Richardson M E
Manning Base Hospital, Taree, New South Wales, Australia.
Aust N Z J Psychiatry. 1996 Apr;30(2):263-9. doi: 10.3109/00048679609076104.
To provide, via 'rooming-in', a local, less coercive and less frightening alternative to involuntary detention. Rooming in is the voluntary participation of so-called 'confidants', who may be chosen family members or trusted friends, in the management of acute, severe psychiatric disturbance by their providing a 24 hour vigil with the patient in a single, safe hospital room.
There were 73 admissions to the rooming-in program at the Manning Base Hospital, Taree, New South Wales (NSW), Australia between 5 August 1986 and 21 September 1992. During the same period 78 patients were remitted from the hospital on an involuntary basis to urban detention centres: 'scheduled' under the NSW Mental Health Act. Demographic and diagnostic characteristics of the two populations, both of whom met identical criteria for involuntary detention, are compared in this retrospective, case report study. These two groups constituted only 6% of total psychiatric consults carried out at the hospital over the same 6 year period and those roomed-in represented only 12% of the psychiatric admissions. A quality assurance study evaluated the acceptability of the program.
The scheduled patients were more likely to be single, of no fixed abode and without a local family. They were more likely to have a schizophrenic disorder, compounded by polysubstance abuse, than a mood disorder. The average inpatient stay for those roomed-in was 10 days. Seventy per cent of confidants were required for 4 days or less. The rooming-in program was valued highly by nursing staff, patients and their families.
A search of the world literature would suggest that rooming-in, as a model of care, is unique, at least in the developed world. It allows some seriously disturbed patients to be provided with a local and less restrictive general hospital alternative.
通过“陪伴住院”提供一种比非自愿拘留更本地化、强制性更低且更不令人恐惧的替代方式。陪伴住院是指所谓的“密友”（可以是选定的家庭成员或可信赖的朋友）自愿参与对急性、严重精神障碍的管理，他们在一间安全的单人病房内与患者一起进行24小时监护。
1986年8月5日至1992年9月21日期间，澳大利亚新南威尔士州塔里市曼宁基地医院有73名患者进入陪伴住院项目。同期，有78名患者根据新南威尔士州《精神健康法》被非自愿地转送至城市拘留中心。在这项回顾性病例报告研究中，对这两组均符合非自愿拘留相同标准的人群的人口统计学和诊断特征进行了比较。这两组患者仅占同一6年期间该医院进行的全部精神科会诊的6%，而陪伴住院的患者仅占精神科住院患者的12%。一项质量保证研究评估了该项目的可接受性。
被转送至拘留中心的患者更可能是单身、无固定住所且在当地没有家人。与心境障碍患者相比，他们更可能患有精神分裂症且伴有多种物质滥用。陪伴住院患者的平均住院天数为10天。70%的密友陪伴时间为4天或更短。护理人员、患者及其家属对陪伴住院项目评价很高。
对世界文献的检索表明，陪伴住院作为一种护理模式至少在发达国家是独一无二的。它使一些严重精神障碍患者能够在当地综合医院获得限制更少的护理。
