Martinelli Alessandra, Dal Corso Elisa, Pozzan Tecla, Cristofalo Doriana, Bonetto Chiara, Ruggeri Mirella
IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli Brescia Italy.
ICISS - Istituti Civici di Servizio Sociale Verona Italy.
Psychiatr Res Clin Pract. 2023 Nov 8;6(1):12-22. doi: 10.1176/appi.prcp.20230034. eCollection 2024 Spring.
Italian residential facilities (RFs) aim to promote human rights and recovery for individuals with severe mental disorders. Italian RFs can be distinguished into five main types: high-intensity rehabilitation (RF1), medium-intensity rehabilitation (RF2), medium-level support (RF3.1), high-level support (RF3.2), low-level support (RF3.3). This study aimed to assess the effectiveness of Italian RFs in achieving functional autonomy while upholding human rights and recovery.
Data on socio-demographics, clinical information, patient and staff assessments of functional autonomy, types of interventions, and RF performance in various domains were collected in a pilot study with a cross-sectional design. Descriptive and inferential analyses were conducted.
Twelve RFs and 113 patients participated, with varying proportions in each RF type. RF1 patients were the oldest ( < 0.001) with the lowest functional autonomy ( < 0.001), while RF2 patients were the youngest ( < 0.001) with the lowest hospitalization rate ( < 0.001). RF3.1 patients had the highest employment rate ( = 0.024), while RF3.2 had the lowest employment rate ( = 0.024) and the longest service contact ( < 0.001). RF3.3 users had the highest functional autonomy ( < 0.001). The highest functional autonomy was in self-care which received the highest focus in objectives and interventions. Patients rated their functional autonomy higher than professionals ( < 0.001). RFs excelled in the "human rights" and "social interface" domains but performed poorly in "recovery-based practice," with RF1 having the lowest performance and RF3.3 the highest.
This pilot study suggests that Italian RFs generally aligne with their mission and human rights principles, but personalizing interventions and implementing recovery-oriented practices face challenges.
意大利的居住设施（RFs）旨在促进严重精神障碍患者的人权和康复。意大利的居住设施可分为五种主要类型：高强度康复（RF1）、中等强度康复（RF2）、中等水平支持（RF3.1）、高水平支持（RF3.2）、低水平支持（RF3.3）。本研究旨在评估意大利居住设施在维护人权和促进康复的同时实现功能自主的有效性。
在一项采用横断面设计的试点研究中，收集了社会人口统计学数据、临床信息、患者和工作人员对功能自主的评估、干预类型以及居住设施在各个领域的表现。进行了描述性和推断性分析。
12个居住设施和113名患者参与了研究，每种居住设施类型的比例各不相同。RF1患者年龄最大（<0.001），功能自主程度最低（<0.001），而RF2患者最年轻（<0.001），住院率最低（<0.001）。RF3.1患者就业率最高（=0.024），而RF3.2患者就业率最低（=0.024），服务接触时间最长（<0.001）。RF3.3的使用者功能自主程度最高（<0.001）。功能自主程度最高的是自我护理，这在目标和干预中得到了最高关注。患者对其功能自主的评价高于专业人员（<0.001）。居住设施在“人权”和“社会互动”领域表现出色，但在“基于康复的实践”方面表现不佳，RF1表现最差，RF3.3表现最好。
这项试点研究表明，意大利的居住设施总体上符合其使命和人权原则，但在干预措施个性化和实施以康复为导向的实践方面面临挑战。
