A descriptive study of pathways to care among hospitalized urban African American first-episode schizophrenia-spectrum patients
A descriptive study of pathways to care among hospitalized urban African American first-episode schizophrenia-spectrum patients
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DOI：
10.1007/s00127-006-0065-z
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发表时间：
2006-07-01
影响因子：
4.4
通讯作者：
Kaslow, Nadine J.
中科院分区：
文献类型：
--
作者：
Compton, Michael T.;Esterberg, Michelle L.;Kaslow, Nadine J.
背景 研究护理途径或从疾病发作到首次开始治疗期间的接触对于了解如何改进精神障碍的早期识别和治疗至关重要。然而，人们对美国首发精神病患者的治疗途径知之甚少。本研究的目的是检查首发患者住院前的护理途径和帮助联系人数量，并确定与初级保健提供者和警察联系的频率。 方法 对 25 名城市非裔美国患者的护理途径（包括从前驱症状出现到首次入院期间的所有求助接触者）进行了评估。作为一项正在进行的未治疗精神病持续时间预测因素研究的一部分，获得了其他测量值。 结果 从发病到入院以及从出现阳性精神病症状到入院的中位持续时间分别为 128.0 周（范围 0.6-476.9）和 32.9 周（范围 0.4-337.7）。在 83 名接触者中，有 17 名与警方接触，而只有 4 名与初级保健提供者接触。虽然每位患者的接触次数从 1 到 8 人不等，但 25 名患者中有 16 人在首次接触寻求帮助后 1 周内入院。 结论 研究结果表明，该人群的护理途径差异很大，需要进行额外的研究，以更好地了解这些途径的性质和决定因素。此类调查可以提供有关增强服务的见解，从而促进早期发现和干预，从而改善疾病结果。
Background Studying pathways to care, or contacts made during the period of time from the onset of illness until the first initiation of treatment, is critical for understanding how to improve the early recognition and treatment of mental disorders. However, little is known about pathways to care among patients with first-episode psychosis in the United States. The objectives of this study were to examine the pathways to care and number of help contacts prior to hospitalization in first-episode patients, and to ascertain the frequency of contact with primary care providers and police.Method Pathways to care, including all contacts for help from the onset of prodromal symptoms until first hospital admission, were assessed in 25 urban African American patients. Other measures were obtained as part of an ongoing study of predictors of the duration of untreated psychosis.Results The median durations from the onset of illness to hospital admission and from the emergence of positive psychotic symptoms to hospital admission were 128.0 weeks (range 0.6-476.9) and 32.9 weeks (range 0.4-337.7), respectively. Of the 83 total contacts, 17 were with police, whereas only four were with primary care providers. While the number of contacts per patient ranged from one to eight, 16 of the 25 patients were admitted within 1 week of their first contact for help.Conclusions The findings indicate that pathways to care in this population are highly variable, and there is a need for additional research to better understand the nature and determinants of these pathways. Such investigations may provide insights into service enhancements that can promote early detection and intervention, thus improving illness outcomes.