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改善社区心理健康:老年心理健康日间治疗服务的结果评估

Improving Mental Health in the Community: Outcome Evaluation of a Geriatric Mental Health Day Treatment Service.

作者信息

Knight Christine A, Alarie Richard M

机构信息

a Alberta Health Services , Calgary , Alberta , Canada.

出版信息

Clin Gerontol. 2017 Mar-Apr;40(2):77-87. doi: 10.1080/07317115.2016.1263709. Epub 2016 Nov 30.

Abstract

OBJECTIVES

This program evaluation reviewed the outcomes of a new 10-week multi-modal mental health day treatment program for elderly clients with mood and anxiety disorders.

METHODS

A retrospective chart review of clients admitted during the first 3 years of the program (N = 255) was conducted. Paired sample t-tests were used to compare admission and discharge data. Focus groups were run with clients who attended the program during the previous months, to delineate the strengths of the program and to identify areas for improvement.

RESULTS

Analyses showed statistically and clinically significant improvements in client symptomatology, as evidenced by reductions on the Geriatric Depression Scale and the Clinical Outcomes in Routine Evaluation Outcome Measure in clients who completed the program. Focus group participants overwhelmingly described the program as very beneficial, but the desire for on-going follow-up was clearly articulated.

CONCLUSIONS

A practice model employing group-based cognitive-behavioural and interpersonal strategies that emphasizes behavioral activation and socialization is associated with a reduction in depressive symptoms and psychological distress in a large sample of elderly adults in a day treatment service with mild to moderate symptoms of depression and anxiety.

CLINICAL IMPLICATIONS

In the future, a mechanism for on-going mental health support should be included. Many clients want to remain connected to the system, but there is not always a clear path along the continuum of care, particularly for clients who no longer meet criteria for a psychiatric disorder.

摘要

目标

本项目评估回顾了一项针对患有情绪和焦虑障碍的老年客户的为期10周的新型多模式心理健康日间治疗项目的成果。

方法

对该项目前3年收治的客户(N = 255)进行回顾性病历审查。采用配对样本t检验比较入院和出院数据。与前几个月参加该项目的客户进行焦点小组讨论,以明确该项目的优势并确定改进领域。

结果

分析显示,完成该项目的客户在老年抑郁量表和常规评估结果测量的临床结果量表上的得分降低,这表明客户症状在统计学和临床上有显著改善。焦点小组参与者压倒性地将该项目描述为非常有益,但明确表达了对持续随访的需求。

结论

一种采用基于小组的认知行为和人际策略的实践模式,强调行为激活和社交化,与在日间治疗服务中一大群有轻度至中度抑郁和焦虑症状的老年人的抑郁症状和心理困扰的减少相关。

临床意义

未来,应纳入持续心理健康支持机制。许多客户希望与该系统保持联系,但在连续护理过程中并不总是有明确的途径,特别是对于那些不再符合精神疾病标准的客户。

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