Mao Wanying, Shalaby Reham, Owusu Ernest, Elgendy Hossam, Shalaby Nermin, Agyapong Belinda, Nichols Angel, Eboreime Ejemai, Nkire Nnamdi, 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.
J Clin Med. 2023 Dec 7;12(24):7559. doi: 10.3390/jcm12247559.
(1) Background: Transitioning from mental health inpatient care to community care is often a vulnerable time in the treatment process where additional risks and anxiety may arise. We collected data for this study as part of a pragmatic cluster-randomized, longitudinal approach in Alberta. As the first phase of the ongoing innovative supportive program, this paper assessed the progression of mental health symptoms in patients six weeks after hospital discharge. Factors that may contribute to the presence or absence of anxiety and depression symptoms, as well as well-being, following return to the community were investigated. This provides evidence and baseline data for future phases of the project. (2) Methods: An observational study design was adopted for this study. Data on a variety of sociodemographic and clinical factors were collected at discharge and six weeks after via REDCap. Anxiety, depression, and well-being symptoms were assessed using the Generalized Anxiety Disorder (GAD-7) questionnaire, the Patient Health Questionnaire-9 (PHQ-9), and the World Health Organization-Five Well-Being Index (WHO-5), respectively. Descriptive, chi-square, independent -tests, and multivariate regression analyses were conducted. (3) Result: The survey was completed by 88 out of 306 participants (28.8% response rate). The chi-square/Fisher exact test and independent -test revealed no significant change in the mental health conditions from baseline to six weeks after discharge. It was found that the only significant factor predicting symptoms six weeks after discharge from inpatient treatment was the baseline symptoms in all three logistic regression models. It was four times more likely for those who experienced anxiety and depression at baseline to experience anxiety and depression symptoms six weeks after discharge (OR = 4.27; 95% CI: 1.38-13.20) (OR = 4.04; 95% CI: 1.25-13.05). Those with poor baseline well-being were almost 12 times more likely to experience poor well-being six weeks after discharge (OR = 11.75; 95% CI: 3.21-42.99). (4) Conclusions: Study results found no significant change in mental health conditions in the short term following hospital discharge. It is essential that researchers and policymakers collaborate in order to implement effective interventions to support and maintain the mental health conditions of patients following discharge.
（1）背景：从心理健康住院治疗过渡到社区护理在治疗过程中往往是一个脆弱时期，可能会出现额外风险和焦虑。作为艾伯塔省一项务实的整群随机纵向研究方法的一部分，我们收集了本研究的数据。作为正在进行的创新支持项目的第一阶段，本文评估了患者出院六周后心理健康症状的进展情况。研究了回归社区后可能导致焦虑和抑郁症状出现与否以及幸福感的因素。这为该项目的后续阶段提供了证据和基线数据。（2）方法：本研究采用观察性研究设计。通过REDCap在出院时和六周后收集了各种社会人口统计学和临床因素的数据。分别使用广泛性焦虑障碍问卷（GAD - 7）、患者健康问卷 - 9（PHQ - 9）和世界卫生组织五福安康指数（WHO - 5）评估焦虑、抑郁和幸福感症状。进行了描述性分析、卡方检验、独立样本t检验和多元回归分析。（3）结果：306名参与者中有88名完成了调查（应答率为28.8%）。卡方检验/费舍尔精确检验和独立样本t检验显示，出院后六周心理健康状况与基线相比无显著变化。在所有三个逻辑回归模型中发现，预测住院治疗出院六周后症状的唯一显著因素是基线症状。基线时经历焦虑和抑郁的人在出院六周后出现焦虑和抑郁症状的可能性高出四倍（OR = 4.27；95%置信区间：1.38 - 13.20）（OR = 4.04；95%置信区间：1.25 - 13.05）。基线幸福感较差的人在出院六周后幸福感较差的可能性几乎高出12倍（OR = 11.75；95%置信区间：3.21 - 42.99）。（4）结论：研究结果发现出院后短期内心理健康状况无显著变化。研究人员和政策制定者必须合作，以便实施有效的干预措施，以支持和维持患者出院后的心理健康状况。
