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[意大利和英国基于社区的精神科护理模式]

[Models of community-based psychiatric care in Italy and England].

作者信息

Ter-Israelyan A Yu, Evdokimova T E, Kardashian R A, Grishina N K, Solovyova N B

机构信息

State Medical Institution «Psychiatric Clinical Hospital No. 13 of the Moscow City Health Department», Moscow, Russia.

Peoples Friendship University of Russia, Moscow, Russia.

出版信息

Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(2):56-60. doi: 10.17116/jnevro202212202156.

Abstract

THE AIM OF THE STUDY

Is to study and compare models of out-of-hospital psychiatric care in different countries-Italy and England.

UNLABELLED

In the Italian model of community-based psychiatric care, institutions have been created - homes for permanent residence with a security regime (REMS), the most common of which are intensive (or assertive) treatment in the community and mandatory outpatient treatment. The form of intensive treatment is an active and long-term maintenance and treatment of patients. The essence of the methodology is to provide assistance at home, which is carried out by specially trained multidisciplinary teams, including psychiatrists, nurses, psychologists, social workers. However, in the long term, there is a tendency to increase relapses and acute conditions. The English model of community psychiatric care is based on the practice of the method of «individual case management». After the acute attack is stopped, the main work program includes work with a psychologist and/or a psychotherapist in the form of a number of multidimensional group and family therapy activities, training of social skills and ways of independent living, development of communication, self-esteem and confident behavior, which is achieved through psychocorrective work, as well as drug therapy and didactic training on appropriate simulators.

UNLABELLED

Special attention is paid to social recovery, work with the family, social and labor recovery and instrumental support.

摘要

研究目的

是研究并比较不同国家(意大利和英国)的院外精神科护理模式。

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在意大利基于社区的精神科护理模式中,已经建立了一些机构——设有安全管理制度的永久居住之家(REMS),其中最常见的是社区强化(或积极)治疗和强制门诊治疗。强化治疗形式是对患者进行积极且长期的维持和治疗。该方法的本质是由经过专门培训的多学科团队(包括精神科医生、护士、心理学家、社会工作者)在家中提供援助。然而,从长远来看,复发和急性病发作有增加的趋势。英国社区精神科护理模式基于“个案管理”方法的实践。急性发作停止后,主要工作计划包括与心理学家和/或心理治疗师合作,形式为一系列多维度的团体和家庭治疗活动、社交技能和独立生活方式培训、沟通、自尊和自信行为培养,这通过心理矫正工作以及药物治疗和在适当模拟器上的教学培训来实现。

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特别关注社会康复、家庭工作、社会和劳动康复以及工具性支持。

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