The NAMI consumer survey analysis of unmet needs. National Alliance for the Mentally Ill.
The NAMI consumer survey analysis of unmet needs. National Alliance for the Mentally Ill.
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NAMI 消费者调查分析未满足的需求。
DOI：
10.1176/ps.45.4.372
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发表时间：
1994
期刊：
影响因子：
--
通讯作者：
Mechanic,D
中科院分区：
文献类型：
--
作者：
Uttaro,T;Mechanic,D
方法收集与消费者未满足需求相关的数据，并结合对 1990 年 NAMI 会员名单上的 1,722 个具有全国代表性的家庭进行电话调查(9)。这项调查于 1990 年 10 月至 1991 年 3 月期间进行，样本中 81% 的家庭接受了采访。家庭采访结束时，受访者被要求允许采访其患有精神疾病的亲属，76% 的人同意。总共采访了 5 52 名消费者，即获得 &milies 许可的合格受访者的 77%。资格要求包括年满 18 岁或以上、居住在社区中并且可以通过电话联系。采访者是 Survey Research Associates, Inc. 的员工，该公司在治疗严重和持续性精神疾病患者方面拥有丰富的经验。他们通过结构化访谈来获取消费者在住房、金融、就业、个人相关 15 个领域的感知需求信息。 l 人际关系以及日常生活的其他方面。在每个领域，受访者都被要求表明他们是否认为有需要、正在接受帮助或需要更多帮助。此外，在调查开始和结束时，消费者都被要求回答雷曼兄弟生活质量访谈中的一个总结性问题(8)：“您对自己的整体生活感觉如何？”使用主要成分因素分析来检查消费者确定的未满足的需求。当考虑到各种人口、社会和临床因素时，进行多元回归分析以评估服务利用与未满足的需求和生活质量之间的关联。临床因素包括基于家庭成员报告的八种特定症状的行为干扰测量（α = . 7 1），以及基于抑郁症状量表中常用的 1 3 项的抑郁症状测量（α = . 87）。作者提供了有关措施和分析的更多详细信息。结果分析表明，我们样本中的消费者相当能代表 NAMI 家庭成员的消费者，但 NAMI 是一个选定的群体，结果不一定适用于患有严重精神疾病的人群。样本中 93% 是白人，68% 是男性。 12% 的受访者已婚，24% 的受访者有自己的孩子。平均年龄为 33 岁，90% 的受访者年龄在 48 岁或以下。他们的教育水平中位数是高中毕业。 49% 的受访者居住在自己的家中或公寓，35% 的受访者与家人住在一起。其中 14% 居住在受监管的住所。 76% 的受访者被诊断为精神分裂症，88% 服用精神药物。受访者有严重的药物滥用和身体健康问题。 5% 的人报告非法吸毒，26% 的人报告中度至重度饮酒，37% 的人报告与精神疾病不同的身体问题，33% 的人将他们的身体健康状况描述为“ir”或“差”。
MethodThe data related to consumers’ unmet needs were collected in conjunction with a telephone survey of a nationally representative sample of 1,722 families on NAMI membership lists in 1990(9). Eighty-one percent of the families in the sample were interviewed in the survey, which was conducted between October 1990 and March 1991. At the conclusion of the family interview, respondents were asked for penmission to interview their mentally ill relative, and 76 percent consented. Interviews were completed with a total of5 52 consumers, or 77 percent of the eligible respondents whose &milies gave permission. Eligibility requirements included being age 18 or olden, residing in the community, and being reachable by telephone. The interviewers were employees ofSurvey Research Associates, Inc., a firm with considerable experience in working with persons with severe and persistent mental illness. They used a structured interview to obtain information about consumers’ perceived needs in 15 areas related to housing, finance, employment, persoria. l relationships, and other aspects of daily living. In each of the areas, respondents were asked to indicate whether they perceived a need, were receiving help, or wanted more assistance. In addition, both at the beginning and end ofthe survey consumers were asked to respond to a summary question from Lehman’s Quality of Life interview(8),“How do you feel about your life as a whole?” Unmet needs identified by consumers were examined using a pnincipal components factor analysis. Multiple regression analyses were performed to assess the association between service utilization and unmet needs and quality of life when various demographic, social, and clinical factors were taken into account. The clinical factors included a measure of behavioral disruption based on family members’ reports of eight specific symptoms(alpha=. 7 1), and a measure of depressive symptoms based on 1 3 items commonly used in depression symptom scales (alpha=. 87). Further detail on the measures and the analysis arc available from the authors.Results Analyses showed that the consumers in our sample were reasonably representative of consumers who were members of NAMI families, but NAMI is a selected group, and the results are not necessarily generalizable to the population of persons with severe mental illness. The samplc was 93 percent white and 68 percent male. Twelve percent of the respondents were married, and 24 percent had children of their own. The median age was 33 years, and 90 percent of the respondents were age 48 or younger. Their median level of education was high school graduation. Forty-nine percent of the respondents resided in their own home or apartment, 35 percent resided with their fs. milies, and 14 percent resided in a supervised residence. Seventy-six percent ofthe respondents had been given a diagnosis of schizophrenia, and 88 percent took psychotropic medication. Respondents had significant substance abuse and physical health problems. Five percent reported illegal drug use, 26 percent reported moderate to heavy alcohol use, 37 percent reported physicalproblems distinct from their mental illness, and 33 percent descnibed their physical health status as &ir or poor.