Tadesse Sinan, Gizaw Abraham Tamirat, Abraha Getachew Kirose, Gebretsadik Lakew Abebe
Department of Internal Medicine, Public Health and Medical Sciences College, Jimma University, P. O. Box: 378, Jimma, Ethiopia.
Department of Health Education and Behavioural Sciences, Public Health and Medical Sciences College, Jimma University, Jimma, Ethiopia.
Int J Ment Health Syst. 2017 Jun 14;11:41. doi: 10.1186/s13033-017-0148-0. eCollection 2017.
Psychiatric morbidity burden accounts 12.45% of the disease admission burden in Ethiopia; only two referral hospitals are found to manage all cases. The aim of this study is to assess the predictors of patient outcomes.
A 3 years retrospective patients' cards, charts and medical notes review in psychiatry case admission department of Jimma university teaching and training specialised hospital was conducted. All the admitted cases included in this study. Bivariate and multivariable logistic regression analyses were conducted to identify independent predictors of outcomes.
Among 402 study participants, the majority of them 301 (74.9%), were improved from their mental illnesses. First to eight grades completed study participants were found to be 1.34 times more likely improved mental illness than not able to read or write [AOR = 1.34, 95% CI (1.18-2.78), P < 0.009)]. The probability of improving from mental illness on married study participants was found 2.81 times more likely than single study participants [AOR = 2.81, CI (1.90-4.50), P < 0.043]. First time admitted cases improved 2.82 times more likely than those having a previous admission history [AOR = 2.82, CI (2.05-3.17), P < 0.05]. Duration of stay from 31 to 44 days showed more likely than from 1 to 20 days on patient improvement, [AOR = 1.88, CI (1.42-2.65), P < 0.034]. However, the hospital stay above 44 days does not show any statistical association with patient's medical improvement.
Married, better educated, and the hospital stay of one to one-and-half month predicts better health outcome. Thus, this study suggests, psychiatric case management needs the collaborative care of the family in concurrence with counselling and guidance with enough time to better-off patients' outcomes. Our findings are useful in designing and improving-patient services for psychiatric patient programs and focused health communication and counselling strategies in relation to psychoactive substances in Ethiopia.
在埃塞俄比亚,精神疾病负担占疾病住院负担的12.45%;仅发现两家转诊医院负责管理所有病例。本研究的目的是评估患者预后的预测因素。
对吉姆马大学教学与培训专科医院精神科病例收治部门3年的患者病历、图表和医疗记录进行回顾。本研究纳入所有收治病例。进行双变量和多变量逻辑回归分析以确定预后的独立预测因素。
在402名研究参与者中,大多数301名(74.9%)精神疾病有所改善。发现完成一至八年级学业的参与者精神疾病改善的可能性是不识字或不会写字者的1.34倍[AOR = 1.34,95% CI(1.18 - 2.78),P < 0.009]。已婚研究参与者精神疾病改善的可能性是单身研究参与者的2.81倍[AOR = 2.81,CI(1.90 - 4.50),P < 0.043]。首次收治病例改善的可能性是有既往收治史病例的2.82倍[AOR = 2.82,CI(2.05 - 3.17),P < 0.05]。住院时间为31至44天的患者改善的可能性大于住院1至20天的患者,[AOR = 1.88,CI(1.42 - 2.65),P < 0.034]。然而,住院时间超过44天与患者病情改善无任何统计学关联。
已婚、受教育程度较高以及住院一至一个半月预示着更好的健康结局。因此,本研究表明,精神科病例管理需要家庭的协同护理,同时需要进行咨询和指导,并给予足够时间以改善患者结局。我们的研究结果有助于为埃塞俄比亚的精神科患者项目设计和改善患者服务,以及制定有关精神活性物质的重点健康沟通和咨询策略。