School of Nursing Sciences, University of East Anglia, Norwich, United Kingdom, NR7 4TJ; Eating Disorders Research Team, St George's, University of London, London, United Kingdom, SW17 0RE.
Int J Eat Disord. 2014 Jan;47(1):40-6. doi: 10.1002/eat.22190. Epub 2013 Oct 28.
To investigate treatment drop-out by comparing clinical indicators of patients whose discharge was initiated by staff with those who initiated discharge themselves.
Ninety participants with anorexia completed questionnaires at admission and four weeks into hospitalized treatment. Weight data was collected over this same period. At discharge, participants were categorized into completer (n = 38) or patient-initiated (n = 36) /staff-initiated (n = 16) premature termination groups.
Significant differences between staff-initiated and patient-initiated discharge groups were found at admission. Staff initiated groups were on average older (p = .035), and more likely to have had prior compelled treatment (p = .039). At 4 weeks those in the patient-initiated group had put on weight at a faster rate (p = .032) and reported a decrease in alliance (p = .017). At discharge, staff initiated discharge demonstrated greater time in treatment (p = .001), greater weight gain (p = .027), and a higher discharge BMI (p = .013). At discharge, staff-initiated drop-outs had comparable end-of-treatment outcomes to those who completed treatment as planned.
There are key differences between those who prematurely discharge themselves from treatment, compared to those who are prematurely discharged by clinical staff. Future research into drop-out needs to take into account and recognize these differences.
通过比较由工作人员发起出院和患者自行发起出院的患者的临床指标，来研究治疗中断的情况。
90 名厌食症患者在入院时和住院治疗 4 周后完成了问卷调查。在此期间还收集了体重数据。出院时，将参与者分为完成治疗者（n = 38）、患者自行发起（n = 36）/工作人员发起（n = 16）提前终止治疗的组别。
在入院时，工作人员发起和患者自行发起出院组之间存在显著差异。工作人员发起的组平均年龄较大（p =.035），且更有可能接受过强制治疗（p =.039）。在第 4 周，患者自行发起组的体重增加速度更快（p =.032），且对治疗联盟的评价下降（p =.017）。出院时，工作人员发起出院的患者治疗时间更长（p =.001），体重增加更多（p =.027），出院 BMI 更高（p =.013）。出院时，提前终止治疗的患者与按计划完成治疗的患者的治疗结束时的结局相当。
与那些由临床工作人员提前终止治疗的患者相比，那些自行提前终止治疗的患者存在关键差异。未来的辍学研究需要考虑并认识到这些差异。
