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慢性精神分裂症的再次住院治疗

Rehospitalization in chronic schizophrenia.

作者信息

Caton C L, Koh S P, Fleiss J L, Barrow S, Goldstein J M

出版信息

J Nerv Ment Dis. 1985 Mar;173(3):139-48. doi: 10.1097/00005053-198503000-00002.

Abstract

This report on rehospitalization in chronic schizophrenia is based on a 1-year study of the postdischarge experiences of 119 chronic schizophrenics in New York City. The life table method of analysis identified the important role of discharge planning, community treatment compliance, and interpersonal stress in the patient's living environment in determining the number of days postdischarge that the patient remained in the community without further inpatient care. A mathematical model to predict days in hospital over the follow-up period, based on three specific components of time in hospital defined in numerical terms (PR, NR, LSR), was devised and tested. The first component, the experience of rehospitalization (PR), was determined by interpersonal stress, social supports, and aftercare treatment compliance. Adequacy of discharge planning, an intervention designed to link the patient to community treatment services, has its greatest impact in identifying number of rehospitalizations for the rehospitalized group (NR). Aftercare treatment compliance has its greatest effect in relation to length of subsequent rehospitalization episodes (LSR). Test of the model revealed that it can predict time in hospital within less than one half of a standard deviation of observed hospital days in approximately 50% of cases.

摘要

这份关于慢性精神分裂症再住院情况的报告,是基于对纽约市119名慢性精神分裂症患者出院后一年经历的研究。分析的生命表方法确定了出院计划、社区治疗依从性以及患者生活环境中的人际压力在决定患者出院后在社区中无需再次住院治疗的天数方面所起的重要作用。设计并测试了一个基于以数值定义的住院时间的三个特定组成部分(PR、NR、LSR)来预测随访期内住院天数的数学模型。第一个组成部分,再住院经历(PR),由人际压力、社会支持和后续护理治疗依从性决定。出院计划的充分性,即一种旨在将患者与社区治疗服务联系起来的干预措施,在确定再住院组的再住院次数(NR)方面影响最大。后续护理治疗依从性对后续再住院发作的时长(LSR)影响最大。该模型的测试表明,在大约50%的病例中,它能够在观察到的住院天数的标准差的不到一半范围内预测住院时间。

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