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精神卫生保健中的出院计划:文献综合综述

Discharge planning in mental health care: an integrative review of the literature.

作者信息

Nurjannah Intansari, Mills Jane, Usher Kim, Park Tanya

机构信息

School of Nursing, Midwifery and Nutrition, James Cook University, Cairns, Qld, Australia.

出版信息

J Clin Nurs. 2014 May;23(9-10):1175-85. doi: 10.1111/jocn.12297. Epub 2013 Jul 12.

Abstract

AIMS AND OBJECTIVES

To identify the evidence base related to discharge planning in the context of acute and community mental healthcare service provision to ascertain the need for future research.

BACKGROUND

Discharge planning is an important activity when preparing consumers to transition from hospital to home. The efficiency of discharge planning for consumers living with a mental health issue can influence both the number of future readmissions to acute-care facilities and their quality of life at home.

DESIGN

An integrative review of the peer-reviewed literature.

METHOD

This review uses specific search terms and a 21-year time frame to search two key nursing databases CINAHL (Cinahl Information Systems, Glendale, CA, USA) and PSYCHINFO (American Psychological Association, Washington, DC, USA) for research reports investigating the substantive area of enquiry. Hand searches of reference lists and author searches were also conducted. Nineteen peer-reviewed journal articles met the inclusion criteria for this review.

RESULTS

Research findings about discharge planning for people living with a mental health issue identify the importance of communication between health professionals, consumers and their families to maximise the effectiveness of this process. The complexity of consumer's healthcare needs influences the discharge planning process and impacts on aftercare compliance and readmission rates. There is a limited amount of research findings relating to differences between health professionals and families' perceptions of the level of information required for effective discharge planning, and the appropriate level of involvement of individuals living with a mental health issue in their own discharge planning. Results from this integrative review will inform future research related to this topic.

CONCLUSION

Discharge planning for consumers living with a mental health issue involves many stakeholders who have different expectations regarding the type of information required and the necessary level of involvement of people living with a mental health issue in this process.

RELEVANCE TO CLINICAL PRACTICE

Comprehensive discharge planning can result in reduced readmissions to both acute and community mental health services. Understanding the impact of effective communication on the outcomes of discharge planning is an important step in promoting success.

摘要

目的与目标

识别在急性和社区精神卫生保健服务背景下与出院计划相关的证据基础,以确定未来研究的必要性。

背景

出院计划是帮助患者从医院过渡到家庭时的一项重要活动。为有心理健康问题的患者制定出院计划的效率会影响其未来再次入住急性护理机构的次数以及在家中的生活质量。

设计

对同行评审文献进行综合综述。

方法

本综述使用特定搜索词并在21年的时间范围内,搜索两个主要护理数据库CINAHL(美国加利福尼亚州格伦代尔的Cinahl信息系统)和PSYCHINFO(美国华盛顿特区的美国心理协会),以查找调查该实质性研究领域的研究报告。还对手稿参考文献列表进行了手工检索以及作者检索。19篇同行评审期刊文章符合本综述的纳入标准。

结果

关于为有心理健康问题的人制定出院计划的研究结果表明,卫生专业人员、患者及其家属之间的沟通对于使这一过程达到最大效果至关重要。患者医疗保健需求的复杂性会影响出院计划过程,并对后续护理的依从性和再入院率产生影响。关于卫生专业人员和家属对有效出院计划所需信息水平的认知差异,以及有心理健康问题的个人在其自身出院计划中的适当参与程度,相关研究结果有限。本次综合综述的结果将为该主题的未来研究提供参考。

结论

为有心理健康问题的患者制定出院计划涉及许多利益相关者,他们对所需信息的类型以及有心理健康问题的人在此过程中的必要参与程度有不同期望。

与临床实践的相关性

全面的出院计划可减少急性和社区精神卫生服务的再入院率。了解有效沟通对出院计划结果的影响是促进成功的重要一步。

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