Värnå Emma, Nederman Jonas, Saliba-Gustafsson Erika A, Eckerström Joachim
Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden.
Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden.
Int J Ment Health Nurs. 2025 Feb;34(1):e13457. doi: 10.1111/inm.13457. Epub 2024 Oct 27.
Patient-initiated brief admission (PIBA) is an innovative psychiatric care intervention that gives patients the autonomy to initiate a short admission (approximately 1-3 days) to psychiatric inpatient care. This intervention is structured around a mutual agreement between the patient and their care provider that outlines the specific structure and content of their care. Unlike regular psychiatric admissions, healthcare professionals do not review the patient's decision for admission during PIBA. Similar interventions have been developed globally to reduce the need for long inpatient admissions and compulsory care by enhancing patient autonomy, promoting active participation in care, and empowering patients to recognise early signs of mental health deterioration. The objective of this systematic review was to explore the experiences of PIBA among individuals with mental health disorders. A systematic review was conducted using qualitative articles sourced from the PubMed, CINAHL, and PsycINFO databases. A total of thirteen original articles were included in the review, encompassing 186 patients. Research demonstrates that PIBA significantly impacts patients' care experiences in various ways. Access to PIBA gives patients the opportunity to take a break from daily stressors, which has proven significant in interrupting the cycle of worsening symptoms and negative thoughts. Furthermore, when the care environment is characterised by trust and respect, patients experience an increased sense of freedom, which contributes to a more effective recovery process. PIBA provides patients with a sense of safety and offers the possibility of a more functional daily life. Healthcare professionals'attitude and care provision also significantly influences patients' experiences. Central to a positive patient experience are a warm reception, attentiveness, and active listening. PIBA can not only change patients' perceptions of healthcare but, more importantly, fosters a transformative view of themselves as active participants in their own well-being. Knowledgeable healthcare professionals are crucial for the successful implementation of this intervention. By offering dignity and warmth alongside safety, PIBA addresses a critical gap in patient mental health care.
患者自主发起的短期住院（PIBA）是一种创新的精神科护理干预措施，它赋予患者自主发起短期住院（约1 - 3天）接受精神科住院护理的权利。这种干预措施围绕患者与其护理提供者之间的共同协议构建，该协议概述了护理的具体结构和内容。与常规精神科住院不同，在PIBA期间医疗保健专业人员不会审查患者的住院决定。全球已开发出类似的干预措施，以通过增强患者自主权、促进积极参与护理以及使患者能够识别心理健康恶化的早期迹象来减少长期住院和强制护理的需求。本系统评价的目的是探索精神健康障碍患者对PIBA的体验。使用从PubMed、CINAHL和PsycINFO数据库中获取的定性文章进行了系统评价。该评价共纳入13篇原创文章，涵盖186名患者。研究表明，PIBA在多个方面对患者的护理体验产生显著影响。获得PIBA使患者有机会从日常压力源中解脱出来，这已被证明在中断症状恶化和消极思维的循环方面具有重要意义。此外，当护理环境以信任和尊重为特征时，患者会体验到更强的自由感，这有助于更有效的康复过程。PIBA为患者提供了安全感，并提供了更具功能性的日常生活的可能性。医疗保健专业人员的态度和护理提供也显著影响患者的体验。积极的患者体验的核心是热情接待、专注和积极倾听。PIBA不仅可以改变患者对医疗保健的看法，更重要的是，能培养他们将自己视为自身健康积极参与者的转变性观念。知识渊博的医疗保健专业人员对于成功实施这种干预措施至关重要。通过在提供安全的同时给予尊严和温暖，PIBA填补了患者心理健康护理中的一个关键空白。
