Morrow-Howell N L, Proctor E K, Blinne W R, Rubin E H, Saunders J A, Rozario P A
Center of Mental Health Services Research, George Warren Brown School of Social Work, Washington University, St. Louis 63130, USA.
Aging Ment Health. 2006 Jul;10(4):352-61. doi: 10.1080/13607860500409963.
This study addressed factors associated with six-month post-acute dispositions (continuous community stay, medical hospitalization, psychiatric rehospitalization, nursing home placement, death) for older adults hospitalized for depression and discharged to the community. The sample included 199 older adults; and data were collected via medical records, interviews with discharge planners, patients, and family members. Over half of the sample remained in the community throughout the observation period; 23% experienced psychiatric re-admission and 10% entered a nursing home. Several factors associated with nursing home placement were identified: less improvement in depression during the hospitalization, lower Global Assessment of Functioning (GAF) scores at discharge; and less mental health service use in the post-acute period. Those at higher risk of psychiatric re-admission had more previous psychiatric hospitalizations and were marginally more likely to be married and have lower Brief Psychiatric Rating Scale (BPRS) scores at discharge. Differentiating those at risk for nursing home placement may be easier than differentiating those at risk of psychiatric readmission.
本研究探讨了因抑郁症住院并出院回到社区的老年人六个月急性后期处置情况(持续社区居住、医疗住院、精神科再次住院、养老院安置、死亡)的相关因素。样本包括199名老年人;数据通过病历、对出院计划者、患者及家庭成员的访谈收集。超过一半的样本在整个观察期内留在社区;23%经历了精神科再次入院,10%进入了养老院。确定了几个与养老院安置相关的因素:住院期间抑郁症改善较少、出院时功能总体评定量表(GAF)得分较低;以及急性后期心理健康服务使用较少。精神科再次入院风险较高的人有更多既往精神科住院史,并且在出院时略更有可能已婚且简明精神病评定量表(BPRS)得分较低。区分有养老院安置风险的人可能比区分有精神科再入院风险的人更容易。