Mental disturbances and perceived complexity of nursing care in medical inpatients

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 oil 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 oil the Whiteley-7 and the CAGE. At discharge, nurses rated the complexity of the patient's care.Results. Patients with high scores oil anxiety and depression (SCL-8D) and on somatization received higher ratings oil 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 oil 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.