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 a nd depression, somatization and alcohol abuse-on admission to internal medi cine units and perceived complexity of care as indicated by the nurse at di scharge was studied. The goal Was to Study the utility of short screeners f or 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 co nducted within the framework of the European Biomed 1 Risk Factor Study. Research methods and instruments. In the first 3 days of admission the pati ents 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 th an those with low Scores, with and Without control for age, severity of ill ness and chronicity. The actual nursing intensity and medical care utilizat ion, as measured daily by means of a checklist, Could not explain these rel ations. 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 distur bances to detect patients for whom nurses might need additional help. Howev er, mental disturbance is not the sole criterion: functional status and oth er variables that predict medical and nursing care utilization should be in cluded in a screening strategy for case-management programmes.