Lakioti En, Angelopoulos Nv, Tomaras Vd
Psychiatric Unit, University of Thessaly, Medical School, University Hospital of Larissa, Larissa.
1st Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece.
Psychiatriki. 2014 Apr-Jun;25(2):119-28.
With the implementation of the psychiatric reform in Greece, the care of chronically mentally ill persons has been transferred into sheltered housing in the community (nursing homes, hostels, sheltered apartments), for the psychosocial rehabilitation of the patients, aiming at the deinstutionalization and their social reintegration. The scope of the present study was to record and analyze the attitudes and perceptions of both staff members and resident-patients of the 17 residential units (5 nursing homes, 4 hostels and 8 sheltered apartments) of "Psychargos" Project in Thessaly, as well as to check the hypothesis of "neo" institutionalization for the units under investigation. Data were collected onsite (field study) from 157 staff members and 88 resident-patients, by structuring and using original questionnaires as well as the Global Assessment Scale (GAS). The independent variables for the staff members (sex, age, education, profession, legal form of the residential unit, previous professional experience in mental health services) as well as for the resident-patients (sex, age, GAS score, legal form of the residential unit, residence time in the unit, and previously in other psychiatric institutions) were correlated to dependent variables in order to assess possible statistical relationships (x2). The statistical significance test p-value was set at 0.05. Data statistical processing was carried out using SPSS 16.0. The hypothesis of "neo"-institutionalization for these residential units was checked in a 34-month follow-up period. Regarding the staff, a positive attitude towards the institution of residential care structures itself was recorded. Nevertheless, a negative opinion regarding the prospect of resident patients recovery, and even skepticism as to the acceptability of these persons by the local community, were expressed. Surely, it is positive that a remarkable percentage of the staff members are willing, even though under certain conditions, to provide foster care to resident-patients. On their part, the resident-patients maintain good relationships with staff and fellow residents, and feel content with their residence itself and the services provided. However, most of them (especially the most functional and with milder symptoms) express their desire for more autonomy, with regard to the degree of supervision received by the staff, their contact with the local community, the perspective of receiving foster care, the perspective of return in their natural family as well as of autonomous living. Ultimately however, the survey results give rise to pessimism with respect to an intermediate-transitional character of the residential units, since only a few resident-patients moved during the follow-up period (34 months) towards reduced-supervision housing and none to the community. However, the functionality of a non-insignificant part of the resident-patients could be employed for leaving "neo"-institutionalized housing and living, and finally their social reintegration.
随着希腊精神病学改革的实施,慢性精神病患者的护理已转移至社区中的庇护性住房(疗养院、旅社、庇护公寓),以促进患者的心理社会康复,目标是实现去机构化并使其重新融入社会。本研究的范围是记录和分析色萨利“Psychargos”项目17个居住单元(5家疗养院、4家旅社和8套庇护公寓)的工作人员和住院患者的态度与看法,并检验所调查单元的“新”机构化假设。通过构建和使用原始问卷以及全球评估量表(GAS),对157名工作人员和88名住院患者进行了现场数据收集(实地研究)。将工作人员的自变量(性别、年龄、教育程度、职业、居住单元的法律形式、以前在精神卫生服务方面的专业经验)以及住院患者的自变量(性别、年龄、GAS评分、居住单元的法律形式、在该单元的居住时间以及以前在其他精神病机构的情况)与因变量相关联,以评估可能的统计关系(χ²)。统计显著性检验的p值设定为0.05。使用SPSS 16.0进行数据统计处理。在34个月的随访期内检验了这些居住单元的“新”机构化假设。关于工作人员,记录到他们对居住护理机构本身持积极态度。然而,他们对住院患者康复前景持负面看法,甚至对当地社区对这些人的接受程度表示怀疑。当然,值得肯定的是,相当比例的工作人员愿意(即使在某些条件下)为住院患者提供寄养服务。就住院患者而言,他们与工作人员和其他住院患者保持良好关系,对自己的居住环境和所提供的服务感到满意。然而,他们中的大多数人(尤其是功能较好且症状较轻的患者)表示,希望在工作人员的监督程度、与当地社区的接触、接受寄养服务的可能性、回归原生家庭以及自主生活等方面拥有更多自主权。然而,最终调查结果引发了对居住单元过渡性质的悲观情绪,因为在随访期(34个月)内只有少数住院患者搬到了监督较少的住房,没有人回归社区。不过,可以利用相当一部分住院患者的功能使其离开“新”机构化住房并实现生活自理,最终实现社会重新融入。