Structure of needs among persons with schizophrenia.
BACKGROUND
The importance of needs assessment for service development has been widely recognised. Several studies have focused on the associations between ratings of needs by patients and staff and have found clear differences, especially concerning the unmet needs.


METHODS
The present study is part of a Nordic Multicentre study that investigates the life and care of outpatients with a schizophrenia group illness in all the Nordic countries. The aim of this paper is to study the patterns of needs as identified by patients and staff according to the Camberwell Assessment of Needs (CAN). Quality of life, level of functioning, and psychiatric symptoms were assessed.


RESULTS
The sample includes 300 patients, 194 (65%) men and 106 (35%) women. The factor analysis identified five factors for patients and four factors for staff in the questionnaire on ratings of needs. In four of the five patient-related factors a meaningful interpretation was possible, and the factors were named skills, illness, coping, and substance abuse. The staff-related factors were named skills, impairment, symptom, and substance abuse. There were significant associations between the sum scores constructed from the factors and measures of functioning level and symptoms.


CONCLUSIONS
It seems that the sum factor reflecting secondary needs was the most important of the identified factors among both patient and staff ratings. The item-by-item comparisons in previous studies have emphasised differences between patient and staff ratings, but our analysis of the structure of needs also found similarities in the structures and in the associations between the identified sum scores and measures of symptoms, functioning level, and quality of life.
Korkeila
Jyrki
J
Dept. of Psychiatry, Turku University Central Hospital and University of Turku, Turku, Finland. jyrki.korkeila@turku.fi
Heikkilä
Jyrki
J
Hansson
Lars
L
Sørgaard
Knut W
KW
Vahlberg
Tero
T
Karlsson
Hasse
H
D000223:Adaptation, Psychological; D000328:Adult; D000553:Ambulatory Care; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D011788:Quality of Life / Q000523:psychology; D012537:Scandinavian and Nordic Countries; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires
Nord J Psychiatry. 2003;57(1):5-11
12745786
Can J Psychiatry. 2003 Feb;48(1):14-21
12635559
Br J Psychiatry. 1995 Nov;167(5):589-95
8564313
Psychol Med. 1998 May;28(3):543-50
9626711
Soc Psychiatry Psychiatr Epidemiol. 1998 Feb;33(2):49-56
9503987
Arch Gen Psychiatry. 2003 Jun;60(6):565-71
12796219
Acta Psychiatr Scand. 2000 Jul;102(1):58-64
10892611
Acta Psychiatr Scand. 2001 Jan;103(1):45-51
11202128
Soc Psychiatry Psychiatr Epidemiol. 2001 Aug;36(8):381-90
11766968
Soc Psychiatry Psychiatr Epidemiol. 1997 Feb;32(2):76-83
9050348
Drugs. 2002;62(5):743-55
11929329
Br J Psychiatry. 1999 May;174:404-8
10616605
Soc Psychiatry Psychiatr Epidemiol. 2001 Jan;36(1):13-9
11320803
Soc Psychiatry Psychiatr Epidemiol. 1996 Jun;31(3-4):109-13
8766455
Acta Psychiatr Scand. 1997 Dec;96(6):459-68
9421343
J Clin Psychiatry. 2002 Oct;63(10):892-909
12416599