Timko C, Moos R H
Center for Health Care Evaluation, Veterans Affairs Health Care System, Palo Alto, California, USA.
J Nerv Ment Dis. 1998 Feb;186(2):96-103. doi: 10.1097/00005053-199802000-00005.
This study examined determinants of the treatment climate in 89 psychiatric and substance abuse programs. Clearer policies giving patients more control, and more health and treatment services, were related to more supportive, autonomous, expressive, and practically oriented milieus. In contrast, more policy choice and daily living assistance were associated with less support, personal expression, and practical orientation. Programs in which staff had more paraprofessionals and better team functioning, and in which patients had more social resources and better mental functioning, tended to be more supportive and to have more emphasis on autonomy, personal expression, and practical orientation. Based on these results, we suggest some guidelines on how to change the treatment milieu to benefit patients' adjustment.
本研究调查了89个精神科和药物滥用治疗项目中治疗环境的决定因素。更明确的政策给予患者更多控制权、更多健康和治疗服务，与更具支持性、自主性、表达性和注重实际的环境相关。相比之下，更多的政策选择和日常生活援助与较少的支持、个人表达和注重实际相关。工作人员中有更多辅助专业人员且团队运作更好，以及患者有更多社会资源且心理功能更好的项目，往往更具支持性，且更强调自主性、个人表达和注重实际。基于这些结果，我们就如何改变治疗环境以促进患者适应提出了一些指导方针。
