Linking inpatients with schizophrenia to outpatient care
Linking inpatients with schizophrenia to outpatient care
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DOI：
10.1176/ps.49.7.911
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发表时间：
1998-07-01
影响因子：
3.8
通讯作者：
Hansell, S
中科院分区：
文献类型：
--
作者：
Olfson, M;Mechanic, D;Hansell, S
目的：本研究的重点是精神分裂症或情感性精神障碍住院患者，这些患者计划开始门诊治疗，而临床医生以前没有治疗过他们。作者评估了出院前患者与门诊医生之间的沟通对患者转诊依从性、精神症状和出院后3个月随访时社区功能的影响。研究方法：共有104名患有精神分裂症或分裂情感性障碍的成年住院患者计划接受之前从未治疗过他们的临床医生的门诊治疗，他们在出院时接受了评估，并在三个月后再次接受评估。比较出院前与门诊医生有电话或面对面接触的患者和没有这种接触的患者。结果：大约一半（51%）的住院病人在离开医院前与门诊医生进行了沟通。与没有沟通的患者相比，那些与门诊医生交谈的患者更有可能完成门诊转诊。在控制基线评分和其他协变量后，出院前与门诊医生联系与随访时简明精神病评定量表总评分显著降低和自我评估控制症状困难减少相关。两组患者在随访期间再次入院或精神科急诊室就诊的比例没有显著差异。结论：住院患者和新的门诊医生之间的直接沟通可能有助于顺利过渡到门诊治疗，从而有助于改善临床症状的控制。
Objective: This study focused on inpatients with schizophrenia or schizoaffective disorder who were scheduled to begin outpatient care with clinicians who had not previously treated them. The authors evaluated the effects of communication between the patients and their outpatient clinicians before discharge on patients' referral compliance, psychiatric symptoms, and community function at follow-up three months after discharge. Methods: In total of 104 adult inpatients with schizophrenia or schizoaffective disorder who were scheduled to receive outpatient care from clinicians who had not previously treated them were evaluated at hospital discharge and again three months later. Comparisons were made between patients who had telephone or face-to-face contact with an outpatient clinician before hospital discharge and patients who did not have such contact. Results: About half (51 percent) of the inpatient sample communicated with an outpatient clinician before leaving the hospital. Compared with patients who had no communication, those who spoke with an outpatient clinician were significantly more likely to complete the outpatient referral. After baseline scores and other covariates were controlled for, predischarge contact with an outpatient clinician was associated with a significantly lower total Brief Psychiatric Rating Scale score at follow-up and less self-assessed difficulty controlling symptoms. Nonsignificant trends toward improved medication compliance and a lower rate of homelessness were also found. The two patient groups did not significantly differ in the proportion who were readmitted to the hospital or who made a psychiatric emergency room visit during the follow-up period. Conclusions: Direct communication between inpatients and new outpatient clinicians may help smooth the transition to outpatient care and thereby contribute to improved control of clinical symptoms.