Trauer T, Farhall J, Newton R, Cheung P
Department of Psychological Medicine, Monash University, Monash Medical Centre, Clayton, Victoria, Australia.
Soc Psychiatry Psychiatr Epidemiol. 2001 Aug;36(8):416-9. doi: 10.1007/s001270170032.
In the context of deinstitutionalization of psychiatric services, Community Care Units (CCUs) were developed to provide accommodation, clinical care and rehabilitation for patients discharged from the long-stay open wards of a large psychiatric hospital that was in the process of closing. CCUs are 20-bed units built in suburban locations and staffed on a 24-h basis by multidisciplinary clinical teams.
An initial group of 125 hospital patients was assessed at 1 month pre-move, 1 month post-move, and again at 1 year, on range of measures covering clinical status, personal functioning, quality of life, residential preferences, aggressive behaviour, and social networks. Staff attitudes, relative and carer perceptions and preferences, and residential environments were also assessed.
Most of the transferred patients were still resident in their CCU at 1 year. The clearest result was that patients showed improved quality of life in relation to their living environment. Comparison of the hospital and CCU environments showed that the latter were significantly less restrictive and regimented. Most relatives and carers also preferred the CCU. On average, symptom and disability levels were little changed at 1 year.
Our results suggest that the CCU is an appropriate form of service delivery for most long-stay hospital inpatients, but that both more and less supervised settings are also required. While symptoms and disability were little changed at 1 year, it is possible that further follow-up may detect delayed or slow changes. Given the widespread replacement of psychiatric hospitals with community-based services, the future role of the CCU needs to be reviewed.
在精神科服务去机构化的背景下，社区护理单元（CCU）应运而生，旨在为一家正在关闭的大型精神病院长期开放病房出院的患者提供住宿、临床护理和康复服务。CCU是建于郊区的20张床位的单元，由多学科临床团队提供24小时服务。
对最初的125名住院患者在搬入前1个月、搬入后1个月以及1年后进行评估，评估内容包括临床状况、个人功能、生活质量、居住偏好、攻击行为和社交网络等一系列指标。还评估了工作人员的态度、亲属和护理人员的看法与偏好以及居住环境。
大多数转院患者在1年后仍住在他们的CCU中。最明显的结果是患者在生活环境方面的生活质量有所改善。对医院和CCU环境的比较表明，后者的限制和管控明显更少。大多数亲属和护理人员也更喜欢CCU。平均而言，1年后症状和残疾水平变化不大。
我们的结果表明，CCU是大多数长期住院患者合适的服务提供形式，但也需要更多和更少监管的环境。虽然1年后症状和残疾变化不大，但进一步随访可能会发现延迟或缓慢的变化。鉴于精神病医院广泛被社区服务所取代，CCU的未来作用需要重新审视。
