Reynolds W, Lauder W, Sharkey S, Maciver S, Veitch T, Cameron D
Turku Polytechnic, Ylhaistentie, Salo, Finland.
J Psychiatr Ment Health Nurs. 2004 Feb;11(1):82-8. doi: 10.1111/j.1365-2850.2004.00692.x.
This pilot randomized control trial was motivated by the discovery that many individuals with mental health problems are re-hospitalized within a year, with many being unable to fully adjust to community living. A solution was proposed in the form of an intervention called transitional discharge. The transitional discharge model included: (1) peer support, which is assistance from former patients who provide friendship, understanding and encouragement; and (2) overlap of inpatient and community staff in which the inpatient staff continue to work with the discharged patient until a working relationship is established with a community care provider. The overall aim of this study was to test the discharge model designed to assist patients discharged from acute admission wards to adjust to community living. This aim was tested through a number of related hypotheses, which suggest that, 5 months following discharge from an acute admission ward of a psychiatric hospital, individuals participating in a transitional discharge model: (1) report fewer symptoms; (2) report better levels of functioning; (3) have better quality of life; (4) are less likely to have been re-admitted to hospital. The study used a randomized experimental design with two conditions: experimental and usual treatment. In general, both the control and the experimental group demonstrated significant improvements in symptom severity and functional ability after 5 months. Usual treatment subjects in the control group were more than twice as likely to be re-admitted to hospital. This study needs to be replicated in Scotland with a larger sample and with a modified variation of the intervention called the Transitional Care Intervention.
这项试点随机对照试验的起因是发现许多有心理健康问题的人在一年内再次住院，许多人无法完全适应社区生活。于是提出了一种名为过渡性出院的干预措施作为解决方案。过渡性出院模式包括：（1）同伴支持，即来自曾经的患者提供友谊、理解和鼓励的帮助；（2）住院部和社区工作人员的重叠，即住院部工作人员继续与出院患者合作，直到与社区护理提供者建立工作关系。本研究的总体目标是测试旨在帮助从急性入院病房出院的患者适应社区生活的出院模式。这一目标通过一些相关假设进行了检验，这些假设表明，在从精神病医院的急性入院病房出院5个月后，参与过渡性出院模式的个体：（1）报告的症状较少；（2）报告的功能水平较好；（3）生活质量较高；（4）再次入院的可能性较小。该研究采用了随机实验设计，有两种情况：实验组和常规治疗组。总体而言，对照组和实验组在5个月后症状严重程度和功能能力均有显著改善。对照组的常规治疗受试者再次入院的可能性是实验组的两倍多。这项研究需要在苏格兰以更大的样本量和一种名为过渡性护理干预的改良版干预措施进行重复。
