Geha Mental Health Center, Petah Tikva, Israel.
Am J Occup Ther. 2011 May-Jun;65(3):314-9. doi: 10.5014/ajot.2011.001362.
We retrospectively assessed the effect of social-, cognitive-, and task-oriented functioning levels at hospital discharge on the readmission rate of patients with schizophrenia.
We assessed the functional capability of 71 inpatients (37 men and 34 women), mean age 41.3 (standard deviation = 11.9 yr), who underwent daily occupational therapy interventions, at admission and at discharge using a comprehensive function score. We examined readmission rates up to 6.8 yr after discharge.
Function scores improved significantly during the hospital stay (p < .001). Patients with a higher comprehensive function score (75th percentile) at the end of the index admission had a significantly lower readmission rate (p < .05). A higher comprehensive function score (75th percentile) at discharge was a better predictor for readmission than the Brief Psychiatric Rating Score (25th percentile).
These findings demonstrate the predictive value of occupational therapy functional monitoring at discharge for risk of readmission and the importance of cognitive/functional interventions for long-lasting remission.
我们回顾性评估了出院时患者的社会功能、认知功能和任务导向功能水平对精神分裂症患者再入院率的影响。
我们评估了 71 名住院患者(37 名男性和 34 名女性)的功能能力,他们在入院时和出院时使用综合功能评分接受了日常职业治疗干预,平均年龄为 41.3(标准差=11.9 岁)。我们检查了出院后长达 6.8 年的再入院率。
功能评分在住院期间显著提高(p<.001)。在指数入院结束时综合功能评分(第 75 个百分位数)较高的患者,再入院率显著降低(p<.05)。出院时较高的综合功能评分(第 75 个百分位数)比简明精神病评定量表(第 25 个百分位数)更能预测再入院。
这些发现表明出院时职业治疗功能监测对再入院风险的预测价值,以及认知/功能干预对长期缓解的重要性。