Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-09T08:19:14.164Z Has data issue: false hasContentIssue false

The needs of older people with mental health problems in a Portuguese psychiatric setting

Published online by Cambridge University Press:  08 February 2017

Joaquim Passos
Affiliation:
Health Sciences Unit, School of Health Sciences, Polytechnic Institute of Viana do Castelo, Rua D, Moisés Alves de Pinho, 4900-314, Viana do Castelo, Portugal
Aníbal Fonte
Affiliation:
Psychiatric and Mental Health Department, Alto Minho Local Health Unit, Santa Luzia Hospital, Estrada de Santa Luzia, 4901-858, Viana do Castelo, Portugal
Cláudia Camila Dias
Affiliation:
Department of Health Information and Decision Sciences (CIDES) and CINTESIS, Faculty of Medicine, University of Porto, Al. Hernâni Monteiro, 4200-319, Porto, Portugal
Lia Fernandes*
Affiliation:
UNIFAI/CINTESIS Research Unit, Faculty of Medicine, University of Porto, Al, Hernâni Monteiro, 4200-319 Porto, Portugal
*
Correspondence should be addressed to: Lia Fernandes, Faculty of Medicine, University of Porto, Al, Hernâni Monteiro, 4200–319 Porto, Portugal. Phone: 00351222052525. Email: [email protected].

Abstract

Background:

This study aims to identify met and unmet needs, according to the patient, the carer and the staff, and their relationship with socio-demographic and clinical characteristics in elderly people with mental health problems.

Methods:

A sample of 306 elderly patients ≥65 years, of both sexes, diagnosed with mental illness (ICD-10 criteria), was recruited from inpatient/outpatient settings in a Department of Psychiatry and Mental Health, in northern Portugal. Patients were assessed with the Camberwell Assessment of Need for the Elderly/CANE.

Results:

The majority of diagnoses were depression (33.7%), dementia (24.5%), and schizophrenia (12.7%). The patients’ main unmet needs found were psychological distress (15.0%), daytime activities (10.5%), and benefits (6.5%). Patients reported significantly lower unmet and global needs than carers and staff (Z = −8.58, p < 0.001; Z = −11.07, p < 0.001, respectively). A larger number of global needs (met and unmet) were associated with the diagnosis of dementia, followed by schizophrenia, bipolar, and depressive disorder (p < 0.001), with inpatients reporting more needs than outpatients.

Conclusions:

Mental disorders were associated with a greater number of needs in elderly patients, which makes this assessment important as it includes the patients’ perspective, when they are the focus of intervention, in order to decrease distress and make more beneficial use of services, especially in inpatient settings. These different perspectives are crucial when assessing and planning psychiatric and mental health services.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ashaye, O. A., Livingston, G. and Orrell, M. W. (2003). Does standardized needs assessment improves the outcome of psychiatric day hospital care for older people? A randomized controlled trial. Aging & Mental Health, 7, 195199.CrossRefGoogle ScholarPubMed
Audit Commission (2000). Forget me not-national report on mental health services for older people. Audit Commission for Local Authorities and National Health Service in England and Wales, London.Google Scholar
Ayis, S., Paúl, C. and Ebrahim, S. (2010). Psychological disorders in old age: better identification for better treatment. European Journal of Psychological Assessment, 26, 3945.CrossRefGoogle Scholar
Benedetti, T., Borges, L. J., Petroski, E. L. and Gonçalves, L. (2008). Physical activity and mental health status among elderly people. Revista de Saúde Pública, 42, 302307.CrossRefGoogle ScholarPubMed
Crane-Ross, D., Roth, D. and Lauber, B. G. (2000). Consumers’ and case managers’ perceptions of mental health and community support service needs. Community Mental Health Journal, 36, 161178.CrossRefGoogle ScholarPubMed
Deck, H. and Machleidt, W. (2004). Relevance and applicability of the CANE in the German health care system. In Orrell, M. and Hancock, G. (eds.), CANE – Camberwell Assessment of Need for the Elderly (pp. 2934). London: Gaskell.Google Scholar
Direcção-Geral da Saúde/DGS (2013). Portugal saúde Mental em Números 2013. Programa Nacional para a Saúde Mental. Lisboa: DGS.Google Scholar
Fernandes, L. et al. (2009). Validation study of the camberwell assessment of need for the elderly (CANE) in Portugal. International Psychogeriatrics, 21, 94102.CrossRefGoogle ScholarPubMed
Field, E., Walker, M. and Orrell, M. (2004). The needs of older people living in sheltered housing. In Orrell, M. and Hancock, G. (eds.), CANE – Camberwell Assessment of Need for the Elderly (pp. 3544). London: Gaskell.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-Mental State”: a pratical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Graffar, M. (1956). Une méthode de classification sociale d‘échantillons de population. Courrier, 6, 455459.Google Scholar
Greaves, S., Bhat, M., Regan, C., Qazi, A., Miranda-Castillo, C. and Orrell, M. (2006). The unmet needs of referrals to old age psychiatry liaison services. Psychogeriatria Polska, 3, 175182.Google Scholar
Hancock, G. A., Reynolds, T., Woods, B., Thornicroft, G. and Orrell, M. (2003). The needs of older people with mental health problems according to the user, the carer and the staff. International Journal of Geriatric Psychiatry, 18, 803811.CrossRefGoogle Scholar
Hoe, J., Orrell, M., Lambert, J. and Prettyman, R. (2004). The needs of long term day hospital attenders. In Orrell, M. and Hancock, G. (eds.), CANE – Camberwell Assessment of Need for the Elderly (pp. 5766). London: Gaskell.Google Scholar
Houtjes, W., Van Meijel, B., Deeg, D. J. H. and Beekman, A. T. F. (2011). Unmet needs of outpatients with late-life depression; a comparison of patient, staff and carer perceptions. Journal of Affective Disorders, 134, 242248.CrossRefGoogle ScholarPubMed
Instituto Nacional de Estatística/INE (2012). Censos 2011. Resultados Definitivos Portugal. Lisboa: INE.Google Scholar
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179186.CrossRefGoogle ScholarPubMed
Mahoney, F. I. and Barthel, D. (1965). Functional evaluation: the barthel index. Maryland State Medical Journal, 14, 5661.Google ScholarPubMed
Mateos, R., Ybarzábal, M., García, M., Amboage, M. and Fraguela, I. (2004). The Spanish CANE: validation study and utility in epidemiological surveys. In Orrell, M. and Hancock, G. (eds.), CANE –Camberwell Assessment of Need for the Elderly (pp. 2128). London: Gaskell.Google Scholar
Meaney, M., Croke, M. and Kirby, M. (2005). Needs assessment in dementia. International Journal of Geriatric Psychiatry, 20, 322329.CrossRefGoogle ScholarPubMed
Miranda-Castillo, C., Woods, B. and Orrell, M. (2010). People with dementia living alone: what are their needs and what kind of support are they receiving? International Psychogeriatrics, 22, 607617.CrossRefGoogle ScholarPubMed
Miranda-Castillo, C., Woods, B. and Orrell, M. (2013). The needs of people with dementia living at home from user, caregiver and professional perspectives: a cross-sectional survey. BMC Health Services Research, 13, 110.CrossRefGoogle ScholarPubMed
Oliveira, C., Rosa, M., Pinto, A., Botelho, M., Morais, A. and Veríssimo, M. (2010). Estudo do Perfil do Envelhecimento da População Portuguesa. Lisboa: Eurotrials.Google Scholar
Orrell, M. and Hancock, G. (2004). CANE: Camberwell Assessment of Need for the Elderly. London: Gaskell.Google Scholar
Orrell, M., Hancock, G. A., Liyanage, K. C., Woods, B., Challis, D. and Hoe, J. (2008). The needs of people with dementia in care homes: the perspectives of users, staff and family caregivers. International Psychogeriatrics, 20, 941951.CrossRefGoogle ScholarPubMed
Passos, J., Sequeira, C. and Fernandes, L. (2012). The needs of older people with mental health problems: a particular focus on dementia patients and their carers. International Journal of Alzheimer's Disease. Article ID 638267, 1–7.Google Scholar
Paúl, C. (2007). Old-old people: major recent findings and the European contribution to the state of the art. In Fernandez-Ballesteros, R. (eds.), Geropsychology. European perspectives for an Ageing World (pp. 128144). Gottingen: Hogrefe & Huber Publishers.Google Scholar
Reynolds, T. et al. (2000). Camberwell assessment of need for the elderly: development, validity and reliability. British Journal of Psychiatry, 176, 444452.CrossRefGoogle ScholarPubMed
Shulman, K. I., Shedletsky, R. and Silver, I. L. (1986). The challenge of time: clock-drawing and cognitive function in the elderly. International Journal of Geriatric Psychiatry, 1, 135140.CrossRefGoogle Scholar
Sousa, R. M., Scazufca, M., Menezes, R. P., Crepaldi, A. L. and Prince, M. J. (2009). Feasibility and reliability of the elderly version of the camberwell assessment of needs (CANE): results from the São Paulo ageing & health study. Revista Brasileira de Psiquiatria, 31, 48.Google Scholar
Walters, K., Iliffe, S., Tai, S. S. and Orrell, M. (2000). Assessing needs from patient, carer and professional perspectives: the camberwell assessment of need for elderly people in primary care. Age and Ageing, 29, 505510.CrossRefGoogle ScholarPubMed
World Health Organization/WHO (2010). ICD-10 International Statistical Classification of Diseases and Related Health Problems 10th Revision. Geneva: WHO.Google Scholar
Yesavage, J. A. et al. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal Psychiatric Research, 17, 3749.CrossRefGoogle Scholar
Supplementary material: File

Passos supplementary material

Supplementary Tables

Download Passos supplementary material(File)
File 35.4 KB