The assessment of patients with long-term psychotic disorders: application of the WHO Disability Assessment Schedule II
The assessment of patients with long-term psychotic disorders: application of the WHO Disability Assessment Schedule II
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DOI：
10.1080/j.1440-1614.2004.01448.x
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发表时间：
2004-09-01
影响因子：
4.6
通讯作者：
Herrman, H
中科院分区：
文献类型：
--
作者：
Chopra, PK;Couper, JW;Herrman, H
目的：评估世界卫生组织残疾评估表II （WHODAS II）的使用情况，这是一份衡量长期精神障碍患者残疾的患者问卷。方法：本研究在澳大利亚墨尔本圣文森特精神卫生服务中心进行。本研究选取了20名长期精神障碍患者，他们分别接受住院社区护理单位或门诊流动支援及治疗服务的护理。对于所有20名患者，使用国际损伤、残疾和残疾分类-2 （ICIDH-2）、生活技能概况（LSP）和国家健康结局量表（HoNOS）记录临床医生对残疾和功能状态的评估。然后对每位患者进行WHODAS II调查。WHODAS II在初步评估后5天内由第二评价者重新给药，以进行重测信度分析。每位患者还完成了世卫组织生活质量量表（WHQOL-BREF），这是一份关于生活质量的自我报告问卷。结果：WHODAS II的经验是相对复杂的，有时难以管理与充分合作在这个临床背景下。总体而言，重测信度是公平的。它获得的信息为了解患者的经历提供了宝贵的见解。大多数参与者报告的心理功能损伤和活动限制比临床医生报告的要少。然而，由于环境障碍，患者在参与社会活动和限制方面有明显的限制。WHOQOL-BREF通过探讨患者在生活体验的各个方面的困难和满意度，突出了患者在参与社会过程中遇到的困难，该工具得到了广泛接受。结论：在评估长期精神障碍患者的预后时，需要患者的自我报告经验以及临床评定的措施。WHODAS II记录和测量患者自身的残疾经历。它可以与WHOQOL-BREF一起使用，WHOQOL-BREF是一种独特而互补的生活质量自我报告评估。
Objectives: To evaluate the use of the World Health Organization Disability Assessment Schedule II (WHODAS II), a patient questionnaire measuring disability, in patients treated for long-term psychotic disorders.Method: The study was conducted at St. Vincent's Mental Health Service, Melbourne, Australia. Twenty patients with long-term psychotic disorders under the care of either the residential Community Care Unit or the outpatient Mobile Support and Treatment Service were selected. For all 20 patients a clinician assessment of disability and functional status was recorded using the International Classification of Impairments, Disabilities and Handicaps-2 (ICIDH-2), Life Skills Profile (LSP) and Health of the Nation Outcome Scale (HoNOS). The WHODAS II survey was then administered to each patient. The WHODAS II was re-administered by a second rater within 5 days of the initial assessment for the purpose of test-retest reliability analysis. Each patient also completed the WHO Quality of Life instrument (brief version) (WHQOL-BREF), a self-report questionnaire on quality of life.Results: The WHODAS II was experienced as relatively complex and at times difficult to administer with full co-operation in this clinical context. Overall, test-retest reliability was fair. The information it yielded gave valuable insights into patients' experiences. Most of the participants reported fewer impairments in mental functions and fewer activity limitations than reported by clinicians. However, patients reported significant restrictions in participation in social activities and limitations due to environmental barriers. The WHOQOL-BREF highlighted difficulties experienced by patients in their participation in society, through exploring difficulties and satisfaction with various aspects of life experience and this instrument was well accepted.Conclusions: The self-reported experience of patients is needed alongside clinician-rated measures to assess outcomes in people with long-term psychotic disorders. The WHODAS II records and measures patients' own experiences of disability. It may be used together with the WHOQOL-BREF, a distinct and complementary self-report assessment of quality of life.