Akpalu B, Lund C, Doku V, Ofori-Atta A, Osei A, Ae-Ngibise K, Awenva D, Cooper S, Flisher A J
Kintampo Health Research Centre, Ghana.
Afr J Psychiatry (Johannesbg). 2010 May;13(2):109-15. doi: 10.4314/ajpsy.v13i2.54356.
This paper aims to explore the options available for developing community-based care and improving the quality of care in psychiatric hospitals in Ghana.
Semi-structured interviews (SSIs) and focus group discussions (FGDs) were conducted: with a cross-section of stakeholders including health professionals, researchers, policy makers, politicians, users and carers. The SSIs and FGDs were recorded digitally and transcribed verbatim. Apriori and emergent themes were coded and analysed with NVivo version 7.0, using a framework analysis.
Psychiatric hospitals in Ghana have a mean bed occupancy rate of 155%. Most respondents were of the view that the state psychiatric hospitals were very congested, substantially compromising quality of care. They also noted that the community psychiatric system was lacking human and material resources. Suggestions for addressing these difficulties included committing adequate resources to community psychiatric services, using psychiatric hospitals only as referral facilities, relapse prevention programmes, strengthening psychosocial services, adopting more precise diagnoses and the development of a policy on long-stay patients.
There is an urgent need to build a credible system of community-based care and improve the quality of care in psychiatric hospitals in Ghana.
本文旨在探索加纳发展社区护理及提高精神病院护理质量的可行方案。
开展了半结构式访谈（SSIs）和焦点小组讨论（FGDs）：与包括卫生专业人员、研究人员、政策制定者、政治家、服务使用者及其照顾者在内的各利益相关方进行了交流。SSIs和FGDs均进行了数字录音并逐字转录。使用框架分析法，通过NVivo 7.0版本对先验主题和新出现的主题进行编码和分析。
加纳精神病院的平均床位占用率为155%。大多数受访者认为，国家精神病院非常拥挤，严重影响了护理质量。他们还指出，社区精神病系统缺乏人力和物力资源。解决这些困难的建议包括为社区精神病服务投入充足资源、仅将精神病院用作转诊机构、开展预防复发项目、加强心理社会服务、采用更精确的诊断方法以及制定长期住院患者政策。
迫切需要在加纳建立一个可靠的社区护理体系并提高精神病院的护理质量。
