Nugter M Annet, Engelsbel Fabiana, Bähler Michiel, Keet René, van Veldhuizen Remmers
Department of Research and Monitoring, Mental Health Service Organization GGZ Noord-Holland-Noord, PO Box 18, 1850 BA, Heiloo, The Netherlands.
Department of Community Mental Health, Mental Health Service Organization GGZ Noord-Holland-Noord, PO Box 18, 1850 BA, Heiloo, The Netherlands.
Community Ment Health J. 2016 Nov;52(8):898-907. doi: 10.1007/s10597-015-9831-2. Epub 2015 Feb 4.
This study aimed to investigate social and clinical outcomes and use of care during and after implementation of FLEXIBLE Assertive Community Treatment (ACT). Three teams and 372 patients were involved. Model fidelity, clinical and social assessments were performed at baseline and after 1 and 2 years. Use of care was registered continuously. Model fidelity was good at the end of the study. Data showed much variation between patients in number and duration of ACT periods. Statistically significant improvements were found in compliance, unmet needs and quality of life. Improvement of quality of life and functioning was related to duration of ACT. The percentage of remissions increased with 9 %. The number of admissions, admission days and face to face contacts differed between ACT and non-ACT patients, but generally decreased. Findings suggest that implementation of FACT results in a more flexible adaptation of care to the needs of the patients.
本研究旨在调查灵活主动社区治疗（FLEXIBLE Assertive Community Treatment，ACT）实施期间及之后的社会和临床结局以及护理利用情况。研究涉及三个团队和372名患者。在基线以及1年和2年后进行了模式保真度、临床和社会评估。持续记录护理利用情况。研究结束时模式保真度良好。数据显示，患者在ACT周期的数量和持续时间方面存在很大差异。在依从性、未满足的需求和生活质量方面发现了具有统计学意义的改善。生活质量和功能的改善与ACT的持续时间有关。缓解率提高了9%。ACT患者和非ACT患者在入院次数、住院天数和面对面接触方面存在差异，但总体上有所减少。研究结果表明，实施FACT可使护理更灵活地适应患者的需求。
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