Baker R
Department of Psychology, Royal Cornhill Hospital, Aberdeen, Scotland.
J Adv Nurs. 1988 Sep;13(5):631-9. doi: 10.1111/j.1365-2648.1988.tb01457.x.
A ward-based token economy programme which formed one part of a larger rehabilitative service for long-stay psychiatric patients is described. The clinical effectiveness of the programme is examined by the use of various nursing, psychological and psychiatric assessments before and after the patients' treatment on the ward, and the progress of former patients is followed-up as they move to different parts of the rehabilitation service. Significant clinical gains in patients' psychiatric symptomatology and problem behaviour on the ward are reported, although there were indications that improvement was not fully maintained as the patients moved on to other parts of the service. Comparison of the present clinical programme with the earlier research programmes on the ward indicated that the present regime was superior. The advantages and problems of token economy as a rehabilitative facility are discussed, outlining the various different roles for token economy with psychiatric rehabilitation. Finally, the future of token economy for long-stay patients is considered, questioning whether it might more appropriately be replaced by other structured ward programmes.
本文描述了一项基于病房的代币经济计划，该计划是为长期住院精神科患者提供的一项更大规模康复服务的一部分。通过在患者在病房接受治疗前后使用各种护理、心理和精神评估来检验该计划的临床效果，并对康复服务不同阶段的患者进展进行随访。报告显示，患者在病房的精神症状和问题行为有显著的临床改善，不过有迹象表明，随着患者进入康复服务的其他阶段，改善情况并未完全维持。将当前的临床计划与该病房早期的研究计划进行比较表明，当前的方案更具优势。文中讨论了代币经济作为一种康复设施的优点和问题，概述了代币经济在精神康复中的各种不同作用。最后，对长期住院患者代币经济的未来进行了思考，质疑它是否可能更适合被其他结构化的病房计划所取代。
