School of Nursing & Midwifery, Flinders University of South Australia, Adelaide, Australia.
J Clin Nurs. 2011 Mar;20(5-6):706-13. doi: 10.1111/j.1365-2702.2010.03553.x.
The purpose of this study was to examine absconding behaviour (a patient leaving the hospital without permission) in acute and rehabilitation wards of one Australian psychiatric institution to describe the characteristics of the absconding patient and these events.
Absconding is a significant issue in psychiatric inpatient settings, with risks that include patient harm, aggression and violence. In spite of this, limited research has been conducted in Australia on patients who abscond while receiving psychiatric care.
The study was a retrospective descriptive analysis.
Absconding events from three acute and seven rehabilitation wards over a 12-month period were studied.
The rate of absconding events by detained patients was 20.82%. Gender was not significantly associated with absconding, although 61.19% of those who absconded were men diagnosed with schizophrenic disorders. Over half of acute care patients who absconded left during their first 21-day detention order. More than half of absconding events were by patients that absconded more than once. There was limited support for the efficacy of locking ward doors. Age and diagnosis emerged as particularly important factors to consider.
The study revealed that men are not more likely to abscond than women, that locking ward doors does not deter the determined absconders and that once a person has absconded, they are more likely to do so again. Younger patients and those with a schizophrenic disorder may be particularly likely to abscond. There also appears to be a link between continuing detention orders and an absconding event.
Findings provide new data about the profile of absconding patients in Australia. Exploration of the reasons why patients abscond and why many do so repeatedly warrants further investigation.
Risk management approaches taking into account factors associated with absconding could be trialled to reduce the incidence of absconding in psychiatric inpatient settings.
本研究旨在考察澳大利亚一家精神病院急症病房和康复病房的擅自离院行为（未经许可离开医院的患者），描述擅自离院患者的特征和这些事件。
擅自离院是精神病住院患者中一个严重的问题，存在患者受到伤害、攻击和暴力的风险。尽管如此，澳大利亚对接受精神科护理时擅自离院的患者进行的研究有限。
该研究是一项回顾性描述性分析。
研究了 12 个月内三个急症病房和七个康复病房的擅自离院事件。
被拘留患者的擅自离院事件发生率为 20.82%。性别与擅自离院无显著相关性，尽管 61.19%的擅自离院者是被诊断为精神分裂症的男性。超过一半在头 21 天拘留令期间擅自离院的急症病房患者。超过一半的擅自离院事件发生在多次擅自离院的患者身上。锁定病房门的效果有限。年龄和诊断是需要特别考虑的重要因素。
该研究表明，男性擅自离院的可能性并不高于女性，锁定病房门并不能阻止有决心的擅自离院者，而且一旦有人擅自离院，他们更有可能再次擅自离院。年轻患者和患有精神分裂症的患者可能特别容易擅自离院。连续拘留令和擅自离院事件之间似乎也存在联系。
研究结果提供了有关澳大利亚擅自离院患者特征的新数据。进一步调查患者擅自离院的原因以及许多人多次擅自离院的原因是值得的。
考虑到与擅自离院相关的因素的风险管理方法可以在精神病住院环境中试用，以降低擅自离院的发生率。
