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尼日利亚一家精神病医院门诊患者首次预约失约的患病率及其相关因素

Prevalence and Correlates of Missed First Appointments among Outpatients at a Psychiatric Hospital in Nigeria.

作者信息

Akhigbe Si, Morakinyo O, Lawani Ao, James Bo, Omoaregba Jo

机构信息

Department of Clinical Services, Federal Neuro-Psychiatric Hospital, Benin City, Edo State, Nigeria.

Department of Mental Health, University of Benin, Benin City, Edo State, Nigeria.

出版信息

Ann Med Health Sci Res. 2014 Sep;4(5):763-8. doi: 10.4103/2141-9248.141550.

Abstract

BACKGROUND

Missed appointments are common in psychiatric practice. It compromises quality of care, results in poor treatment outcomes and drains financial resources. In Nigeria, where mental health services are poorly organized, missed appointments and its resultant consequences may be burdensome.

AIM

This study sought to determine the prevalence and factors (sociodemographic and clinical) associated with missed clinic appointments at a regional psychiatric hospital.

SUBJECTS AND METHODS

A study on a cohort of patients attending the Outpatient Clinics for the first time between June and September 2011 was conducted. We interviewed each participant at their first presentation then tracked through case records to determine adherence to scheduled first clinic appointments after 4 weeks. A questionnaire was used in eliciting sociodemographic characteristics, clinical variables, and patient/caregiver satisfaction with treatment. Descriptive statistics were used to summarize the data and inferential statistics to test associations using the SPSS 16.

RESULTS

Three hundred and ten patients were recruited over the study period. The prevalence of missed first appointment was 32.6% (101/310). Participants who were single (P = 0.04), living alone (P < 0.01) or aggressive (P < 0.01) were more likely to miss their first appointment. However, having received previous treatment for a psychiatric illness (P = 0.02) and having comorbidity (P = 0.05) was associated with less likelihood to miss a first appointment. A binary logistic regression analysis showed that having received previous treatment independently predicted a less likelihood to miss first appointment (P = 0.03).

CONCLUSION

Quite a proportion (32.6%) of patients attending outpatient clinics miss scheduled clinic appointments. Receiving previous psychiatric care predicted adherence to scheduled appointment.

摘要

背景

在精神科诊疗中,失约现象很常见。这会损害医疗质量,导致治疗效果不佳并耗费财力。在尼日利亚,心理健康服务组织不善,失约及其带来的后果可能会很严重。

目的

本研究旨在确定一家地区精神病医院门诊失约的患病率以及与之相关的因素(社会人口统计学和临床因素)。

对象与方法

对2011年6月至9月首次到门诊就诊的一组患者进行了研究。我们在每位参与者首次就诊时进行访谈,然后通过病例记录追踪,以确定4周后是否遵守首次门诊预约时间。使用问卷调查来获取社会人口统计学特征、临床变量以及患者/照顾者对治疗的满意度。使用描述性统计来汇总数据,并使用SPSS 16进行推断性统计以检验相关性。

结果

在研究期间招募了310名患者。首次预约失约的患病率为32.6%(101/310)。单身(P = 0.04)、独居(P < 0.01)或有攻击性(P < 0.01)的参与者更有可能错过首次预约。然而,曾接受过精神疾病治疗(P = 0.02)和患有合并症(P = 0.05)与错过首次预约的可能性较小有关。二元逻辑回归分析表明,曾接受过治疗可独立预测错过首次预约的可能性较小(P = 0.03)。

结论

相当一部分(32.6%)门诊患者错过预约门诊时间。曾接受过精神科护理可预测其遵守预约情况。

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