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[长期住院的精神科患者出院回归社区后生活质量如何变化?]

[How does the quality of life of long-term hospitalized psychiatric patients change after their discharge into the community?].

作者信息

Hoffmann K, Kaiser W, Isermann M, Priebe S

机构信息

Abteilung für Sozialpsychiatrie Freie Universität Berlin.

出版信息

Gesundheitswesen. 1998 Apr;60(4):232-8.

PMID:9617010
Abstract

In the Berlin deinstitutionalisation study, quality of life in 134 long-term hospitalised psychiatric patients was examined twice: Discharged patients were interviewed again one year after their return to the community, whereas patients who continued to be hospitalised were reinterviewed after 1(1/2)-2 years after the first interview. Quality of life was assessed by the Berlin Quality of Life Profile. Four groups were distinguished in the analysis: 1. patients who continued as inpatients in the same hospital, 2. patients who had been referred to other hospitals, 3. patients who had been discharged after less than one year of continuous inpatient care, and 4. patients discharged after more then one year of hospital care. The four groups differed significantly in several sociodemographic and illness-related variables. Regarding the objective quality of life data, the four groups differed significantly in respect of the spheres leisure, social contacts and safety at follow-up. Discharged patients had more leisure activities, more often a "good friend", and more frequent social contacts within the last week. They had been less often victim to a crime. In a cross-sectional analysis, the four groups showed significant differences regarding subjective quality of life in the spheres accommodation and safety. In a longitudinal analysis, no group showed any significant negative changes. Positive changes were found in the group of patients formerly hospitalised for more than a year most often: satisfaction with leisure activities, with the financial situation, and with accommodation improved significantly during the follow-up period. Results show a marked and significant improvement in the objective and subjective quality of life indicators in formerly long-term hospitalised patients after discharge.

摘要

在柏林去机构化研究中,对134名长期住院的精神病患者的生活质量进行了两次检查:出院患者在回到社区一年后再次接受访谈,而继续住院的患者在首次访谈后1.5至2年接受再次访谈。生活质量通过《柏林生活质量概况》进行评估。分析中区分了四组:1. 在同一家医院继续住院的患者;2. 被转诊到其他医院的患者;3. 连续住院不到一年后出院的患者;4. 住院一年以上后出院的患者。这四组在几个社会人口统计学和疾病相关变量上存在显著差异。关于客观生活质量数据,这四组在随访时的休闲、社交和安全领域存在显著差异。出院患者有更多的休闲活动,更常拥有“好朋友”,并且在过去一周内社交接触更频繁。他们更少成为犯罪受害者。在横断面分析中,这四组在居住和安全领域的主观生活质量方面存在显著差异。在纵向分析中,没有一组显示出任何显著的负面变化。在以前住院一年以上的患者组中最常发现积极变化:在随访期间,对休闲活动、财务状况和居住的满意度显著提高。结果显示,以前长期住院的患者出院后,客观和主观生活质量指标有显著且明显的改善。

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