Valoración del programa social de atención a personas con trastorno mental grave: un estudio Delphi / Evaluation of the social care program for persons with severe mental disorders: a Delphi study

RESUMEN

Fundamento. En enero de 2005 el Gobierno de Navarra aprobó el “Programa de Atención a Personas con Trastorno Mental Grave” (PA-TMG). El objetivo del presente trabajo es conocer la opinión de expertos acerca del PA-TMG. Identificar los elementos de acuerdo en la valoración de aspectos positivos y aspectos mejorables. Realizar recomendaciones a partir de su opinión. Material y métodos. Se diseñó un estudio Delphi con 34 expertos en la atención sanitaria o social de enfermos mentales. Mediante cuestionarios repetidos se identificaron las ideas que alcanzaran un consenso >=90%, y se asignó un nivel de prioridad. Se presentan los porcentajes de acuerdo, estadísticos descriptivos de la prioridad, y se elaboran las recomendaciones de análisis de las áreas de consenso. Resultados. De los 34 expertos participantes, finalizaron el estudio 25 (71,4%) 1 socióloga, 5 trabajadoras sociales, 3 psiquiatras, 5 psicólogos, 1 representante de las familias, 3 terapeutas ocupacionales, 1 técnico en integración social y 6 médicos de familia. Valoran positivamente el Plan el 64% y 72% opinan que se ha elaborado sin suficiente participación profesional. Todos piensan que podría mejorarse si se amplia la participación de expertos. Conclusiones. Las principales ideas consensuadas han sido que la atención socio-sanitaria debe garantizarse por los poderes públicos; se deben establecer buenos sistemas de información y de evaluación; el Plan debe tener presupuesto propio; debe garantizar el seguimiento profesional del paciente por los diferentes dispositivos; se deben descentralizar muchas tomas de decisiones; se debe universalizar el acceso a un catálogo de prestaciones sociales para estos enfermos

ABSTRACT

Background. In January 2005 the Government of Navarre approved the “Care Program for Persons with Severe Mental Disorder” (PA-TMG). This article is intended to ascertain the opinion of experts regarding the PA-TMG. To identify the elements of agreement in the evaluation of positive aspects and aspects that can be improved. To make recommendations on the basis of their opinions. Methods. A Delphi study was designed with 34 experts in health or social care of mentally ill persons. By means of repeated questionnaires, ideas that achieved a consensus of >=90% were identified and a level of priority was assigned. The percentages of agreement and descriptive statistics of priority were presented, and the recommendations of analysis of the areas of consensus were drawn up. Results. Out of the 34 participating experts, 25 (71.4%) completed the study 1 sociologist, 5 social workers, 3 psychiatrists, 5 psychologists, one representative of the families, 3 occupational therapists, 1 technician in social integration and 6 family doctors. Sixty-four percent evaluated the Plan positively, and 72% were of the opinion that it was drawn up without sufficient professional participation. All thought that it could be improved by widening the participation of experts. Conclusions. The principal ideas on which there was consensus were socio-health care must be guaranteed by the public administration; good systems of information and evaluation must be established; the Plan must have its own budget; professional follow-up of the patient by the different mechanisms must be guaranteed; a lot of the decision making must be decentralised; access to social benefits for these patients must be universalised