systematic monitoring of needs for care and global outcomes in patients with severe mental illness系统的监测需要护理和全球性的严重精神疾病患者预后.pdf
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Drukker et al. BMC Psychiatry 2010, 10:36
/1471-244X/10/36
R E S E A R C H A R T I C L E Open Access
Research article
Systematic monitoring of needs for care and global
outcomes in patients with severe mental illness
1 1,2 1,3 3 1,3
Marjan Drukker* , Jim van Os , Maarten Bak , Joost à Campo and Philippe Delespaul
Abstract
Background: It was hypothesised that the introduction of tools that allow clinicians to assess patients needs and to
negotiate treatment (Cumulative Needs for Care Monitor; CNCM), would be associated with global outcome
improvements in patients diagnosed with severe mental illness.
Methods: The CNCM was introduced in one region in South Limburg (the Netherlands) in 1998 (REGION-1998) and in
the rest of South Limburg in 2004 (REGION-2004). By comparing these two regions, changes after the introduction of
the CNCM could be assessed (between-region comparison). In addition, a pre-post within-patient comparison was
conducted in both regions.
Results: The within-patient comparison revealed that global outcomes of psychopathology and impairment improved
in the first 3-5 years after the introduction of the CNCM. The between-region comparison revealed an improvement in
global psychopathology but not in global impairment in REGION-2004 after 2004, while there was no such
improvement in REGION-1998.
Conclusion: Systematic clinical monitoring of individual severe mental illness patients, in combination with provision
of feedback, is associated with global improvement in psychopathology. More research is needed to determine the
degree to which this association reflects a causal effect.
Background plans are needs based [7,8]. H
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