Department of Psychiatry, Univeristy of Toronto, Mount Sinai Hospital, 260 Spadina Ave., Suite 204, Toronto, Ontario M5T 2E4, Canada.
Psychiatr Serv. 2011 Aug;62(8):971-4. doi: 10.1176/ps.62.8.pss6208_0971.
The assertive community treatment (ACT) teams of Mount Sinai Hospital in Toronto and the KUINA Center, Hitachinaka, Japan, were compared with regard to ACT fidelity, organizational structure, populations served, and treatment outcomes. Ethnocultural adaptations to the ACT model made by both teams included enhanced family support and intervention, culturally and linguistically matched staff and patients when possible, culturally informed therapy, routine cultural assessments, culturally matched housing and community support, and flexible funding models.
Data were gathered by chart reviews (66 patients in Toronto and 40 patients in Japan), a satisfaction measure, a standard measure of ACT fidelity, and a pre-post measure of treatment outcomes (the Brief Psychiatric Rating Scale), and hospitalization days.
Both teams achieved good fidelity to ACT and reductions in hospitalization and symptom severity. Family satisfaction scores were high.
With culturally informed adaptations, ACT can be effective in a Canadian mixed ethnocultural population and a homogeneous Japanese population.
多伦多西奈山医院的坚定社区治疗（ACT）团队和日本日立市 KUINA 中心的 ACT 团队在 ACT 保真度、组织结构、服务人群和治疗结果方面进行了比较。两个团队对 ACT 模型进行的种族文化适应包括加强家庭支持和干预、尽可能实现工作人员和患者在文化和语言上相匹配、提供文化知情治疗、常规文化评估、文化匹配的住房和社区支持，以及灵活的资金模式。
通过图表审查（多伦多 66 名患者和日本 40 名患者）、满意度衡量、ACT 保真度的标准衡量以及治疗结果（简明精神病评定量表）和住院天数的前后衡量来收集数据。
两个团队都实现了 ACT 的良好保真度，减少了住院和症状严重程度。家庭满意度评分很高。
通过文化知情的适应，ACT 可以在加拿大的混合种族文化人群和同质的日本人群中有效。
