Rossi Alberto, Sandri Marco, Bianco Maria, Marsilio Alessandra, Tansella Michele, Amaddeo Francesco
Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro 10, 37134 Verona, Italy.
Soc Psychiatry Psychiatr Epidemiol. 2006 Oct;41(10):832-40. doi: 10.1007/s00127-006-0105-8. Epub 2006 Jul 24.
This cross-sectional study attempted to identify factors associated with clinicians' dispositions of patients after the first visit in an out-patient psychiatric department.
Over a 33-month period, all new episodes of care with the department were included in the study. For each patient, socio-demographic, clinical information and contact characteristics were prospectively collected in relation to the first visit, as was information on case disposition. Factors associated with clinicians' disposition were analysed.
Of the 1,138 patients who met the study criteria, 848 (75%) were followed up by the department, 150 (13%) were referred to other services and 140 (12%) were discharged. Suffering from a major psychiatric disorder, being younger and not living in an institution influenced clinicians' disposition to follow-up patients. Older age increased the chances of being referred to other services rather than discharged.
Examining decision-making behaviour in out-patient psychiatric departments is a worthwhile endeavour because this setting represents the main entry point of modern and accessible community-based systems of care. The findings confirmed the importance of psychiatric determinants in the dispositional process and contribute to make clinicians more aware of other factors related to their decision-making.
本横断面研究试图确定与门诊精神科首次就诊后临床医生对患者处置方式相关的因素。
在33个月的时间里，该科室所有新的护理病例均纳入研究。对于每位患者，前瞻性收集与首次就诊相关的社会人口学、临床信息及联系特征，以及病例处置信息。分析与临床医生处置方式相关的因素。
在符合研究标准的1138例患者中，848例（75%）由该科室进行随访，150例（13%）被转介至其他服务机构，140例（12%）出院。患有重度精神障碍、年龄较小且不住在机构中会影响临床医生对患者进行随访的处置方式。年龄较大增加了被转介至其他服务机构而非出院的可能性。
研究门诊精神科的决策行为是一项有价值的工作，因为这种环境是现代且可及的社区护理系统的主要切入点。研究结果证实了精神科决定因素在处置过程中的重要性，并有助于使临床医生更加意识到与其决策相关的其他因素。
