Shaar Menashe Mental Health Center, Israel; National Insurance Institute in Israel, Haifa, Israel.
Shaar Menashe Mental Health Center, Israel.
Psychiatry Res. 2018 Sep;267:541-550. doi: 10.1016/j.psychres.2018.05.030. Epub 2018 May 13.
This cross-sectional study compared the levels of needs, care satisfaction, quality of life, and social support of compulsory admitted patients with severe mental disorders to a comparable group of voluntary admitted patients. One hundred and twenty-five patients with schizophrenia and schizoaffective disorder were admitted to a hospital by district psychiatrist order (DPO), court observation order (COO), or voluntary (VA). Participants were assessed before discharge using questionnaires, and psychiatric rating scales. A linear discriminant analysis revealed eight variables that best differentiated the three groups. COO patients were significantly discriminated from the two other groups (DPO and VA) by severe negative symptoms, better satisfaction with both nursing staff and family support. COO subjects had more non-illness unmet needs, while reported better hedonic capacity for social and interpersonal pleasure - compared to VA patients. DPO patients were significantly indicated by poorer awareness to illness, but better satisfaction with subjective feelings. VA subjects were significantly discriminated from compulsory admitted patients by higher illness severity scores. Assessment of unmet needs, satisfaction with care, quality of life, hedonic capacity, and social support constitute the factors that differentiate compulsory admitted patients and could be targets for interventions aimed to reduce the negative effects of compulsory admissions.
本横断面研究比较了强制性住院的严重精神障碍患者与可比自愿住院患者的需求水平、护理满意度、生活质量和社会支持。125 名精神分裂症和分裂情感障碍患者因区精神科医生命令（DPO）、法院观察令（COO）或自愿（VA）入院。参与者在出院前使用问卷和精神科评定量表进行评估。线性判别分析显示，有 8 个变量可最好地区分三组。COO 患者与其他两组（DPO 和 VA）的严重负性症状明显不同，对护理人员和家庭支持的满意度更高。COO 患者的非疾病需求未得到满足的情况更多，但与 VA 患者相比，他们对社会和人际关系愉悦的享乐能力更好。DPO 患者的疾病意识较差，但对主观感受的满意度较高，因此与强制性住院患者明显不同。VA 患者与强制性住院患者的疾病严重程度评分明显不同。评估未满足的需求、护理满意度、生活质量、享乐能力和社会支持构成了区分强制性住院患者的因素，这些因素可能是旨在减少强制性住院负面影响的干预措施的目标。
