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精神科医生对非自愿门诊治疗的看法。

Psychiatrists' opinion about involuntary outpatient reatment.

机构信息

Complejo Hospitalario Universitario de Huelva.

Médico Forense en excedencia.

出版信息

Rev Esp Sanid Penit. 2020 Jan-Apr;22(1):39-45. doi: 10.18176/resp.0006. Epub 2020 Apr 27.

Abstract

INTRODUCTION

Involuntary outpatient treatment (IOT) is a kind of compulsory outpatient treatment, whose aim is to improve the adherence to the treatment in people with severe mental illness and with no awareness of disease. In these cases, therapeutic abandonment involves a high risk of relapse, with appearance of disruptive and/or self-aggressive or hetero-aggressive behavior, repeated hospitalizations and frequent emergencies. The application of IOT is not an issue without contention. Therefore, the need of legislative regulation in Spain has been a controversial subject for several years, and there are both advocates and opponents.

OBJECTIVE

The objective of this study is to bring together the opinion of clinical psychiatrists and resident doctors in psychiatry on the involuntary outpatient treatment and its legislative regulation.

MATERIAL AND METHOD

This study is descriptive in nature. The study population consists of 42 clinical professionals in mental health (32 psychiatrists and 10 resident doctors in psychiatry). At the beginning of this study (March 2018), some of these professionals were working in the Psychiatry Department's facilities of the University Hospital Complex of Huelva. A personal survey in paper form consisting of ten questions about IOT was carried out to each member of this study.

RESULTS

85.7% of clinicians know the current initiative that tries to carry out the legislative regulation of IOT, and 92.8% of them agree to such regulation. In this sense, 83.3% of them are against the fact that more coercive measures for the psychiatric patients such as the involuntary commitment or the civil incapacitation are regulated and IOT is not. On the one hand, 78.6% of the professionals in mental health believe that IOT is beneficial for the patients. Moreover, 95.2% of them think that is beneficial for their relatives, too. On the other hand, 78.6% of clinicians do not consider that the application of IOT to mentallyill patients is stigmatizing.

CONCLUSION

The vast majority of clinicians think that the legislative regulation of involuntary outpatient treatment is necessary in Spain, and they think this treatment is beneficial not only for the patient but also for their family.

摘要

简介

非自愿门诊治疗(IOT)是一种强制性门诊治疗,旨在提高对无病识感的严重精神疾病患者的治疗依从性。在这些情况下,放弃治疗会带来很高的复发风险,出现破坏性行为和/或自我攻击或他攻击行为、反复住院和频繁出现紧急情况。IOT 的应用并非没有争议。因此,西班牙立法监管的必要性多年来一直是一个有争议的话题,既有支持者也有反对者。

目的

本研究旨在汇集临床精神科医生和精神科住院医师对非自愿门诊治疗及其立法监管的意见。

材料和方法

本研究为描述性研究。研究人群由 42 名精神卫生临床专业人员(32 名精神科医生和 10 名精神科住院医师)组成。在这项研究开始时(2018 年 3 月),其中一些专业人员在韦尔瓦大学医院综合大楼的精神科部门工作。对每位研究对象进行了一项关于 IOT 的十项问题的个人问卷调查。

结果

85.7%的临床医生了解当前试图对 IOT 进行立法监管的倡议,92.8%的医生对此表示赞成。在这方面,83.3%的医生反对对精神病患者实施更多的强制性措施,如非自愿住院或民事无能力,而 IOT 则不受此限制。一方面,78.6%的精神卫生专业人员认为 IOT 对患者有益。此外,95.2%的人认为这对他们的亲属也有好处。另一方面,78.6%的临床医生不认为对精神病患者实施 IOT 具有污名化。

结论

绝大多数临床医生认为,西班牙有必要对非自愿门诊治疗进行立法监管,他们认为这种治疗不仅对患者有益,对患者家属也有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52a6/7307653/cf05021f62e0/2013-6463-sanipe-22-01-39-gf1.jpg

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