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Development of the C4 inventory: a measure of common characteristics that complicate care in outpatient psychiatry
BACKGROUND: Psychiatric syndromes are complicated by comorbidity and other factors that burden patients, making guideline-informed psychiatric care challenging, and negatively affecting outcome. A comprehensive intake tool could improve the quality of care. Existing tools to quantify these character...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Swiss Medical Press GmbH
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556446/ https://www.ncbi.nlm.nih.gov/pubmed/29090175 http://dx.doi.org/10.15256/joc.2016.6.66 |
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author | Maunder, Robert G. Wiesenfeld, Lesley Rawkins, Sian Park, Jamie |
author_facet | Maunder, Robert G. Wiesenfeld, Lesley Rawkins, Sian Park, Jamie |
author_sort | Maunder, Robert G. |
collection | PubMed |
description | BACKGROUND: Psychiatric syndromes are complicated by comorbidity and other factors that burden patients, making guideline-informed psychiatric care challenging, and negatively affecting outcome. A comprehensive intake tool could improve the quality of care. Existing tools to quantify these characteristics do not identify specific complications and may not be sensitive to phenomena that are common in psychiatric outpatients. OBJECTIVE: To develop a practical inventory to capture observations related to complex care in psychiatric outpatients and quantify the overall burden of complicating factors. DESIGN: We developed a checklist inventory through literature review and clinical experience. The inventory was tested and compared with related measures in a cross-sectional study of 410 consenting outpatients at the time of initial assessment. RESULTS: The summed score of inventory checklist items was significantly correlated with patient-assessed measures of distress (K10, r=0.36) and function (WHODAS 2.0, r=0.31), and physician-assessed measures of function (GAF, r=−0.42), number of psychiatric diagnoses [F(df3)=33.6], and most complex diagnosis [F(df3)=37.4]. In 53 patients whose assessment was observed by two clinicians, inter-rater reliability was acceptable for both total inventory score (intraclass correlation, single measures = 0.74) and agreement on specific items (mean agreement score = 90%). CONCLUSIONS: The Psychiatric C4 Inventory is a reliable instrument for psychiatrists that captures information that may be useful for quality improvement and resource planning. It demonstrates convergent validity with measures of patient distress, function, and complexity. Further tests of validity and replication in other settings are warranted. |
format | Online Article Text |
id | pubmed-5556446 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Swiss Medical Press GmbH |
record_format | MEDLINE/PubMed |
spelling | pubmed-55564462017-10-31 Development of the C4 inventory: a measure of common characteristics that complicate care in outpatient psychiatry Maunder, Robert G. Wiesenfeld, Lesley Rawkins, Sian Park, Jamie J Comorb Original Article BACKGROUND: Psychiatric syndromes are complicated by comorbidity and other factors that burden patients, making guideline-informed psychiatric care challenging, and negatively affecting outcome. A comprehensive intake tool could improve the quality of care. Existing tools to quantify these characteristics do not identify specific complications and may not be sensitive to phenomena that are common in psychiatric outpatients. OBJECTIVE: To develop a practical inventory to capture observations related to complex care in psychiatric outpatients and quantify the overall burden of complicating factors. DESIGN: We developed a checklist inventory through literature review and clinical experience. The inventory was tested and compared with related measures in a cross-sectional study of 410 consenting outpatients at the time of initial assessment. RESULTS: The summed score of inventory checklist items was significantly correlated with patient-assessed measures of distress (K10, r=0.36) and function (WHODAS 2.0, r=0.31), and physician-assessed measures of function (GAF, r=−0.42), number of psychiatric diagnoses [F(df3)=33.6], and most complex diagnosis [F(df3)=37.4]. In 53 patients whose assessment was observed by two clinicians, inter-rater reliability was acceptable for both total inventory score (intraclass correlation, single measures = 0.74) and agreement on specific items (mean agreement score = 90%). CONCLUSIONS: The Psychiatric C4 Inventory is a reliable instrument for psychiatrists that captures information that may be useful for quality improvement and resource planning. It demonstrates convergent validity with measures of patient distress, function, and complexity. Further tests of validity and replication in other settings are warranted. Swiss Medical Press GmbH 2016-05-25 /pmc/articles/PMC5556446/ /pubmed/29090175 http://dx.doi.org/10.15256/joc.2016.6.66 Text en Copyright: © 2016 The Authors http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the Creative Commons Attribution-NonCommercial License, which permits all noncommercial use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Original Article Maunder, Robert G. Wiesenfeld, Lesley Rawkins, Sian Park, Jamie Development of the C4 inventory: a measure of common characteristics that complicate care in outpatient psychiatry |
title | Development of the C4 inventory: a measure of common characteristics that complicate care in outpatient psychiatry |
title_full | Development of the C4 inventory: a measure of common characteristics that complicate care in outpatient psychiatry |
title_fullStr | Development of the C4 inventory: a measure of common characteristics that complicate care in outpatient psychiatry |
title_full_unstemmed | Development of the C4 inventory: a measure of common characteristics that complicate care in outpatient psychiatry |
title_short | Development of the C4 inventory: a measure of common characteristics that complicate care in outpatient psychiatry |
title_sort | development of the c4 inventory: a measure of common characteristics that complicate care in outpatient psychiatry |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556446/ https://www.ncbi.nlm.nih.gov/pubmed/29090175 http://dx.doi.org/10.15256/joc.2016.6.66 |
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