Wasylenki D, Goering P, Lancee W, Fischer L, Freeman S J
Can J Psychiatry. 1985 Aug;30(5):329-36. doi: 10.1177/070674378503000506.
In the face of the trend toward brief hospitalization, rising re-admission rates and other indices of poor community adjustment, concern has developed about the adequacy of psychiatric aftercare services. The authors report on a comprehensive study of psychiatric aftercare in a large metropolitan area (population 2.5 million). The study followed prospectively a group of 747 patients, representative of a significant proportion of patients in the care system. The findings document inadequacies in hospital-based discharge planning, unbalanced use of aftercare services and poor patient outcomes six months and two years post-discharge. The study found heavy reliance on medical/therapeutic aftercare services with a relative neglect of housing, vocational/educational, financial and social/recreational services. Despite the large volume of medical/therapeutic service use, the patient group had a high readmission rate, high levels of symptomatology and poor social adjustment on follow-up. The authors suggest that community-based practitioners with specialized training in psychiatric rehabilitation would improve the system of aftercare.
面对住院时间缩短的趋势、再入院率上升以及其他社区适应不良的指标，人们对精神科后续护理服务的充分性产生了担忧。作者报告了一项对一个大都市地区（人口250万）精神科后续护理的综合研究。该研究前瞻性地跟踪了一组747名患者，他们代表了护理系统中相当比例的患者。研究结果表明，基于医院的出院计划存在不足，后续护理服务使用不均衡，出院后六个月和两年的患者预后较差。研究发现，人们严重依赖医疗/治疗性后续护理服务，而相对忽视了住房、职业/教育、财务和社会/娱乐服务。尽管大量使用了医疗/治疗性服务，但该患者群体的再入院率很高，症状水平很高，随访时社会适应不良。作者建议，接受过精神科康复专业培训的社区从业者将改善后续护理系统。
