Medical inpatients' adherence to outpatient psychiatric aftercare: a prospective study of patients evaluated by an inpatient consultation liaison psychiatry service.
Medical inpatients' adherence to outpatient psychiatric aftercare: a prospective study of patients evaluated by an inpatient consultation liaison psychiatry service.
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DOI：
10.2190/pm.44.1.a
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发表时间：
2012
影响因子：
2
通讯作者：
Himelhoch SS
中科院分区：
文献类型：
--
作者：
Ehrenreich MJ;Robinson CT;Glovinsky DB;Dixon LB;Medoff DR;Himelhoch SS
本研究旨在确定住院咨询精神科医生评估的接受精神科药物治疗的患者是否在出院后8周进行了精神科善后护理和继续精神科药物治疗。评估护理障碍及其对术后随访的影响。这是一项前瞻性研究，研究对象为在马里兰州大学医学中心普通内科或外科住院部接受精神科咨询并在住院期间接受精神科药物处方的成人连续样本。基线信息收集自36例接受住院精神科咨询的患者，这些患者：（1）处方精神科药物;（2）出院回家。在出院后8周收集了其中21例（58.3%）患者的随访数据。在36名提供基线数据的患者中，93%的人认识到他们患有精神疾病，90%的人认识到服用精神药物的重要性，80%的人认识到精神病善后的重要性。只有33%的患者出院说明中包含了术后护理建议。在提供随访数据的21名患者中，57%报告接受精神病善后护理。没有接受精神病善后护理的患者更有可能出现识字率低的风险（88.9% vs. 33.3% Fisher精确检验= 0.024），并且在出院时较少接受精神病善后护理指导（22% vs. 42%）。不良沟通的善后指示，以及穷人的识字可能与缺乏精神病善后。咨询精神科医生应该评估识字率，并确保为患者提供善后信息。
This study sought to determine whether patients on psychiatric medication evaluated by inpatient consultation psychiatrists followed up with psychiatric aftercare and continued psychiatric medication 8 weeks post-discharge. Barriers to care and their effect on aftercare follow-up were assessed. This was a prospective study of a consecutive sample of adults who received a psychiatric consultation and were prescribed psychotropic medication during hospitalization on the general medical or surgical inpatient units at the University of Maryland Medical Center. Baseline information was collected from 36 patients who received an inpatient psychiatric consultation and were: (1) prescribed psychiatric medications; and (2) discharged to home. Follow-up data was collected from 21 (58.3%) of these patients 8 weeks post-discharge. Of 36 patients who provided baseline data, 93% recognized they had a psychiatric disorder, 90% recognized the importance of taking psychiatric medication, and 80% recognized the importance of psychiatric aftercare. Aftercare recommendations were included in only 33% of patient discharge instructions. Of 21 patients providing follow-up data, 57% reported receiving psychiatric aftercare. Patients who did not receive psychiatric aftercare were significantly more likely to be at risk for poor literacy (88.9% vs. 33.3% Fisher's exact test = 0.024) and were less often given psychiatric aftercare instructions at discharge (22% vs. 42%). Poor communication of aftercare instructions as well as poor literacy may be associated with lack of psychiatric aftercare. Consultation psychiatrists should assess literacy and insure aftercare information is provided to patients.