Oxford Institute of Nursing, Midwifery and Allied Health Research - OxINMAHR, Oxford Brookes University, Oxford, UK.
Southern Cross University, Ballina, New South Wales, Australia.
Int J Ment Health Nurs. 2018 Feb;27(1):46-60. doi: 10.1111/inm.12426.
This review aimed to synthesize the evidence on the likelihood of harm and mortality on medical and surgical inpatient wards for people with severe mental illness (SMI). From 937 results identified through database searching, and a further 10 papers identified through citation searching and hand searching, 11 papers met the criteria for inclusion in the final review. This review did not find strong evidence for higher in-hospital mortality in people with SMI. There was evidence that adverse events are higher in people with SMI. A higher likelihood of emergency instead of planned care, and poorer access to treatment were identified as potential contributing factors to these adverse events. In addition, service users with SMI were more likely to have a longer length of stay, associated with a higher cost of care. The severity of the mental illness increased the likelihood of harm or death, and people with schizophrenia were more likely than people with other mental illnesses to experience these adverse outcomes. There is evidence that people with SMI are provided with lower-quality health care, whereas higher-quality, better-planned care is required to overcome the inequalities in access faced by this vulnerable population.
这篇综述旨在综合严重精神疾病（SMI）患者在医疗和外科住院病房中受到伤害和死亡的可能性的证据。通过数据库搜索确定了 937 个结果，通过引文搜索和手动搜索又确定了 10 篇文章，最终有 11 篇文章符合纳入最终综述的标准。本综述没有发现 SMI 患者住院死亡率更高的有力证据。有证据表明，SMI 患者的不良事件发生率更高。更高的紧急护理而不是计划护理的可能性，以及更差的治疗机会被确定为这些不良事件的潜在促成因素。此外，SMI 服务使用者更有可能住院时间延长，这与护理成本更高有关。精神疾病的严重程度增加了受到伤害或死亡的可能性，而精神分裂症患者比其他精神疾病患者更有可能经历这些不良后果。有证据表明，SMI 患者接受的医疗保健质量较低，而需要更高质量、更好计划的护理，以克服这一弱势群体面临的获得服务的不平等。
