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Gomez-Sanchez-Lafuente C, Guzman-Parra J, Lopez-Zambrano MA, Moreno-Kustner B, Mayoral-Cleries F. Met and Unmet Needs in an Inpatient Psychiatry Setting in Spain. Neuropsychiatr Dis Treat 2021; 17:1859-1868. [PMID: 34135587 PMCID: PMC8197593 DOI: 10.2147/ndt.s307394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Patients with severe mental disorder have health and social needs that require care. The aim of the study was to determine the main areas of perceived needs among inpatients with severe mental disorders and to identify risk factors of the group of patients with the greatest unmet needs. PATIENTS AND METHODS A total of 150 patients with severe mental illness were assessed during admission prior to discharge from the hospital. Camberwell Assessment of Needs was used as evaluation measure, in addition to clinical status (The Brief Psychiatric Rating Scale), social functioning (Personal and Social Performance) and sociodemographic variables. A descriptive and a multivariate logistic regression analysis were used to analyse variables related to the group of patients with the highest number of unmet needs (≥3). RESULTS Mean number of needs was 7.93, being 4.61 the mean number of needs met and 3.32 the needs unmet. The highest proportion of unmet needs were intimate relationships (44.0%), company (40.7%) and daytime activities (38.7%). A relationship was also found between the presence of three or more unmet needs and the following variables: Brief Psychiatric Rating Scale score (p=0.004), Personal and Social Performance score (p = 0.013), marital status (p=0.018), employment status (p=0.009) and voluntary admission (p=0.032). The multivariate model explained 29.5% of the variance (Nagelkerke's R2: 0.295). CONCLUSION Treatments aimed at improving social relationships and daytime activities could be a good option for inpatients with many unmet needs.
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Affiliation(s)
- Carlos Gomez-Sanchez-Lafuente
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Málaga, 29010, Spain.,Universidad de Málaga, Andalucía Tech, Facultad de Psicología, Málaga, 29071, Spain
| | - Jose Guzman-Parra
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Málaga, 29010, Spain
| | - Maria Alejandra Lopez-Zambrano
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Málaga, 29010, Spain
| | - Berta Moreno-Kustner
- Universidad de Málaga, Andalucía Tech, Facultad de Psicología, Málaga, 29071, Spain
| | - Fermin Mayoral-Cleries
- Unidad de Gestión Clínica de Salud Mental, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Málaga, 29010, Spain
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Torres-González F, Ibanez-Casas I, Saldivia S, Ballester D, Grandón P, Moreno-Küstner B, Xavier M, Gómez-Beneyto M. Unmet needs in the management of schizophrenia. Neuropsychiatr Dis Treat 2014; 10:97-110. [PMID: 24476630 PMCID: PMC3897352 DOI: 10.2147/ndt.s41063] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Studies on unmet needs during the last decades have played a significant role in the development and dissemination of evidence-based community practices for persistent schizophrenia and other severe mental disorders. This review has thoroughly considered several blocks of unmet needs, which are frequently related to schizophrenic disorders. Those related to health have been the first block to be considered, in which authors have examined the frequent complications and comorbidities found in schizophrenia, such as substance abuse and dual diagnosis. A second block has been devoted to psychosocial and economic needs, especially within the field of recovery of the persistently mentally ill. Within this block, the effects of the current economic difficulties shown in recent literature have been considered as well. Because no patient is static, a third block has reviewed evolving needs according to the clinical staging model. The fourth block has been dedicated to integrated evidence-based interventions to improve the quality of life of persons with schizophrenia. Consideration of community care for those reluctant to maintain contact with mental health services has constituted the fifth block. Finally, authors have aggregated their own reflections regarding future trends. The number of psychosocial unmet needs is extensive. Vast research efforts will be needed to find appropriate ways to meet them, particularly regarding so-called existential needs, but many needs could be met only by applying existing evidence-based interventions. Reinforcing research on the implementation strategies and capacity building of professionals working in community settings might address this problem. The final aim should be based on the collaborative model of care, which rests on the performance of a case manager responsible for monitoring patient progress, providing assertive follow-up, teaching self-help strategies, and facilitating communication among the patient, family doctor, mental health specialist, and other specialists.
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Affiliation(s)
- Francisco Torres-González
- Centro de Investigación Biomédica en Red de Salud Mental, University of Granada, Spain ; Maristán Network, University of Granada, Granada, Spain
| | - Inmaculada Ibanez-Casas
- Centro de Investigación Biomédica en Red de Salud Mental, University of Granada, Spain ; Maristán Network, University of Granada, Granada, Spain
| | - Sandra Saldivia
- Department of Psychiatry and Mental Health, Faculty of Medicine, University of Concepcion, Chile ; Maristán Network, University of Granada, Granada, Spain
| | - Dinarte Ballester
- Sistema de Saúde Mãe de Deus, Escola Superior de Saúde, Universidade do Vale do Rio dos Sinos, Brazil ; Maristán Network, University of Granada, Granada, Spain
| | - Pamela Grandón
- Department of Psychology, Faculty of Social Sciences, University of Concepcion, Chile ; Maristán Network, University of Granada, Granada, Spain
| | - Berta Moreno-Küstner
- Andalusian Psychosocial Research Group and Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Malaga, Spain ; Maristán Network, University of Granada, Granada, Spain
| | - Miguel Xavier
- Department of Mental Health, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal ; Maristán Network, University of Granada, Granada, Spain
| | - Manuel Gómez-Beneyto
- Centro de Investigación Biomédica en Red de Salud Mental, University of Valencia, Spain ; Maristán Network, University of Granada, Granada, Spain
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