Predictors of Number of Healthcare Professionals Consulted by Individuals with Mental Disorders or High Psychological Distress
Abstract
:1. Introduction
2. Method
2.1. Study Design and Setting
2.2. Selection Criteria and Study Population
2.3. Conceptual Framework, Variables, and Instruments
2.4. Analyses
3. Results and Discussion
3.1. Results
3.2. Discussion
3.3. Limitations
4. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | Instruments, References, and Psychometric Properties | Description |
---|---|---|
Predisposing factors | ||
Age | Canadian Community Health Survey of MH and Well-Being CCHS 1.2 [41] | Calculated from date of birth and confirmed by participants One item Numeric value |
Gender | CCHS 1.2 [41] | As declared by participants Two items (male/female) |
Civil status | CCHS 1.2 [41] | As declared by participants Two items (living as a couple; living alone) |
Household size | CCHS 1.2 [41] | As declared by participants One item Numeric value |
Number of children in the household | CCHS 1.2 [41] | As declared by participants One item Numeric value |
Self-perception of physical health | CCHS 1.2 [41] | Self-perception of physical health One item Five-point Likert scale Higher = more negative |
Self-perception of mental health (MH) | CCHS 1.2 [41] | Self-perception of mental health (MH) One item Five-point Likert scale Higher = more negative |
Satisfaction with health services | CCHS 1.2 [41] | Measure satisfaction with health services 30 items Four-point Liker scale Higher = greater satisfaction |
Enabling factors | ||
Having a family physician | CCHS 1.2 [41] | As declared by participants Yes/No |
Previous use of MH services | CCHS 1.2 [41] | As declared by participants Yes/No |
Employment status | CCHS 1.2 [41] | As declared by participants Yes/No |
Personal well-being | Australian Unity Well-being Index [42] Cronbach alpha: 0.85 | Measures personal satisfaction with life as a whole and in Eight sub-dimensions Nine items 10-point Likert scale Higher = more positive |
Emotional well-being | MH Continuum—Short Form [43] | Measures the degree of emotional well-being defined in terms of positive affect/satisfaction with life; social well-being as described in Keyes [44] model of social well-being 14 items Seven-point Likert scale Range: 1–98 Higher = more negative |
Quality of life | Satisfaction with Life Domains Scale [45]; adapted by Baker and Intagliata [46] for psychiatric patients Cronbach alpha: 0.9 | Quality of life in five domains 20 items Seven-point Likert scale Range: 0–140 Higher = better quality of life |
Needs factors | ||
Major depressive disorder | Composite International Diagnostic Interview (CIDI) and CIDI-SF [47] | Psychiatric diagnoses based on the definitions and criteria of ICD-10 a and DSM-IV b. Yes/No and multiple choice |
Generalized anxiety disorder | Composite International Diagnostic Interview (CIDI) and CIDI-SF [47] | Psychiatric diagnoses based on the definitions and criteria of ICD-10 and DSM-IV. Yes/No and multiple choice |
Post-traumatic stress disorder (PTSD) | Composite International Diagnostic Interview (CIDI) and CIDI-SF [47] | Psychiatric diagnoses based on the definitions and criteria of ICD-10 and DSM-IV. Yes/No and multiple choice |
Drug and alcohol dependence | Composite International Diagnostic Interview (CIDI) and CIDI-SF [47] | Psychiatric diagnoses based on the definitions and criteria of ICD-10 and DSM-IV Yes/No and multiple choice |
Suicide ideation | Tousignant et al. [48] | Suicide ideation at life in the last 12 months Yes/No |
Functional disability | 12-item version of the World Health Organization Disability Assessment Schedule II (WHO-DAS-II) [49] | Measure functional disability 12 items Five-point Likert-scale Range: 0–60 Score of 45 or greater indicates substantial disability [50] |
Stressful events | Lifetime Events Questionnaire [51] | Stressful events in the last 12 months related to housing, family and friends, income, love, and aggressive experiences 25 items Yes/No |
High psychological distress | K-10 scale [52] Cronbach alpha: 0.93 | Measure frequency of distress symptoms in the past month such as nervousness, tiredness, despair, agitation, sadness, and feeling of worthlessness 10 items Five-point Likert scale (cut-off point for determining high psychological distress = 9) |
Physical illnesses | CCHS 1.2 [41] | Number of physical illness as declared by participants Yes/No |
Physical aggression | Modified Observed Aggression Scale [53] | Assess 4 categories of aggressive behavior: Verbal aggression, aggression to propriety, self-inflicted aggression, physical aggression 20 items Yes/No |
Unmet need for help | Perceived Need for Care Questionnaire [54] | Five items Yes/No |
Frequency Distributions | Bivariate Associations with Number of Healthcare Professionals Visited at T4 | ||||||||
---|---|---|---|---|---|---|---|---|---|
Variables at T3 | Min | Max | n/Mean | %/SD | Beta | t | p Value | ||
Predisposing factors | Age | 15.00 | 72.00 | 43.71 | 14.04 | 0.011 | 0.289 | 0.773 | |
Gender | Female | 460 | 61.7 | 1 | |||||
Male | 286 | 38.3 | −0.063 | −1.725 | 0.085 | ||||
Civil status | Living alone | 473 | 63.4 | 1 | |||||
Living as a couple | 273 | 36.6 | −0.106 | −2.903 | 0.004 | ||||
Household size | 0.00 | 13.00 | 2.47 | 1.47 | −0.071 | −1.950 | 0.052 | ||
Self-perception of physical health in the past 12 months | 1.00 | 5.00 | 2.75 | 1.05 | −0.128 | −3.529 | <0.001 | ||
Self-perception of MH | 1.00 | 5.00 | 2.89 | 0.98 | −0.287 | −8.179 | <0.001 | ||
Satisfaction with health services | 4.00 | 90.00 | 51.68 | 13.78 | −0.136 | −3.747 | <0.001 | ||
Enabling factors | Having a family physician | 515 | 69.0 | 0.130 | 3.568 | <0.001 | |||
Previous use of services for MH reasons | 219 | 29.4 | 0.346 | 10.065 | <0.001 | ||||
Private insurance coverage including visits to psychologist | 46 | 6.2 | 0.142 | 3.921 | <0.001 | ||||
Employment status | 138 | 18.5 | 0.098 | 2.685 | 0.007 | ||||
Quality of life (QOL) (total score) a | 45.00 | 135.00 | 100.95 | 15.50 | −0.199 | −5.533 | <0.001 | ||
Emotional well-being b | 4.00 | 70.00 | 42.47 | 12.20 | −0.159 | −4.404 | <0.001 | ||
Personal well-being c | 2.00 | 90.00 | 58.48 | 13.69 | −0.186 | −5.168 | <0.001 | ||
Needs factors | Stressful events (total score) | 0.00 | 14.00 | 3.84 | 2.45 | 0.221 | 6.174 | <0.001 | |
High psychological distress | 0.00 | 35.00 | 13.83 | 5.13 | 0.201 | 5.593 | <0.001 | ||
Physical illnesses | 1.36 | 1.47 | 0.079 | 2.169 | 0.030 | ||||
Unmet need for help | 110 | 14.7 | 0.151 | 4.171 | <0.001 | ||||
Major depressive episode | 129 | 17.3 | 0.250 | 7.028 | <0.001 | ||||
Generalized anxiety disorder | 15 | 2.0 | 0.099 | 2.707 | 0.007 | ||||
Post-traumatic stress disorder (PTSD) | 50 | 6.7 | 0.225 | 6.286 | <0.001 | ||||
Drug and alcohol dependence | 29 | 3.9 | 0.070 | 1.916 | 0.056 | ||||
Number of mental disorders | 0.00 | 5.00 | 0.37 | 0.71 | 0.253 | 7.142 | <0.001 | ||
Physical aggression | 43 | 5.8 | 0.085 | 2.332 | 0.020 | ||||
Functional disability d | 13.00 | 49.00 | 19.33 | 6.91 | 0.186 | 5.157 | <0.001 | ||
Suicide ideation | 69 | 9.2 | 0.213 | 5.949 | <0.001 |
Variables | Block 1 | Block 2 | Block 3 | Block 4 | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Beta | p | Beta | p | Beta | p | Beta | t | p | 95.0% CI for B | Collinearity Statistics | ||||
LB a | UB b | Tolerance | VIF c | |||||||||||
Needs 1 Factors (Clinical) | (Constant) | 0.128 | 0.278 | 0.012 | 0.761 | 0.447 | −0.205 | 0.464 | ||||||
High psychological distress | 0.085 | 0.024 | 0.042 | 0.286 | −0.004 | 0.926 | 0.003 | 0.081 | 0.935 | −0.012 | 0.013 | 0.676 | 1.480 | |
Major depressive disorder | 0.159 | <0.001 | 0.132 | <0.001 | 0.102 | 0.007 | 0.055 | 1.476 | 0.140 | −0.039 | 0.274 | 0.771 | 1.297 | |
Generalized anxiety disorder (GAD) | 0.085 | 0.014 | 0.078 | 0.023 | 0.071 | 0.038 | 0.050 | 1.520 | 0.129 | −0.084 | 0.662 | 0.981 | 1.020 | |
Post-traumatic stress disorder (PTSD) | 0.146 | <0.001 | 0.123 | 0.001 | 0.124 | 0.001 | 0.105 | 2.945 | 0.003 | 0.113 | 0.566 | 0.838 | 1.193 | |
Suicide ideation | 0.114 | 0.002 | 0.101 | 0.005 | 0.085 | 0.017 | 0.062 | 1.776 | 0.076 | −0.018 | 0.364 | 0.879 | 1.138 | |
Needs 2 Factors (Other-Clinical) | Stressful events | 0.126 | <0.001 | 0.098 | 0.007 | 0.098 | 2.746 | 0.006 | 0.009 | 0.056 | 0.830 | 1.205 | ||
Functional disability | 0.085 | 0.028 | 0.080 | 0.036 | 0.050 | 1.355 | 0.176 | −0.003 | 0.014 | 0.778 | 1.285 | |||
Predisposing | Self-perception of MH | −0.157 | <0.001 | −0.116 | −2.983 | 0.003 | −0.159 | −0.033 | 0.705 | 1.419 | ||||
Enabling Factors | Previous use of MH services | 0.217 | 5.930 | <0.001 | 0.258 | 0.513 | 0.797 | 1.255 | ||||||
Having a family physician | 0.112 | 3.358 | 0.001 | 0.082 | 0.311 | 0.954 | 1.048 | |||||||
Employment status | 0.079 | 2.332 | 0.020 | 0.026 | 0.301 | 0.940 | 1.064 | |||||||
Goodness of fit | F | 20.038 | 17.340 | 17.450 | 18.543 | |||||||||
p | <0.001 | <0.001 | <0.001 | <0.001 | ||||||||||
Total variance explained (Adjusted R Square) | 0.113 | 0.133 | 0.150 | 0.206 |
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Simo, B.; Caron, J.; Bamvita, J.-M.; Grenier, G.; Fleury, M.-J. Predictors of Number of Healthcare Professionals Consulted by Individuals with Mental Disorders or High Psychological Distress. Int. J. Environ. Res. Public Health 2019, 16, 3010. https://doi.org/10.3390/ijerph16173010
Simo B, Caron J, Bamvita J-M, Grenier G, Fleury M-J. Predictors of Number of Healthcare Professionals Consulted by Individuals with Mental Disorders or High Psychological Distress. International Journal of Environmental Research and Public Health. 2019; 16(17):3010. https://doi.org/10.3390/ijerph16173010
Chicago/Turabian StyleSimo, Béatrice, Jean Caron, Jean-Marie Bamvita, Guy Grenier, and Marie-Josée Fleury. 2019. "Predictors of Number of Healthcare Professionals Consulted by Individuals with Mental Disorders or High Psychological Distress" International Journal of Environmental Research and Public Health 16, no. 17: 3010. https://doi.org/10.3390/ijerph16173010