Owusu Ernest, Shalaby Reham, Elgendy Hossam, Mao Wanying, Shalaby Nermin, Agyapong Belinda, Nichols Angel, Eboreime Ejemai, Nkire Nnamdi, Lawal Mobolaji A, Agyapong Vincent I O
Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada.
Queen Elizabeth II Hospital, Alberta Health Services, Grande Prairie, AB T5J 3E4, Canada.
Healthcare (Basel). 2023 Nov 14;11(22):2958. doi: 10.3390/healthcare11222958.
The transition from hospital to community settings for most mental health service users is often hindered by challenges that affect community adjustment and continuity of care. The first few weeks and days after discharge from mental health inpatient units represent a critical phase for many service users. This paper aims to evaluate the changes in the resilience, personal recovery, and quality of life status of individuals with mental health challenges recently discharged from acute mental health care into the community. Data for this study were collected as part of a pragmatic stepped-wedge cluster-randomized, longitudinal approach in Alberta. A paired sample -test and Chi-squared/Fisher test were deployed to assess changes from baseline to six weeks in the recovery assessment scale (RAS), brief resilience scale (BRS), and EuroQol-5d (EQ-5D), using an online questionnaire. A total of 306 service users were recruited and 88 completed both baseline and six weeks, giving a response rate of 28.8%. There was no statistically significant change in the level of resilience, recovery and quality of life as measured with the brief resilience scale, recovery assessment scale and EQ-5D from baseline to six weeks ( > 0.05). The study showed that there was neither an improvement nor deterioration in resilience, recovery, or quality of life status of service users six weeks post-discharge from inpatient mental health care. The lack of further progress calls into question whether the support available in the community when patient's leave inpatient care is adequate to promote full recovery. The results justify investigations into the effectiveness of innovative and cost-effective programs such as peer and text-based supportive interventions for service users discharged from inpatient psychiatric care.
对于大多数精神卫生服务使用者而言，从医院过渡到社区环境往往会受到影响社区适应和护理连续性的挑战的阻碍。从精神卫生住院单元出院后的最初几周和几天，对许多服务使用者来说是一个关键阶段。本文旨在评估最近从急性精神卫生护理出院进入社区的有精神卫生问题的个体在恢复力、个人康复及生活质量状况方面的变化。本研究的数据收集是艾伯塔省一项实用的阶梯楔形整群随机纵向研究方法的一部分。使用在线问卷，采用配对样本t检验和卡方/费舍尔检验来评估从基线到六周时在康复评估量表（RAS）、简易恢复力量表（BRS）和欧洲五维健康量表（EQ-5D）方面的变化。总共招募了306名服务使用者，88人完成了基线和六周的调查，回复率为28.8%。从基线到六周，用简易恢复力量表、康复评估量表和EQ-5D衡量的恢复力、康复及生活质量水平没有统计学上的显著变化（P>0.05）。该研究表明，精神卫生住院护理出院六周后服务使用者的恢复力、康复或生活质量状况既没有改善也没有恶化。缺乏进一步进展让人质疑患者离开住院护理后社区提供的支持是否足以促进完全康复。研究结果证明有必要调查创新且具成本效益的项目的有效性，如针对从住院精神科护理出院的服务使用者的同伴支持和基于文本的支持性干预措施。
