基于Kano需求模型的重性精神障碍服务对象医务社会工作需求研究与应用实务

Practical Application of Medical Social Work Needs and Corresponding Strategies for Patients with Severe Mental Based on the Kano Model

摘要: 目的：探索基于Kano需求模型的医务社会工作服务策略在重性精神障碍服务对象中的应用，为精准化提高医务社工服务模式提供依据。方法：选取2025年3月~2025年9月本院医务社工服务的200例重性精神障碍服务对象作为研究对象，按采用随机数字表法将患者分为对照组和实验组，每组100人。对照组接受本院原有医务社会工作服务，实验组在基础医务社会工作服务上实施基于Kano模型调整后的精准化重性精神障碍服务对象医务社会工作策略，两组均干预6个月。比较两组患者干预前后简明精神病评定量表(BPRS)评分、评分、WHO残疾评定量表(WHO-DASII)评分及服务满意度。结果：在27项重性精神障碍服务对象医务社会工作服务需求中，3项服务为基本型需求，6项服务为期望型需求，3项服务为兴奋型需求。按需求属性和优先级排序制定相关工作服务策略，进行干预6个月后，实验组PANSS总分、BPRS总分及WHO-DASII评分均显著低于对照组(P < 0.05)，实验组患者服务满意度显著高于对照组(92.5% vs 78.3%, P < 0.05)。结论：基于KANO需求模型的医务社工服务模式能够精准识别患者需求，在重性精神障碍服务对象医务社工资源有限的情况下，显著改善重性精神障碍服务对象的精神症状和社会功能，提高服务满意度，显示出良好的应用前景。

Abstract: Objectives: Explore the application of medical social work service strategies based on the Kano demand model in patients with severe mental disorders, and provide a basis for accurately improving the medical social work service model. Methods: Patients with severe mental disorders admitted to the Haining Fourth People’s Hospital in 2025, in a randomised controlled trial study. software was used to generate a random number table and employ block randomisation to randomly assign 200 eligible participants into two groups, with 100 participants in each group. The control group received the usual medical social work, the experimental group received medical social work needs and corresponding strategies for patients with Severe Mental based on the Kano model. Both groups intervened for 6 months. Outcome Measure: The scores of the Brief Psychiatric Rating Scale (BPRS), WHO Disability Rating Scale (WHO-DASII) and patients satisfaction. Results: Among the 27 medical and social work service needs for patients with severe mental disorders, 3 services are basic needs, 6 services are expectant needs, and 3 services are excitatory needs. Based on the results, determine the medical social work service. The outcome was the difference in BPRS, WHO-DASII and patients satisfaction between the end of the 6-months intervene and baseline. The experimental group was significantly superior to the control group (P < 0.05), and the patients satisfaction in the experimental group was significantly superior to the control group (92.5% vs 78.3%, P < 0.05). Conclusions: The medical social worker service model based on the KANO demand model can accurately identify patient needs. Under the condition of limited medical social worker resources for patients with severe mental disorders, it can significantly improve the mental symptoms and social functions of patients with severe mental disorders, improve service satisfaction, and has important promotion value and social benefit.