Dilonardo J D, Connelly C E, Gurel L, Seifert R F, Kendrick K, Deutsch S I
Center for Substance Abuse Treatment, Rockville, MD, USA.
Psychiatr Serv. 1998 Apr;49(4):504-9. doi: 10.1176/ps.49.4.504.
The effect of scheduled intermittent hospitalization on the hospital utilization, community adjustment, and self-esteem of persons with serious and persistent mental illness was examined in an experimental study.
Fifty-seven male veterans, aged 65 or younger, with a primary axis I psychiatric diagnosis who were frequent utilizers of inpatient care over the previous two years were randomly assigned to two groups. Patients in the experimental group were prescheduled for four hospital admissions, each lasting nine to 11 days, per year for two years. Patients in the control group had traditional access to hospital care. Psychiatric bed days, community adjustment, and self-esteem were assessed during and after the intervention.
No differences between the groups on demographic or clinical variables were detected at study entry. The experimental group showed improvement in self-esteem, affect, and complaints of physical symptoms at one year. No statistically significant differences between groups were found in hospital utilization, financial management, substance abuse, or psychological well-being at one year.
Scheduled intermittent hospitalization may be an appropriate and promising alternative to traditional care for revolving-door patients. This intervention could maintain patients at a higher level of wellness than traditional care and reduce the recurrence of the crises that precipitate hospitalization.
在一项实验研究中，考察了定期间歇性住院对严重和持续性精神疾病患者的医院利用情况、社区适应能力及自尊的影响。
57名年龄在65岁及以下、患有主要轴I精神疾病诊断且在过去两年中频繁使用住院治疗的男性退伍军人被随机分为两组。实验组患者预先安排每年入院4次，每次持续9至11天，为期两年。对照组患者则按传统方式接受医院治疗。在干预期间及干预后，对精神科住院天数、社区适应能力及自尊进行评估。
研究开始时，两组在人口统计学或临床变量方面未发现差异。实验组在一年时自尊、情感及身体症状主诉方面有所改善。在一年时，两组在医院利用情况、财务管理、药物滥用或心理健康方面未发现统计学上的显著差异。
对于频繁住院的患者，定期间歇性住院可能是传统治疗的一种合适且有前景的替代方案。这种干预措施可比传统治疗使患者维持在更高的健康水平，并减少促使住院的危机的复发。
