el cuestionario de evaluación de necesidades de Camberwell. Arch Neurobiol. 1997;60(2):113-24.
  • 28
    Ochoa S, Haro JM, Usall J, Autonell J, Vicens E, Asensio F, et al. Needs and its relation to symptom dimensions in a sample of outpatients with schizophrenia. Schizophr Res. 2005;75(1):129-34.
  • 29
    Korkeila J, Heikkilä J, Hansson L, Sorgaard K, Vahlberg T, Karlsson H. Structure of needs among persons with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2005;40:233-9.
  • 30
    Markkula N, Alvarado R, Minoletti A. Adherence to guidelines and treatment compliance in the Chilean national program for first-episode schizophrenia. Psychiatr Serv. 2011;62(12):1463-9.

Publication Dates

  • Publication in this collection
    15 Aug 2013
  • Date of issue
    2012

History

  • Received
    10 Apr 2012
  • Accepted
    18 Aug 2012
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