2023 Volume 32 Issue 1 Pages 2-9
As psychiatric inpatients are aging, it is important to promote community-based integrated care for the elderly with mental disorders (users). The purpose of this study was to develop a sheet for case information confirmation and -sharing between mental health/medical/welfare and care personnel in supporting these users, and appropriate items for the sheet were examined with cooperation from 13 psychiatrists, visiting psychiatric nurses, mental health social workers, public health nurses, and chief care managers. The information confirmation sheet consisted of 22 items related to basic information and 32 related to specific symptoms/challenges in daily life. For each item, the necessity of confirmation was rated on a 5-point scale (“Necessary at all times” : 5 ; “Unnecessary” : 1), and the grounds of judgment were described in a free-description style. Confirmation was deemed necessary at all times when the mean score was 4.5 or higher, necessary when it was 4.5-3, and unnecessary when it was 3.0 or lower. The overall mean score was 4.37 (SD＝0.32), and all items showed a mean score of 3.0 or higher. The mean scores for the items related to basic information and specific symptoms/challenges in daily life were 4.59 and 4.20, respectively. The items with the highest score (4.92) were [the user’s daily life/desire for care], [presence/absence of diseases other than mental disorders (such as internal diseases)], [points to note when introducing new services], and [current predominant symptoms]. Among the items related to specific symptoms/challenges in daily life, the scores for ［activities requiring care, although the user thinks he/she can perform them him/herself］ (4.69)],［troubles with neighbors/matters that require attention］ (4.62) and [deviant behavior] (4.57), were also high. In contrast, the item with the lowest mean score was [importance of observation in everyday life settings], in addition to confirmation of information from those involved, described as a basis for assessing users’ functioning that markedly varies according to environments. In community-based integrated care for the elderly with mental disorders, it may be necessary to specify required domains, where information should be confirmed among supporters, and those where the level of need for care should be assessed through observation in everyday life settings.
