The Albert Road Clinic, Melbourne, Victoria, Australia.
Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.
BMJ Open. 2019 Feb 22;9(2):e025098. doi: 10.1136/bmjopen-2018-025098.
Improving mental healthcare for adolescents is a global policy priority. Despite demands for community-based services, many adolescents require more intensive interventions, such as an inpatient admission. This is typically at a point of crisis, often accompanied by intense emotional dysregulation, impairment of coping function and impulsivity. However, limited evidence exists on how best to support this group while they are in inpatient care, aside from pharmacological treatments which have a limited role in adolescents. Little is known about the models of care (MoC) offered in inpatient units, whether adolescents perceive these as helpful and the perspectives of caregivers and clinicians. Here, we describe a protocol which aims to explore and evaluate an inpatient MoC.
We designed a longitudinal, mixed-methods, case study. The population consists of adolescents, caregivers and clinicians at a single inpatient unit in Melbourne, Australia. Standardised outcome measures, including semi- structured interviews, will be administered to adolescents at three time-points, T1 (admission), T2 (discharge) and T3 (6 months post discharge). Caregivers will also be interviewed at T1, T2 and T3. Clinicians will be interviewed once. The measures include: Life Problems Inventory, Quick Inventory of Depressive Symptomatology, Kessler Psychological Distress Scale and the Youth Self-Report. Health of the Nation Outcome Scales for Children and Adolescents will be collected at T1 and T2. Quantitative analysis will include descriptive statistics and paired t-tests summarising adolescents admitted to the unit, clinical characteristics and longitudinal data on symptomatology. Qualitative data will be analysed using both thematic and trajectory analysis. Data collection began in May 2017 and will cease with T3 interviews by October 2018. ETHICS AND DISSEMINATION.
改善青少年心理健康是全球政策重点。尽管需要社区为基础的服务，但许多青少年需要更密集的干预，如住院治疗。这通常是在危机时刻，常常伴随着强烈的情绪失调、应对功能受损和冲动。然而，除了在青少年中作用有限的药物治疗外，对于如何在住院治疗期间最好地支持这一群体，证据有限。关于住院病房提供的护理模式（MoC）知之甚少，青少年是否认为这些模式有用，以及照顾者和临床医生的看法。在这里，我们描述了一项旨在探索和评估住院 MoC 的方案。
我们设计了一项纵向、混合方法、案例研究。研究人群包括澳大利亚墨尔本一家住院病房的青少年、照顾者和临床医生。将在三个时间点（T1[入院]、T2[出院]和 T3[出院后 6 个月]）向青少年提供标准化的结果测量，包括半结构化访谈。照顾者也将在 T1、T2 和 T3 进行访谈。临床医生将进行一次访谈。测量包括：生活问题清单、快速抑郁症状清单、凯斯勒心理困扰量表和青少年自我报告。国民健康结果量表将在 T1 和 T2 收集。定量分析将包括描述性统计和配对 t 检验，总结入院青少年、临床特征和症状学的纵向数据。定性数据将使用主题分析和轨迹分析进行分析。数据收集始于 2017 年 5 月，T3 访谈将于 2018 年 10 月结束。
伦理和传播。
