伊朗严重精神障碍患者后续护理服务的疗效：一项随机对照试验。

Efficacy of aftercare services for people with severe mental disorders in Iran: a randomized controlled trial.

作者信息

Ghadiri Vasfi Mohammad, Moradi-Lakeh Maziar, Esmaeili Nazanin, Soleimani Naser, Hajebi Ahmad

机构信息

All of the authors are with the Iran University of Medical Sciences, Tehran, Islamic Republic of Iran, where Dr. Ghadiri Vasfi and Dr. Hajebi are with the Mental Health Research Center and the Faculty of Behavioral Sciences and Mental Health, Dr. Moradi-Lakeh is with the Department of Community Medicine, and Ms. Esmaeili and Mr. Soleimani are with the Department of Psychology in Mental Hospital. Dr. Moradi-Lakeh is also with the Institute for Health Metrics and Evaluation, Seattle, Washington. Send correspondence to Dr. Hajebi (e-mail:

出版信息

Psychiatr Serv. 2015 Apr 1;66(4):373-80. doi: 10.1176/appi.ps.201400111. Epub 2014 Dec 15.

DOI:10.1176/appi.ps.201400111

PMID:25828982

Abstract

OBJECTIVES

This study aimed to determine whether aftercare services reduced the number of rehospitalizations and length of hospital stay among patients with severe mental disorders.

METHODS

A total of 120 patients with schizophrenia and schizoaffective or bipolar disorder between the ages of 15 and 65 were recruited from 2010 to 2012 for a randomized controlled trial. The participants were followed up for 20 months after discharge from a university-affiliated hospital in Tehran, Iran. The selection procedure was random sampling. Sixty patients received aftercare services, which included treatment follow-up, family psychoeducation, and patient social skills training, and 60 patients received treatment as usual. Number of hospitalizations and length of hospital stay were primary outcome measures, and severity of psychopathology and severity of illness were secondary outcome measures. The quantitative primary and secondary outcomes measures were compared by using repeated-measures analysis.

RESULTS

Three members of the control group did not complete the study. The cumulative number of hospitalizations during the follow-up period was 55 for the control group and 26 for the intervention group. Length of stay was significantly greater in the control group compared with the intervention group (rate ratio=2.38, 95% confidence interval=2.17-2.62). Psychopathology was less severe in the intervention group compared with the control group (p<.001).

CONCLUSIONS

Aftercare services are efficacious for reducing both the need for rehospitalization and the severity of psychopathology.

摘要

目的

本研究旨在确定后续照护服务是否能减少重症精神障碍患者的再住院次数及住院时间。

方法

2010年至2012年，从15至65岁的精神分裂症、分裂情感性障碍或双相情感障碍患者中招募了120名患者，进行一项随机对照试验。参与者在伊朗德黑兰一家大学附属医院出院后接受了20个月的随访。选择程序为随机抽样。60名患者接受了后续照护服务，包括治疗随访、家庭心理教育和患者社交技能培训，60名患者接受常规治疗。住院次数和住院时间为主要结局指标，精神病理学严重程度和疾病严重程度为次要结局指标。通过重复测量分析比较定量的主要和次要结局指标。