Kota Munetsugu, Uezono Sae, Ishibashi Yusuke, Kitakaze Sousuke, Arakawa Hideki
Hiroshima Cosmopolitan University.
Hirakawa Hospital.
Phys Ther Res. 2020 Aug 20;23(2):180-187. doi: 10.1298/ptr.E10016. eCollection 2020.
We focused on locomotive syndrome as a low physical function factor that may prevent patients with psychiatric disease from being discharged. The purpose of this study is to clarify the factors, including locomotive syndrome, that prevent discharge from psychiatric long-term care wards.
We enrolled 74 patients who were admitted to psychiatric long-term care wards at three different hospitals in Japan. Nurses or medical social workers in the ward were asked whether the planned discharge destination had been decided, and patients were categorized into a decided group and an undecided group. Outcome measures were age, sex, F code in the ICD-10 Classification of Mental and Behavioral Disorders, length of stay, chlorpromazine equivalent dose of antipsychotics, locomotive syndrome test scores (25-question GLFS, two-step test, stand-up test), and Barthel Index.
Based on the multivariate logistic regression analysis results, the length of stay and the two-step test score significantly explained the difference between the two groups. The odds ratio of a length of stay greater than 10 years was 8.42 times that of a length of stay less than 2 years (P=0.012, 95% CI=1.59, 44.53). Regarding the twostep test, the odds ratio for obtaining stage 2 was 10.62 times that for obtaining stage 0 (P=0.013, 95% CI=1.65, 68.23).
Those who with longer length of stays and lower two-step test scores tended not to be decided the planned discharge destination.
我们关注运动机能综合征这一可能阻碍精神疾病患者出院的低身体功能因素。本研究的目的是阐明包括运动机能综合征在内的阻碍从精神科长期护理病房出院的因素。
我们纳入了日本三家不同医院精神科长期护理病房收治的74例患者。询问病房的护士或医务社会工作者是否已确定计划出院目的地,并将患者分为已确定组和未确定组。观察指标包括年龄、性别、国际疾病分类第10版精神与行为障碍分类中的F编码、住院时间、抗精神病药物氯丙嗪等效剂量、运动机能综合征测试评分(25题简短体能状况量表、两步试验、起立试验)以及巴氏指数。
基于多因素逻辑回归分析结果,住院时间和两步试验评分显著解释了两组之间的差异。住院时间超过10年的比值比是住院时间少于2年的8.42倍(P = 0.012,95%置信区间 = 1.59,44.53)。关于两步试验,达到2期的比值比是达到0期的10.62倍(P = 0.013,95%置信区间 = 1.65,68.23)。
住院时间较长且两步试验评分较低的患者往往未确定计划出院目的地。