权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

An Evaluation of Modified Intensive Care Management(M-ICM)&IPS(Individual Placement and Support) for Psychiatric Patients Readmitted within 3 months of Discharge

改良重症监护管理（M-ICM）的评价

基本信息

批准号：
20592660
负责人：
USAMI Shiori
金额：
$ 3万
依托单位：
Kumamoto University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2008
资助国家：
日本
起止时间：
2008 至 2010
项目状态：
已结题

项目摘要

The purpose of this study was to develop Modified Intensive Care Management(M-ICM,ICM is the same as Community Based Care Management)&IPS care model and to evaluate this care model for psychiatric patients who readmitted psychiatric patients within three month of discharge. This study was conducted with the cooperation of a psychiatric hospital in Kyushu at which M-ICM(CBCM)&IPS were provided to 70 schizophrenic patients from the time of their readmission to six months after discharge.The patients had been unstable both in their psychiatric symptoms and in self-care management. All were either readmitted within three months of their previous discharge or their hospitalization continued more than three months.Evaluations were made upon of readmission, discharge, three months and six months after discharge. Evaluations were based on indexes rating psychiatric symptoms, daily living skills, social functioning, family perceptions of the patient being a burden, Quality of Life (QOL) and wor … More k-rate.The patients were divided into two groups: 35 patients (Group A) were provided M-ICM&IPS and 35 patients (Group B) were provided only M-ICM. Many of the patients of both groups lived with their families, with parents playing the major role in terms of family support.Significant difference were recognized between two groups regarding the Brief Psychiatric Rating Scale (BPRS), the Life Skills Profile (LSP), QOL and work-rate. Furthermore Significant improvements were recognized regarding BPRS, GAF, LSP, FAS and work-rate at the times of admission, discharge, three month and six month after the discharge.Family perceptions of the patient being a burden also improved significantly, especially at times of discharge and three months after discharge in Group A. Group A received support interventions for both patients and their families. Through this it became clear that such interventions were needed, not just for control of symptoms, but for helping patients connect with the community based on an understanding of personality, psychological developmental issues, and desires concerning daily life. Furthermore patients in A-Group had high work-rate compared with that of B-Group. But many patients in A-Group was working at working house for psychiatric patients, not in the company.This study led us to the realization that optimum utilization of all the social resources available to the community-including resources for those with disabilities and difficulties and not necessarily tailored for patients with psychiatric disorders-promotes a patient's stable settlement in the community after discharge from the hospital.These results were discussed from a viewpoint acknowledging the significance of M-ICM(CBCM)&IPS, the necessity of finding and utilizing community resources, and the importance of transitional support from "Person-oriented" to "Place-oriented" so as to widen the patient's support base. Less

本研究的目的是开发改良重症监护管理（M-ICM，ICM与社区基础护理管理相同）和IPS护理模式，并针对出院三个月内重新入院的精神病患者评估这种护理模式。这项研究是与九州一家精神病医院合作进行的，该医院对70名精神分裂症患者从再入院时到出院后6个月期间进行了M-ICM(CBCM)&IPS。这些患者的精神症状和自我护理管理都不稳定。所有患者要么在上次出院后三个月内重新入院，要么住院超过三个月。对重新入院、出院、出院后三个月和六个月进行评估。评估基于精神症状、日常生活技能、社会功能、家庭对患者负担的看法、生活质量（QOL）和工作率等指标。将患者分为两组：35名患者（A组）接受M-ICM&IPS，35名患者（B组）仅接受M-ICM。两组患者中的许多患者都与家人住在一起，父母在家庭支持方面发挥着主要作用。两组之间在简明精神病评定量表（BPRS）、生活技能概况（LSP）、生活质量和工作率方面均存在显着差异。此外，入院时、出院时、出院后三个月和出院六个月时，BPRS、GAF、LSP、FAS 和工作率均得到显着改善。家庭对患者负担的看法也显着改善，尤其是 A 组出院时和出院后三个月。A 组接受了针对患者及其家人的支持干预。通过这一点，我们清楚地认识到，需要此类干预措施，不仅是为了控制症状，而且是为了帮助患者在了解人格、心理发展问题和日常生活愿望的基础上与社区建立联系。此外，与B组相比，A组患者的工作率较高。但 A 组中的许多患者是在精神病患者工作之家工作，而不是在公司工作。这项研究使我们认识到，充分利用社区可用的所有社会资源（包括为残疾人和困难者提供的资源，不一定是为精神疾病患者量身定制的资源）可以促进患者出院后在社区的稳定定居。这些结果是从承认社区的重要性的角度进行讨论的。 M-ICM(CBCM)&IPS，寻找和利用社区资源的必要性，以及从“以人为本”过渡到“以地为本”以扩大患者支持基础的重要性。较少的