Hayat Aalia Akhtar, Ahmed Muhammad Munir, Minhas Fareed Aslam
Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi.
J Coll Physicians Surg Pak. 2013 May;23(5):342-6.
To determine the frequency of patients leaving against medical advice (LAMA) in an inpatient psychiatric facility in Rawalpindi, Pakistan.
Descriptive cross-sectional study.
Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, from August 2010 to February 2011.
Patients who got admitted during study period irrespective of duration of illness and mode of admission were recruited through non-probability consecutive sampling and followed till discharge to determine their mode of leaving hospital. A thirteen-item proforma was developed and information was obtained on demographic, socioeconomic, patient related and disease related variables. Descriptive statistics were calculated on SPSS 14.
The total number (n) of participants was 246. Among the participants, 96 (39%) left against medical advice (LAMA) whereas 150 (61%) left on regular discharge on physician's advice. Frequency of patients who left against medical advice was found to be more in males (63.5%), younger age groups (21 - 30 years), lesser educated (more than half were under matric) and with the ICD-10 diagnosis of substance abuse (23.9%). About half of patients who LAMA had a prior history of psychiatric illness and a significant number (37.5%) had a history of previous psychiatric admission.
Leaving against medical advice is a frequent problem in psychiatric inpatients and is a matter of great concern for the treating doctors.
确定巴基斯坦拉瓦尔品第一家住院精神科机构中违反医嘱擅自离院（LAMA）患者的发生率。
描述性横断面研究。
2010年8月至2011年2月，拉瓦尔品第贝娜齐尔·布托医院精神病研究所。
通过非概率连续抽样招募研究期间入院的患者，无论其病程长短和入院方式如何，并跟踪至出院以确定其出院方式。设计了一份包含13个条目的表格，获取了有关人口统计学、社会经济、患者相关和疾病相关变量的信息。在SPSS 14上进行描述性统计。
参与者总数（n）为246人。其中，96人（39%）违反医嘱擅自离院，而150人（61%）根据医生建议正常出院。发现违反医嘱擅自离院的患者在男性（63.5%）、较年轻年龄组（21 - 30岁）、受教育程度较低（一半以上为中学以下）以及国际疾病分类第十版（ICD - 10）诊断为药物滥用（23.9%）的患者中更为常见。约一半违反医嘱擅自离院的患者有精神疾病既往史，相当数量（37.5%）有先前精神科住院史。
违反医嘱擅自离院是精神科住院患者中常见的问题，也是主治医生极为关注的问题。
