Dencker K
Soc Psychiatry Psychiatr Epidemiol. 1989 May;24(3):156-64. doi: 10.1007/BF01788026.
A political decision to decentralize psychiatric care in a province in Sweden was arrived at in October 1984, leading to the closing down of the only psychiatric hospital in the area (290,000 inh.). The hospital is of the traditional type with 490 beds and 1,294 staff. It has units for long-term care, short-term care and rehabilitation, as well as a unit for research and education. The psychogeriatric patients are to be transferred to their home districts. All of the psychogeriatric staff have been guaranteed new jobs under the auspices of the County Council's medical services. This study is concerned with the nursing staff's reactions to the decentralization and the kind of problems they were faced with. A questionnaire was sent to all nursing staff, and for the psychogeriatric unit (199 patients) the personnel turnover was also registered. The results show that the greatest problems for the nursing staff were the splitting up of their working teams and having to establish relations with new colleagues. They were also worried about longer and more expensive journeys to new places of work. Most of the nursing staff considered the information given about the consequences of the political decision very poor. More than half of the nursing staff (54%) thought the patients would be provided with better care by decentralized psychiatric health services. Many stated that the decision had affected them so that their interest in further education (37%) and in working in a new type of psychiatric care (43%) had increased.(ABSTRACT TRUNCATED AT 250 WORDS)
1984年10月，瑞典某省做出了一项将精神科护理服务去中心化的政治决策，这导致该地区唯一一家精神病医院（服务29万人口）关闭。这家医院是传统类型，有490张床位和1294名工作人员。它设有长期护理、短期护理和康复科室，还有一个科研与教育科室。老年精神病患者将被转移到他们所在的地区。所有老年精神病科工作人员都在郡议会医疗服务部门的支持下获得了新工作保障。本研究关注护理人员对去中心化的反应以及他们所面临的问题类型。向所有护理人员发放了问卷，对于老年精神病科（199名患者），还记录了人员流动情况。结果显示，护理人员面临的最大问题是工作团队的拆分以及必须与新同事建立关系。他们还担心前往新工作地点的路程更长、费用更高。大多数护理人员认为关于这项政治决策后果的信息非常匮乏。超过一半的护理人员（54%）认为去中心化的精神科医疗服务能为患者提供更好的护理。许多人表示，这项决策对他们产生了影响，以至于他们对继续教育的兴趣（37%）以及对在新型精神科护理领域工作的兴趣（43%）都有所增加。（摘要截选于250字）
