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家庭治疗在急性精神卫生保健中的作用:谁最受益?

Home Treatment for Acute Mental Healthcare: Who Benefits Most?

机构信息

Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland.

Psychiatrie Baselland, Liestal, Switzerland.

出版信息

Community Ment Health J. 2021 Jul;57(5):828-835. doi: 10.1007/s10597-020-00618-3. Epub 2020 Apr 11.


DOI:10.1007/s10597-020-00618-3
PMID:32279118
Abstract

Home treatment (HT) has been proposed as an alternative to inpatient treatment for individuals in acute mental crises. However, there is limited evidence concerning the effectiveness of HT to date. The aim of this study was to investigate which patients benefit most from HT. The concept and utilization of two HT services in Switzerland were retrospectively compared based on routine medical data of all patients who were treated in one of the two HT services between July 2016 and December 2017. We examined which patient characteristics were related to successful replacement of hospital care by HT based on a calculated success score using binary regression analyses. The whole sample included 408 individuals with an average age of 43 years and of whom 68% were female. As a result of conceptual similarities, in both HT settings, the typical patient was middle-aged, female and having an affective disorder as the main diagnosis. Half of the treatment cases met the criteria of successful replacement of hospital care (> 50% of the total treatment episodes in HT, treatment duration < 40 days and treatment terminated by mutual agreement). The results of the regression analyses indicated that patients with a lower symptom severity at admission (lower HoNOS score) and those who were employed had more likely a successful replacement of hospital care.The findings suggest that patients with acute mental disorders who have a certain level of functioning and social support might benefit most from HT in the sense of successful replacement of hospital care.

摘要

家庭治疗(HT)已被提议作为急性精神危机患者住院治疗的替代方法。然而,迄今为止,关于 HT 的有效性的证据有限。本研究旨在调查哪些患者最受益于 HT。根据 2016 年 7 月至 2017 年 12 月期间在这两个 HT 服务中的一个接受治疗的所有患者的常规医疗数据,回顾性比较了瑞士两个 HT 服务的概念和使用情况。我们使用二元回归分析计算成功评分,研究了哪些患者特征与 HT 成功替代医院护理相关。整个样本包括 408 名平均年龄为 43 岁的个体,其中 68%为女性。由于概念上的相似性,在这两种 HT 环境中,典型患者为中年、女性,主要诊断为情感障碍。半数治疗病例符合成功替代医院护理的标准(HT 中总治疗例数的>50%、治疗持续时间<40 天且治疗经双方同意终止)。回归分析的结果表明,入院时症状严重程度较低(HoNOS 评分较低)和有工作的患者更有可能成功替代医院护理。研究结果表明,具有一定功能和社会支持的急性精神障碍患者可能最受益于 HT,从而成功替代医院护理。

相似文献

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引用本文的文献

[1]
Cost-Effectiveness of Crisis Resolution Home Treatment for Managing Acute Psychiatric Crises in Southern Switzerland.

Int J Public Health. 2025-7-14

[2]
Crisis versus extended care: bimodal distribution of length of stay in psychiatric inpatients.

BMC Psychiatry. 2025-7-17

[3]
Cost Utility of Intensive Home Treatment Compared With Acute Psychiatric Inpatient Admission.

JAMA Netw Open. 2025-5-1

[4]
Can a crisis resolution team replace an inpatient ward? Results from a French quasi-experimental study.

BMC Health Serv Res. 2025-3-18

[5]
Who Benefits from Acute Psychiatric Home Treatment? A Systematic Review.

Community Ment Health J. 2024-10

[6]
Prescriptive factors for intensive home treatment in acute psychiatry: a secondary analysis of a randomised controlled trial.

Int J Ment Health Syst. 2024-1-3

[7]
Feeling coerced during voluntary and involuntary psychiatric hospitalisation: A review and meta-aggregation of qualitative studies.

Heliyon. 2023-2-2

[8]
Study protocol of a randomized controlled trial evaluating home treatment with peer support for acute mental health crises (HoPe).

BMC Psychiatry. 2022-9-19

[9]
Effectiveness of crisis resolution home treatment for the management of acute psychiatric crises in Southern Switzerland: a natural experiment based on geography.

BMC Psychiatry. 2022-6-17

[10]
Referral for Intensive Home Treatment or Psychiatric Inpatient Care? A Retrospective, Observational Comparison of Patient and Process Characteristics.

Front Psychiatry. 2022-5-25

本文引用的文献

[1]
Health of the Nation Outcome Scales (HoNOS). Research and development.

Br J Psychiatry. 1998-1

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