Development of acute care protocol to promote community living among psychiatric patients in Japan

本文的目的是描述在私人精神病院的急症护理治疗单位的精神疾病患者的护理。本文比较出院后3个月内再入院患者的护理情况（A组）与出院后3个月以上仍留在社区的患者的护理情况（B组）。对某急症护理单位的14名初级护士进行了关于故意护理的访谈。讨论了47例患者的护理。这47名患者也接受了出院后在家自理的采访。护士和病人都同意这项研究，并充分配合。数据收集于2000年8月1日至10月31日。急症护理治疗单元的护理工作是(1)监测症状和自我护理，(2)监测药物的效果和副作用，(3)创造一个合理的环境，(4)了解患者如何控制自己的症状，(5)认识症状和自我护理之间的关系，(6)支持在家与患者互动的其他人，(7)寻找经济支持，(8)扩大自我护理，以满足每个患者的个性化需求。(9)帮助建立家庭病人支持系统。在B组中，护士能够影响护理的各个类别，而在A组中，护士无法影响(5)至(9)的护理类别。此外，在A组，护士无法获得重要的信息，使他们能够影响家庭支持系统的质量。在前人研究的基础上，制定了护理方案，并于2002年10月至2002年1月进行了研究，该护理方案使护士更容易与多学科团队和社区护士合作。此外，护士很容易照顾病人的家人。从本研究的局限性出发，对这些结果进行了讨论。

The purpose of this paper is to describe the nursing care for patients with mental illness at an acute care treatment unit in a praivate psychiatric hospital. This paper compares the nursing care for patients readmitted within 3 month after discharge (Group A) with nursing care for patients remain in the community more than 3 month after their initial discharge(Group B). Fourteen primary nurses were interviewed about intentional nursing care at an acute care treatment unit. They discussed the nursing care given to 47 patients. Those same 47 patients were also interviewed about self-care at home after discharge. The nurses and patients agreed to this study and they cooperated fully. Data were collected between Aug.1 and Oct.31 in 2000.The nursing care at the acute care treatment unit were (1)to monitor symptoms and serf care, (2)to monitor effects and side effects of medication, (3)to create a sage environment, (4)to understand how patients control their own symptoms, (5)to recognize the relationship between symptoms and self-care, (6)to support other people who interact with patients at home, (7)to find financial support, (8)to expand serf-care to meet each patient's individual needs, (9)to help create a patient support-system at home. In group B, nurses were able to influence every category of nursing care, but in group A, nurses were unable to influence nursing category of (5)to(9). Furthermore,in group A, nurse were unable to obtain important information which allow them to influence the quality of the family support system. Based on the previous research nursing care ptorocal had been developed and it had been done between Oct. in 2002 and Jan. in 2002, That nursing care protocol made nurses easy to cooperate with muitidisciplinary team and community nurses. Furthermore nurses were easy to take care of patients's family. These results were discussed from the view point of limitation of this study.