Met and Unmet Needs of Patients with Schizophrenia - Brief Research Report of a Romanian Sample

By Popescu, Codruta; Miclutia, Ioana | Journal of Cognitive and Behavioral Psychotherapies, September 2009 | Go to article overview
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Met and Unmet Needs of Patients with Schizophrenia - Brief Research Report of a Romanian Sample


Popescu, Codruta, Miclutia, Ioana, Journal of Cognitive and Behavioral Psychotherapies


Abstract

The objective of the study was to translate and adapt the Romanian version of the Camberwell Assessment of Needs, and to assess its inter-rater reliability in a sample of patients diagnosed with schizophrenia. Fifty-eight schizophrenic patients were assessed using the 22 domains of the Romanian version of the Camberwell Assessment of Needs. The kappa coefficient was used to assess inter-rater reliability. For 21 domains the inter-rater reliability was almost perfect to total (range: 0.86 to 1.0). The domain with the lowest agreement was companionship. The inter-rater reliability of the Camberwell Assessment of Needs was similar to what has been found in previous studies. The use of standardized instruments to assess needs of care in Romania will contribute to the assessment of the effectiveness of treatment and to the planning of individualized care for individuals with mental illnesses.

Keywords: needs assessment, schizophrenia, psychiatric status, rating scale

Individuals with schizophrenia face limitations in their daily life activities. Their needs are complex. Stevens & Gabbay (1991) define the concept of need as ''the ability to benefit in some way from healthcare''.

In most of the countries, the systematic assessment of needs related to living conditions, routine tasks, social relationships and disabilities associated with the psychotic illness is considered essential for service planning and for the establishment of treatment goals (Joska & Flisher, 2005). Deinstitutionalization of people with schizophrenia increases the importance of evaluating their needs. In Romania, the assessment of needs is infrequently done. Thus far, no instruments have been translated and validated in Romanian. This study was designed to address this need.

Needs have to be negotiated between service users (people who receive intervention) and formal carers (staff who assesses and intervenes to meet those needs) (Najim & McCrone, 2005). The adult Camberwell Assessment of Need (CAN) (Phelan, Slade, Thornicroft et al., 1995) is the only instrument that takes account of both users and staff on the same measures.

The objective of this study was make the instrument accessible to Romanian clinicians, this study translated and validated a Romanian language version of the adult Camberwell Assessment of Needs; it also identified the most common needs of people with schizophrenia living in the community in Romania

Method

Participants

This study was conducted at the Second Psychiatric Clinic in Cluj- Napoca, Romania as part of a research grant "ACCESEGAL - Social inclusion and work access for people with severe mental illness'' (contract PC 91- 1056/2007).

Fifty-eight patients diagnosed with schizophrenia were recruited at the Second Psychiatric Clinic in Cluj-Napoca. Inclusion criteria were: an ICD-10 diagnosis of schizophrenia, a minimum 1 year after the establishment of the diagnosis of schizophrenia, age between 18 and 55 at the time of inclusion. Exclusion criteria were: history of head injury, current substance abuse, a general medical condition that could mimic a psychosis, IQ less than 70.

Measures

The patients were evaluated using the following instruments:

1. A socio-demographic and clinical questionnaire that included information on psychiatric history, professional history, income and housing status;

2. The Camberwell Assessment of Needs -Romanian version.

The adult Camberwell Assessment of Need (CAN) was developed by Slade, Thornicroft and colleagues at the Section of Community Psychiatry (PriSM) of the London Institute of Psychiatry. The adult CAN is a family of questionnaires for assessing the wide range of problems which can be experienced by a mental health service user with severe mental health problems. It covers 22 different areas of life, and can be used to assess the perceptions of the service user, their carer, and clinical staff working with them (i.

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