Donnelly M, McGilloway S, Mays N, Knapp M, Kavanagh S, Beecham J, Fenyo A
Health and Healthcare Research Unit, Queen's University of Belfast.
Br J Psychiatry. 1996 May;168(5):598-606. doi: 10.1192/bjp.168.5.598.
Long-stay patients with learning disabilities (n = 214) were assessed in hospital and 12 and 24 months after discharge in order to examine the effects of relocation.
Each resident acted as his/her own control in a prospective repeated-measures design. Skills and behavioural problems were assessed by keyworkers. Self-perceived quality of life was obtained during interviews with researchers who also completed an environmental checklist of the residents' accommodation.
There was little or no change in people's low pre-discharge skill levels. Certain aspects of problem behaviour improved after 12 months, although socially unacceptable behaviour increased slightly. People were less depressed (P < or = 0.01) 12 months after discharge (N = 119) and were more satisfied (P < or = 0.05) with their new 'homes' (n = 108). There were few changes in the pattern of activities or the social networks of people 12 months later. Little or no further change in outcomes was reported 24 months after discharge.
The implementation of the deinstitutionalisation policy in Northern Ireland has been limited by the predominance of residential and nursing homes and the lack of 'ordinary' accommodation. There is a need for purchasers and providers to give more attention to ways in which the principles of normalisation could be incorporated in the process of contracting and delivering services.
对214名患有学习障碍的长期住院患者在住院时以及出院后12个月和24个月进行了评估，以研究重新安置的效果。
在一项前瞻性重复测量设计中，每位居民都作为自己的对照。由关键工作人员评估技能和行为问题。在与研究人员的访谈中获取自我感知的生活质量，研究人员还完成了居民住所的环境清单。
出院前技能水平较低的人群几乎没有变化。问题行为的某些方面在12个月后有所改善，尽管社会不可接受行为略有增加。出院12个月后（N = 119）人们的抑郁情绪减轻（P≤0.01），并且对新“家”（n = 108）更满意（P≤0.05）。12个月后人们的活动模式或社交网络几乎没有变化。出院24个月后报告的结果几乎没有进一步变化。
北爱尔兰去机构化政策的实施受到养老院和护理院占主导地位以及缺乏“普通”住所的限制。购买者和提供者需要更加关注将正常化原则纳入签约和提供服务过程的方式。
