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Anales de la Facultad de Ciencias Médicas (Asunción)

Print version ISSN 1816-8949

Abstract

MELGAREJO, Osvaldo José; TORALES, Julio  and  BRITEZ CANTERO, José. Code Z: The need to integrate a psychiatric social worker into the in-patient unit of the Psychiatry Service of the Hospital of Clínicas. A pilot study. An. Fac. Cienc. Méd. (Asunción) [online]. 2017, vol.50, n.3, pp.29-40. ISSN 1816-8949.  https://doi.org/10.18004/anales/2017.050(03)29-040.

Introduction:

The annex of the 10thedition of the International Classification of Diseases of the World Health Organization includes a chapter that deals with the factors that influence the state of health and the contact with health services, better known within the professional practice as "Z Codes", due to its prefix to code them. One way to intervene on these Z Codes is through the psychiatric social worker.

Objective:

The objectives of this study were to determine the need to integrate a psychiatric social worker into the in-patient unit of the Psychiatry Service of the Hospital of Clínicas (National University of Asunción, Paraguay) and to describe the sociodemographic and clinical profile and the presence of a Code Z within the in-patients clinical records.

Methodology:

This was an observational, descriptive, cross-sectional study, temporarily retrospective, with non-probabilistic sampling by convenience. We analyzed the medical records of patients 18 years of age or older, hospitalized in the in-patient unit of the Psychiatry Service of the Hospital or Clínicas. Sociodemographic and clinical variables were analyzed.

Results:

284 clinical records were studied, of which 219 were included after meeting the inclusion criteria. 71% of the patients were female. The ages were between 18 and 78 years (mean=36±15). Major depressive disorder was the main diagnosis at admission of the studied patients, since 30.6% registered this disorder. Regarding the use of Code Z, it was observed that 77.6% registered this information in the clinical records and that 99% of the patients did not have a consultation from a psychiatric social worker. Regarding the diagnosis of discharge, personality disorders (24.2%) were the most frequent diagnoses, followed by major depressive disorder (20.5%) and psychotic disorders (20.1%).

Discussion:

Almost all of the patients admitted to the Psychiatry Service of the Hospital of Clínicas present Z Codes. The need to integrate a psychiatric social worker into the in-patient unit of the Psychiatry Service of the Hospital of Clínicas is reaffirmed, highlighting that the number of social workers should be the equivalent of one for every ten patients.

Keywords : Z codes; social worker; hospitalization; psychiatry..

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