Mental disturbances and perceived complexity of nursing care in medical inpatients: results from a European study

Abstract

Mental disturbances and perceived complexity of nursing care in medical inpatients: results from a European study Aims and objectives. The relationship between mental disturbances – anxiety and depression, somatization and alcohol abuse – on admission to internal medicine units and perceived complexity of care as indicated by the nurse at discharge was studied. The goal was to study the utility of short screeners for mental disturbances to select patients for case‐management on admission. Design. The study had a cohort design: patients were included on admission and followed through their hospital stay until discharge. The study was conducted within the framework of the European Biomed 1 Risk Factor study. Research methods and instruments. In the first 3 days of admission the patients were interviewed by a trained health care professional, who scored the SCL‐8D, a somatization questionnaire based on the Whiteley‐7 and the CAGE. At discharge, nurses rated the complexity of the patient’s care. Results. Patients with high scores on anxiety and depression (SCL‐8D) and on somatization received higher ratings on perceived nursing complexity than those with low scores, with and without control for age, severity of illness and chronicity. The actual nursing intensity and medical care utilization, as measured daily by means of a checklist, could not explain these relations. No differences were found between patients with high or low scores on alcohol abuse. Conclusions. The study shows a potential use of screeners for mental disturbances to detect patients for whom nurses might need additional help. However, mental disturbance is not the sole criterion: functional status and other variables that predict medical and nursing care utilization should be included in a screening strategy for case‐management programmes.

The Patient Care Delivery Model – an open system framework: conceptualisation, literature review and analytical strategy

“…2005, Allareddy & Konety 2006, Odetola et al. 2007) and poor mental health status on admission (De Jonge et al. 2001) impact complexity of care and utilisation of service, thereby affecting system cost outcomes.…”

Non‐psychiatric hospitalization of people with mental illness: systematic review

“…De Jonge et al. (2001) evaluated perceived care complexity of patients hospitalized in general hospitals across Europe.…”

Complexity Prediction Instrument to detect ‘complex cases’ in respiratory wards: instrument development

“…The applicability of this simple screener to detect early patients at risk for complex care in the respiratory ward should be stressed. Authors in our workgroup have reported that early detection followed by a relatively simple intervention could greatly reduce healthcare use (de Jonge et al. 2001a,b).…”

“…Cochran's coefficient was selected for this, since it is more stringent than inter-rater reliability coefficients in instruments with a yes/ no answering system such as COMPRI. Furthermore, in relation to the instrument itself, while de Jonge et al (2001b) have expressed some concerns about using subjective ratings of care complexity by physicians and nurses, they have also shown that the potential limitation is overcome by COMPRI's power for prediction. Finally, following methods for the validation of the original version, COMPRI was completed in this study by a research nurse.…”

“…New strategies of health service delivery seemed to be required against this background of intricate clinical problems (Huyse et al 2001b). Such a strategy should ideally have international application, but comparative studies in different health systems may be hampered unless the standardized tools have been adequately studied.…”