Swart Tania T, Davids Eugene L, de Vries Petrus J
Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa.
Child Adolesc Psychiatry Ment Health. 2023 Sep 2;17(1):103. doi: 10.1186/s13034-023-00649-0.
Research regarding the outcomes of child and adolescent psychiatric inpatients appears insufficient and neglected. Where data are available, the majority of studies focus on adolescents. This study aimed (a) to describe child and parental perspectives of short-, medium- and long-term outcomes of children who have had a pre-adolescent inpatient psychiatric admission, and (b) to analyse these dyadic experiential data to identify outcome variables of importance to families and service users that could be used in future outcomes-based research.
The study employed a qualitative methodology, using semi-structured in-depth interviews of ten parent-child dyads to (a) collect the perspectives of children who have had an inpatient psychiatric admission at a pre-adolescent unit and their parents, and (b) to analyse the experiences of inpatient admission and perceived outcomes after discharge using thematic analysis.
Overall, inpatient psychiatric admission was viewed as a positive and empowering experience by parents and children. Clear short-term benefits were reported as a result of new diagnoses, medications and new skills gained through the admission process. More than half of parent-child dyads reported long-term benefits, but many families commented on ongoing challenges. Thematic analysis identified diagnostic certainty, acquisition of cognitive and behavioural skills, appropriate educational environment, peer relationships, sustained follow-up and medication management, and parent-child relationships, as important contributors to outcomes. Importantly, the presence or lack of these elements influenced outcomes.
The study explored parent-child dyadic perspectives about their experiences of inpatient mental health admissions for pre-adolescents and perceived outcomes after admission. The majority of families found inpatient admission positive and helpful, and thematic analysis identified a number of functional variables that may predict outcome. However, positive outcomes were associated with ongoing difficulties over time, as indicated by the theme "a turn in the road, but still a rough journey".
关于儿童和青少年精神科住院患者治疗结果的研究似乎不足且被忽视。在有数据的情况下，大多数研究聚焦于青少年。本研究旨在：（a）描述儿童和家长对于青春期前住院接受精神科治疗的儿童的短期、中期和长期治疗结果的看法；（b）分析这些二元体验数据，以确定对家庭和服务使用者重要的结果变量，这些变量可用于未来基于结果的研究。
本研究采用定性研究方法，对十对亲子进行半结构化深度访谈，以（a）收集在青春期前病房住院接受精神科治疗的儿童及其家长的看法；（b）采用主题分析法分析住院治疗经历及出院后感知到的结果。
总体而言，家长和儿童都认为精神科住院治疗是一次积极且赋予力量的经历。通过新的诊断、药物治疗以及在住院过程中获得的新技能，报告了明显的短期益处。超过半数的亲子报告了长期益处，但许多家庭也提到了持续存在的挑战。主题分析确定了诊断的确定性、认知和行为技能的获得、合适的教育环境、同伴关系、持续的随访和药物管理以及亲子关系，是影响治疗结果的重要因素。重要的是，这些因素的存在或缺失会影响治疗结果。
本研究探讨了亲子对青春期前儿童精神科住院治疗经历及住院后感知结果的看法。大多数家庭认为住院治疗是积极且有帮助的，主题分析确定了一些可能预测治疗结果的功能性变量。然而，正如“道路转折，但旅程仍崎岖”这一主题所示，随着时间推移，积极结果与持续存在的困难相关。
