自2020年4月以来,新的日本精神卫生系统使用强化病例管理筛查表(ICMSS)来确定患者对病例管理服务的需求。本研究旨在检查ICMSS评分与服务强度之间的关联,并将ICMSS评分与服务强度之间的关联程度与其他量表进行比较。
我们招募了从精神科门诊服务的工作人员那里接受病例管理服务的患者,精神病日托项目,或在一家精神病医院的外展团队。病例管理服务需求和功能使用ICMSS进行评估,全球评估功能(GAF)个人和社会绩效(PSP)。病例经理还记录了参与者在2个月内获得的所有服务。检查了每个量表与服务持续时间之间的关联。此外,比较了各量表与服务强度之间的关联程度.
总的来说,138名参与者被纳入分析。最常见的诊断是精神分裂症。平均总服务持续时间与ICMSS(Spearman'sρ=0.320)相关性较弱,但与ICMSS显著相关,GAF(ρ=-0.198),和PSP(ρ=-0.275)得分。Poisson回归模型和估计后检验表明,ICMSS得分系数(B=0.144;95%CI=0.141,0.148)明显大于GAF系数(B=-0.017,95%CI=-0.017,-0.016,χ2=15.70,P<0.001)和PSP(B=-0.016,95%CI=-0.017,-0.016,χ2<0.001)。
ICMSS可能会提供有关案件管理服务需求的初步信息,但是服务水平应基于每个患者的个人需求以及患者和病例管理者之间的共同决策。
Since April 2020, the new Japanese mental health system has used the Intensive
Case Management Screening Sheet (ICMSS) to identify patients\' needs for
case management services. This study aimed to examine the association between ICMSS score and service intensity and compare the magnitude of association between ICMSS score and service intensity with other scales.
We recruited patients who received
case management services from a staff member in a psychiatric outpatient service, psychiatric day-care program, or outreach team based at one psychiatric hospital.
Case management service needs and
functioning were assessed using ICMSS, Global Assessment
Functioning (GAF), and Personal and Social Performance (PSP). The
case manager also documented all services received by the participant for 2 months. The association between each scale and service duration was examined. Furthermore, the magnitude of the association between each scale and service intensity was compared.
Overall, 138 participants were included in the analysis. The most common diagnosis was schizophrenia. Mean total service duration was weakly but significantly correlated with ICMSS (Spearman\'s ρ = 0.320), GAF (ρ = -0.198), and PSP (ρ = -0.275) scores. Poisson\'s regression models and postestimation testing showed that the coefficient for ICMSS score (B = 0.144; 95% CI = 0.141, 0.148) was significantly larger than the coefficients for GAF (B = -0.017, 95% CI = -0.017, -0.016, χ2 = 15.70, P < 0.001) and PSP (B=-0.016, 95% CI = -0.017, -0.016, χ2 = 14.64, P < 0.001) scores.
ICMSS may provide preliminary information on case management service needs, but the level of service should be based on the individual needs of each patient and shared decision-making between the patient and case manager.