Leff J, Dayson D, Gooch C, Thornicroft G, Wills W
Institute of Psychiatry, London, England.
Psychiatr Serv. 1996 Jan;47(1):62-7. doi: 10.1176/ps.47.1.62.
The study compared the quality of life of long-stay psychiatric patients after they had been discharged to community residences for one year with that of long-stay patients who remained hospitalized.
Long-stay patients (that is, those with stays of at least one year) who were discharged from two psychiatric hospitals in London were closely matched with patients likely to stay in the hospital for another year. Baseline (in-hospital) and one-year follow-up assessments were conducted using six instruments to measure factors related to quality of life such as problems in social functioning and size of the social network.
A total of 494 discharged patients were compared with 279 patients who remained in the hospital. The death rate did not differ between the two groups. Only six discharged patients became vagrants, and only two were imprisoned, one briefly. Discharged patients were living under much less restrictive conditions, they preferred their life in the community, and the number of their friends increased, as did the number of acquaintances in the community such as neighbors. No adverse effects of discharge on mental state or social behavior were noted.
The results indicate that community care is a beneficial alternative to long-term care in psychiatric hospitals for the majority of patients, provided it is well planned and adequate resources are available.
本研究比较了长期住院的精神科患者出院后在社区住所生活一年后的生活质量与仍住院的长期住院患者的生活质量。
从伦敦两家精神病医院出院的长期住院患者(即住院至少一年的患者)与可能再住院一年的患者进行了密切匹配。使用六种工具进行基线(住院期间)和一年随访评估,以测量与生活质量相关的因素,如社会功能问题和社交网络规模。
共对494名出院患者和279名住院患者进行了比较。两组的死亡率没有差异。只有6名出院患者成为流浪汉,只有2人被监禁,其中1人是短期监禁。出院患者的生活条件限制少得多,他们更喜欢社区生活,朋友数量增加,社区中的熟人如邻居的数量也增加了。未发现出院对精神状态或社会行为有不良影响。
结果表明,对于大多数患者而言,只要规划良好且有足够的资源,社区护理是精神病医院长期护理的有益替代方案。