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精神病院出院后感知到的社会支持的作用:一项过渡干预有效性的随机对照试验的事后分析。

The role of perceived social support after psychiatric hospitalisation: Post hoc analysis of a randomised controlled trial testing the effectiveness of a transitional intervention.

机构信息

1 Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Zurich, Switzerland.

2 Integrated Psychiatric Clinic of Winterthur and Zurich Unterland (IPW), Winterthur, Switzerland.

出版信息

Int J Soc Psychiatry. 2017 Jun;63(4):297-306. doi: 10.1177/0020764017700664. Epub 2017 Mar 27.

Abstract

BACKGROUND

The association between social support, readmissions and psychopathology following discharge from psychiatric hospitals is not clear.

AIMS

To examine the prospective effects of perceived social support on rehospitalisation rates and psychopathology and to focus on the moderators of a transitional intervention.

METHOD

This post hoc analysis of a multisite randomised controlled trial included 151 patients with no more than three hospitalisations within the last 3 years, a Global Assessment of Functioning (GAF) score ≤60 and aged 18-64 years, assessed at two psychiatric hospitals from Zurich, Switzerland, between September 2011 and February 2014. Participants received either a transitional intervention aimed at improving social support during the transition from inpatient to outpatient care provided by a social worker or treatment as usual.

RESULTS

Lack of perceived social support at discharge significantly predicted subsequent rehospitalisation rates and increased psychopathological impairment across 12-month follow-up. Significant interaction effects between patient characteristics and the intervention on perceived social support comprised living at parent's home, having no children and being of younger age.

CONCLUSION

Perceived social support at discharge from inpatient care may reduce rehospitalisation rates and psychopathological impairment in the long term. A transitional intervention aimed at improving social support may negatively impact on the perceived social support in some patient groups.

摘要

背景

出院后社会支持与再入院率和精神病理学之间的关系尚不清楚。

目的

探讨感知社会支持对再入院率和精神病理学的前瞻性影响,并关注过渡干预的调节因素。

方法

这是一项多地点随机对照试验的事后分析,纳入了 151 名在过去 3 年内住院次数不超过 3 次、全球功能评估(GAF)评分≤60 且年龄在 18-64 岁的患者,他们于 2011 年 9 月至 2014 年 2 月在瑞士苏黎世的两家精神病院接受评估。参与者接受了过渡干预,旨在改善从住院到由社会工作者提供的门诊治疗的过渡期间的社会支持,或接受常规治疗。

结果

出院时缺乏感知社会支持显著预测了随后的再入院率,并在 12 个月的随访中增加了精神病理学损伤。感知社会支持在患者特征和干预之间存在显著的交互作用,包括与父母同住、没有孩子和年龄较小。

结论

住院治疗出院时感知到的社会支持可能会降低长期再入院率和精神病理学损伤。旨在改善社会支持的过渡干预可能会对某些患者群体的感知社会支持产生负面影响。

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