Society for Mental Health Promotion, Plüddemanngasse 45, A-8010, Graz, Austria.
Society for Mental Health Promotion, Hasnerplatz 4, A-8010, Graz, Austria.
BMC Psychiatry. 2019 Dec 3;19(1):382. doi: 10.1186/s12888-019-2369-z.
BACKGROUND: The vast majority of older people with mental illness prefer to live independently in their own homes. Barriers caused by the health care system often prevent adequate, adapted treatments. With regard to the increasing ageing of the population, the determination of effective, age-appropriate service models for elderly patients with mental illness is clearly required. The aim of this review is to examine and to evaluate multidisciplinary psychogeriatric treatment models that include home visits, particularly with regard to the effects on psychiatric symptoms, social and mental health rehabilitation and quality of life. METHODS: A systematic review was carried out of empirical studies with participants who were diagnosed with a mental illness according to ICD-10, aged 60 years or older, and who were living at home. The inclusion criteria comprised a duration of intervention of at least 12 weeks and a minimum of two interventions and domiciliary visits delivered by a multidisciplinary team. The online databases Medline, PsychInfo, Web of Science, Cochrane Register of Controlled Trials, and Google Scholar, as well as hand search, were used to search for relevant studies published between 1996 and 2016. An additional search was performed for studies published between 2016 and 2019. After removing duplicates, abstracts were screened and the remaining articles were included for full-text review. RESULTS: Of the 3536 records discovered in total, 260 abstracts appeared to be potentially eligible. Of these, 30 full-text articles were assessed for eligibility. For the additional search 415 records and abstracts were screened and 11 articles were read full text. Finally, only three studies fully met the inclusion criteria for this review. The results indicate that psychogeriatric home treatment is associated with significant improvements of psychiatric symptoms and psychosocial problems, fewer admissions to hospital and nursing homes, as well as lower costs of care. CONCLUSIONS: Psychogeriatric home treatment has positive effects on older people with mental illness. However, these findings are based upon a small number of studies. The need for further research, especially to specify the effective factors in psychogeriatric home treatment, is clearly indicated.
背景：绝大多数有精神疾病的老年人更愿意独自在家中生活。医疗保健系统造成的障碍常常阻碍了充分、适当的治疗。鉴于人口老龄化不断增加，显然需要确定针对有精神疾病的老年患者的有效、适合年龄的服务模式。本综述的目的是检查和评估包括家访在内的多学科精神老年治疗模式，特别是在精神症状、社会和心理健康康复以及生活质量方面的影响。
方法：对符合 ICD-10 诊断标准、年龄在 60 岁及以上、居住在家中的患有精神疾病的参与者进行的有实证研究进行了系统回顾。纳入标准包括干预时间至少 12 周，以及由多学科团队提供的至少两次干预和家访。使用在线数据库 Medline、PsychInfo、Web of Science、Cochrane 对照试验注册中心和 Google Scholar 以及手工检索，搜索 1996 年至 2016 年间发表的相关研究。还对 2016 年至 2019 年间发表的研究进行了额外搜索。在去除重复项后，筛选了摘要，并对其余文章进行全文审查。
结果：总共发现了 3536 条记录，其中 260 条摘要似乎符合条件。其中，有 30 篇全文文章符合纳入标准。对于额外搜索，筛选了 415 条记录和摘要，并阅读了 11 篇全文文章。最后，只有三项研究完全符合本综述的纳入标准。结果表明，精神老年家庭治疗与精神症状和心理社会问题的显著改善、住院和疗养院入院次数减少以及护理费用降低有关。
结论：精神老年家庭治疗对有精神疾病的老年人有积极影响。然而，这些发现基于少数研究。显然需要进一步研究，特别是要明确精神老年家庭治疗中的有效因素。
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