Bowers L, Jarrett M, Clark N, Kiyimba F, McFarlane L
St Bartholomew School of Nursing and Midwifery, City University, London, England.
J Adv Nurs. 2000 Sep;32(3):644-9. doi: 10.1046/j.1365-2648.2000.01523.x.
Determinants of absconding by patients on acute psychiatric wards Absconding by patients from acute psychiatric wards is a high risk behaviour and has been linked to harm to self and others. Previous research on the characteristics of absconders has been overly reliant on officially generated statistics and small numbers of variables, limiting the conclusions that may be drawn. This paper reports on a prospective study of absconders from 12 acute admission wards in three English National Health Service Trusts over 5 months, compared to a control group matched for ward. Extensive data on absconder and control characteristics were collected from case records and from nursing staff. Absconders were significantly different from controls in many respects. Absconding is linked to other forms of non-compliant patient behaviour, e.g. medication refusal and involvement in violent incidents. Significant variations in the rates of absconding were found between different wards, and between different consultant psychiatrists. Predictive factors were identified by logistic regression. Study in the diverse fields of non-compliance should be brought together as these phenomena are likely to be interrelated. Further investigation is required to determine exactly what it is that consultant psychiatrists and ward nurses do that affects absconding rates.
急性精神科病房患者擅自离院的决定因素 急性精神科病房患者擅自离院是一种高风险行为，且与对自身及他人的伤害有关。以往关于擅自离院者特征的研究过度依赖官方统计数据和少量变量，限制了可得出的结论。本文报告了一项针对来自英格兰三个国民医疗服务信托基金的12个急性入院病房的擅自离院者进行的为期5个月的前瞻性研究，并与匹配病房的对照组进行了比较。从病例记录和护理人员那里收集了关于擅自离院者和对照者特征的大量数据。擅自离院者在许多方面与对照组有显著差异。擅自离院与其他形式的患者不依从行为有关，例如拒绝服药和参与暴力事件。不同病房之间以及不同顾问精神科医生之间的擅自离院率存在显著差异。通过逻辑回归确定了预测因素。由于这些现象可能相互关联，因此应将不同领域的不依从性研究整合起来。需要进一步调查以确切确定顾问精神科医生和病房护士的哪些行为会影响擅自离院率。
