Smith H H
J Clin Psychol. 1982 Jul;38(3):550-4. doi: 10.1002/1097-4679(198207)38:3<550::aid-jclp2270380313>3.0.co;2-q.
Discharge from psychiatric hospitals against medical advice (AMA) is noncompliance with a physician's treatment regimen. Forty-one patients (26 male, 15 female) discharged AMA from a 32-bed proprietary acute care psychiatric hospital were matched by sex to 41 regularly discharged patients. Data that pertained to account status, marital status, race, month of admission, day of week of admission, time of admission, day of week of discharge, time of discharge, length of stay, religion, diagnosis, employment status, presence of prior psychiatric treatment, attending physician, hospital census, and adolescent census at time of admission were analyzed by Student's t-test, Chi-square, and Pearson correlation coefficients. Significant differences were found for length of stay (p less than .01), time of discharge (p less than .002), presence of prior psychiatric treatment (p less than .0005), and attending physician (p less than .02). Age and length of stay for the regularly discharged group were correlated (r = .47; p less than .001). The failure of this study to support much prior research may be related to differences in hospital setting, client population, and therapist variables.
违反医嘱(AMA)从精神病院出院属于不遵守医生的治疗方案。一家拥有32张床位的私立急性护理精神病院中有41名违反医嘱出院的患者(26名男性,15名女性),按性别与41名正常出院的患者进行匹配。通过学生t检验、卡方检验和皮尔逊相关系数对与账户状态、婚姻状况、种族、入院月份、入院星期几、入院时间、出院星期几、出院时间、住院时间、宗教信仰、诊断、就业状况、既往精神科治疗史、主治医生、入院时医院普查人数和青少年普查人数等相关的数据进行了分析。结果发现,住院时间(p <.01)、出院时间(p <.002)、既往精神科治疗史(p <.0005)和主治医生(p <.02)存在显著差异。正常出院组的年龄与住院时间相关(r =.47;p <.001)。本研究未能支持许多先前的研究,这可能与医院环境、患者群体和治疗师变量的差异有关。