Study on situation of long-stay psychiatric inpatients and improvement of hospital environment

长期住院精神科患者现状及医院环境改善研究

• 批准号: 22K10457
• 负责人: 黒田 研二
• 金额: $ 1.33万
• 依托单位: Nishikyushu University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2022
• 资助国家: 日本
• 起止时间: 2022-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-22K10457/
• 关键词: 精神科病院; 病院療養環境; 長期在院患者; 地域移行支援; 630調査; 重回帰分析; ６３０調査

【目的と方法】精神科病院における長期在院患者の発現の背景にある病院環境要因を解明することを目的とした。本年度は大阪府内の精神病床30床以上を有する58病院を対象とし、2020年630調査のデータを用いて長期在院患者の発現状況と、病院療養環境がそれにどのように関与しているかを重回帰分析により分析した。【結果】在院患者数とその中の在院期間が3か月以上、6ヶ月以上、1年以上、5年以上、20年以上の患者割合を算出した。各平均値は、67.8%、59.7%、51.3%、23.1%、4.6%であったが、病院間での較差が大きく、20年以上在院割合が19.6%に達する病院も存在した。各在院期間別割合を従属変数とし、医師対患者数、看護師対患者数、PSW対患者数、統合失調症割合、閉鎖病床割合、医療保護入院割合を独立変数として、重回帰分析（ステップワイズ法）を行ったところ、以下の変数が各在院期間別患者割合を推計するのに有意な標準偏回帰係数（β）を示した。６ヵ月以上割合に対しては、看護師対患者数（0.358）、医師対患者数（0.355）、統合失調症割合（0.189）、在院者数（0.185）。１年以上割合に対しては、看護師対患者数（0.497）、PSW対患者数（0.271）、在院者数（0.244）、統合失調症割合（0.208）。５年以上割合に対しては、統合失調症割合（0.566）、医師対患者数（0.267）、閉鎖病床割合（-0.254）、看護師対患者数（0.231）、在院者数（0.174）である。【考察】この分析結果より、医師、看護師、PSW数に対し患者数が多い病院で長期入院患者割合が多いこと、統合失調症患者割合は、より長期の在院患者割合と強い関連を示すことがわかる。閉鎖病床割合が、５年以上在院割合と負の関連を示すことは、長期在院患者は状態が安定し開放処遇が多くなることを反映していると考えられる。

[objective] the long-term hospitalization of patients in psychiatric hospitals is due to the fact that the environment of psychiatric hospitals has to be affected for the purpose of understanding the situation. This year, there are more than 30 psychiatric beds in Osaka Prefecture, including 58 hospitals in Osaka Prefecture, 630 in 2020, patients in hospital for a long period of time, and the environment in the hospital. the hospital has returned to the hospital for analysis and analysis. [results] the number of patients in the hospital was more than 3 months, 6 months, 1 year, 5 years and 20 years. The average number of patients was 67.8%, 59.7%, 51.3%, 23.1% and 4.6%, the difference between hospitals was large, and 19.6% of them were closed in hospitals for more than 20 years. The number of patients in hospital, the number of patients in hospital, the number of patients in care, the number of patients in PSW, the number of patients with aphasia, the number of patients in hospital, the number of patients in hospital, The following statistics show that the number of patients in the hospital period is calculated according to the standard of partial regression (β). More than 6 months old, the number of patients with dysphagia, nursing care (0.358), medical care (0.355), dysphagia (0.189) and hospitalization (0.185). For more than one year, the number of patients with dysphagia and nursing care (0.497), the number of patients with PSW (0.271), the number of patients in hospital (0.244), and the number of patients with dysphagia (0.208). For more than 5 years, the number of patients with dysphagia (0.566), the number of patients in medical care (0.267), the number of patients in hospital (- 0.254), the number of patients in care (0.231) and the number of patients in hospital (0.174). [investigation] the results of clinical analysis showed that the number of patients with multiple diseases, the number of patients with long-term admission, patients with dysfunctional disorder, patients with dysfunctional disorder and patients with long-term hospitalization were significantly higher than those in the hospital. the results of clinical analysis showed that the number of patients with multiple diseases, patients with long-term hospitalization, patients with long-term dysfunctional disorder and patients with long-term hospitalization were significantly higher than those in the hospital. The hospital bed is cut and closed, the patients who have been in the hospital for more than 5 years, and the patients who have been in the hospital for a long period of time.