使用世界卫生组织残疾评估表对法医精神病住院患者中的精神病谱系障碍患者的残疾评级和工作人员的残疾评级进行比较。

IF 1.1 4区 医学 Q3 CRIMINOLOGY & PENOLOGY
Malin V. Källman, Mathilde Hedlund-Lindberg, Marianne Kristiansson, Anette G. M. Johansson
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引用次数: 0

摘要

背景:法医精神病学服务中的社会心理康复需要对病人和工作人员对社会心理功能的看法进行合理的测量。目的:研究精神病安全医院住院病人的病人和工作人员对世界卫生组织残疾评估表 2.0(WHODAS)的评分,研究他们之间的差异,并探讨与其他临床因素的关联:73名患者在住院3个月后对WHODAS进行了自我评分。职业治疗师大约同时对患者的主治护士和护理团队进行了访谈(员工评分)。分数根据 WHODAS 手册计算。将WHODAS评分与访谈评定的症状严重程度、认知能力、每日抗精神病药物剂量和护理时间进行比较:结果:在总分以及理解与沟通、相处和生活活动等方面,患者评分显示的残疾程度低于工作人员评分。自理能力和参与能力的评分相似。患者更有可能将自己评为行动不便。只有五分之一的患者(16%,22%)和工作人员的评分相似,而近三分之一的患者(23%,32%)的自我评分高于工作人员的评分。在考虑了治疗时间、阴性症状、认知评分和抗精神病药物剂量后,阳性症状越严重,自评的 WHODAS 残疾程度越高。没有任何变量可以解释工作人员与患者之间的评分差异:我们的 WHODAS 平均评分结果与其他患者样本的结果一致--患者低估了与症状严重程度相关的残疾程度。然而,在这项首次在法医精神健康安全住院服务中使用 WHODAS 的研究中,我们发现,通过对个体进行比较,半数患者报告的残疾程度与工作人员报告的残疾程度相当或更高。未来的研究应侧重于向患者阐明是什么导致了他们的自我评分。了解他们在评级时的思维过程可能会有助于制定康复计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A comparison of patient ratings and staff ratings of disability using the World Health Organisation Disability Assessment Schedule in individuals with psychotic spectrum disorders who are forensic psychiatric inpatients

A comparison of patient ratings and staff ratings of disability using the World Health Organisation Disability Assessment Schedule in individuals with psychotic spectrum disorders who are forensic psychiatric inpatients

Background

Psychosocial rehabilitation in forensic psychiatric services requires sound measurement of patient and staff perceptions of psychosocial function. The recommended World Health Organisation Disability Assessment Schedule 2.0 (WHODAS), designed for this, has not been examined with offender patients.

Aims

To examine patient and staff WHODAS ratings of secure hospital inpatients with psychosis, any differences between them and explore associations with other clinical factors.

Methods

Seventy-three patients self-rated on the WHODAS after 3 months as inpatients. An occupational therapist interviewed the patient's primary nurse and care team at about the same time (staff ratings). Scores were calculated according to the WHODAS manual. WHODAS scores and interview-rated symptom severity, cognitive measures, daily antipsychotic dose and duration of care were compared.

Results

Patient ratings indicated less disability than staff ratings for total score and for the domains of understanding and communicating, getting along and life activities. Self-care and participation ratings were similar. Patients were more likely to rate themselves as disabled in getting around (mobility). Only one-fifth of patient- and staff- ratings (16, 22%) were similar, while for nearly a third of the patients (23, 32%) self-ratings were higher than staff ratings. More severe positive symptoms were associated with higher self-rated WHODAS disability after accounting for treatment duration, negative symptoms, cognitive score and antipsychotic dose. No variable accounted for the staff/patient differences in ratings.

Conclusion

Our mean WHODAS score findings echoed those in other patient samples—of patient underestimation of disability, linked to severity of symptoms. In this study using the WHODAS for the first time in a forensic mental health secure inpatient service, however, we found that, by comparing individuals, half of the patients reported equivalent or greater disability than did staff. Future research should focus on elucidating from patients what contributes to their self-ratings. Understanding their thought processes in rating may enhance rehabilitation planning.

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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
40
期刊介绍: Criminal Behaviour & Mental Health – CBMH – aims to publish original material on any aspect of the relationship between mental state and criminal behaviour. Thus, we are interested in mental mechanisms associated with offending, regardless of whether the individual concerned has a mental disorder or not. We are interested in factors that influence such relationships, and particularly welcome studies about pathways into and out of crime. These will include studies of normal and abnormal development, of mental disorder and how that may lead to offending for a subgroup of sufferers, together with information about factors which mediate such a relationship.
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