重新融入社区的长期住院精神科患者的结局：前瞻性队列研究。
Outcome of long stay psychiatric patients resettled in the community: prospective cohort study.
作者信息
Trieman N, Leff J, Glover G
机构信息
Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, London NW3 2PF. n.trieman@fleet69
出版信息
BMJ. 1999 Jul 3;319(7201):13-6. doi: 10.1136/bmj.319.7201.13.
Abstract
OBJECTIVE
To examine the outcome of a population of long stay psychiatric patients resettled in the community.
DESIGN
Prospective study with 5 year follow up.
SETTING
Over 140 residential settings in north London.
SUBJECTS
670 long stay patients from two London hospitals (Friern and Claybury) discharged to the community from 1985 to 1993.
MAIN OUTCOME MEASURES
Continuity and quality of residential care, readmission to hospital, mortality, crime, and vagrancy.
RESULTS
Of the 523 patients who survived the 5 year follow up period, 469 (89.6%) were living in the community by the end of follow up, 310 (59.2%) in their original community placement. A third (210) of all patients were readmitted at least once. Crime and homelessness presented few problems. Standardised mortality ratios for the group were comparable with those reported for similar populations.
CONCLUSIONS
When carefully planned and adequately resourced, community care for long stay psychiatric patients is beneficial to most individuals and has minimal detrimental effects on society.
摘要
目的
研究重新安置到社区的长期住院精神科患者的结局。
设计
进行为期5年随访的前瞻性研究。
地点
伦敦北部140多个居住场所。
研究对象
1985年至1993年从伦敦两家医院（弗里恩医院和克莱伯里医院）出院并安置到社区的670名长期住院患者。
主要结局指标
住院护理的连续性和质量、再次入院情况、死亡率、犯罪率和流浪情况。
结果
在5年随访期内存活的523名患者中，随访结束时469名（89.6%）生活在社区，310名（59.2%）仍处于最初社区安置状态。三分之一（210名）的患者至少再次入院一次。犯罪和无家可归问题较少。该组的标准化死亡率与类似人群报告的死亡率相当。
结论
精心规划并提供充足资源时，对长期住院精神科患者的社区护理对大多数患者有益，对社会的不利影响最小。
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本文引用的文献
1
Homelessness and mental illness.无家可归与精神疾病。
Health Trends. 1989 Aug;21(3):70-1.
2
Excess mortality of mental disorder.精神障碍的超额死亡率
Br J Psychiatry. 1998 Jul;173:11-53. doi: 10.1192/bjp.173.1.11.
3
The TAPS Project 42: the last to leave hospital--a profile of residual long-stay populations and plans for their resettlement. Team for the Assessment of Psychiatric Services.TAPS项目42：最后一批出院者——长期住院剩余人群概况及其重新安置计划。精神科服务评估小组。
Acta Psychiatr Scand. 1998 Nov;98(5):354-9. doi: 10.1111/j.1600-0447.1998.tb10098.x.
4
Lifetime risk of suicide for affective disorder, alcoholism and schizophrenia.情感障碍、酒精中毒和精神分裂症的终身自杀风险。
Br J Psychiatry. 1998 Jan;172:35-7. doi: 10.1192/bjp.172.1.35.
5
The TAPS project. 36: the most difficult to place long-stay psychiatric in-patients. Outcome one year after relocation. Team for the Assessment of Psychiatric Services.TAPS项目。36：最难安置的长期住院精神科患者。搬迁一年后的结果。精神科服务评估团队。
Br J Psychiatry. 1996 Sep;169(3):289-92. doi: 10.1192/bjp.169.3.289.
6
Team for the Assessment of Psychiatric Services (TAPS) Project 33: prospective follow-up study of long-stay patients discharged from two psychiatric hospitals.精神科服务评估团队（TAPS）项目33：两家精神病医院出院的长期住院患者的前瞻性随访研究。
Am J Psychiatry. 1996 Oct;153(10):1318-24. doi: 10.1176/ajp.153.10.1318.
7
Difficult to place patients in a psychiatric hospital closure programme: the TAPs project 24.难以将患者纳入精神病院关闭计划：TAPs项目24
Psychol Med. 1996 Jul;26(4):765-74. doi: 10.1017/s0033291700037788.
8
Factors affecting the success of community placement: the TAPS project 26.影响社区安置成功的因素：TAPS项目26
Psychol Med. 1996 May;26(3):511-20. doi: 10.1017/s0033291700035595.
9
The TAPS Project. 11: The selection of patients for reprovision.TAPS项目。11：重新安置患者的选择。
Br J Psychiatry Suppl. 1993 Apr(19):36-9.
10
The TAPS Project. 10: The long-stay populations of Friern and Claybury hospitals. The baseline survey.塔普斯项目。10：弗里恩医院和克莱伯里医院的长期住院患者群体。基线调查。
Br J Psychiatry Suppl. 1993 Apr(19):30-5.
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