英文摘要
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Objectives: This study examined the rate of discharge against medical advice (AAD) and its related factors among acute psychiatric inpatients. Methods: Acute psychiatric inpatients admitted to a psychiatric hospital between April and August, 2004 were included. The sample comprised 275 patients who were followed up to determine whether they were discharged against medical advice. Data were collected through chart review by psychiatrists and psychiatric nurses. Results: During the research period, 39 patients were discharged against medical advice. The rate of AAD was 14.2%. The factors related to AAD were past history of AAD, inconsistent opinion of family members about the need for care, short expected hospitalization time by family members, high symptom severity at discharge and limited symptom improvement. The risk of AAD was 4.18 times per decline in the unit score of symptom improvement during the hospitalization period. The risk of AAD was 6 times higher when families expected the patient to be discharge within 1 week compared to those who agreed with the hospitalization time suggested by doctors. Conclusion: To prevent the occurrence of AAD, the team in the acute psychiatric ward should manage psychiatric symptoms intensively, and discuss what may be a reasonable expectation of hospitalization time with families on admission.
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参考文献
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王盈彬、郭千哲、方勇駿(2004)。非計畫性出院的精神分裂症病人之臨床特徵。台灣精神醫學,18,207-215。
連結:
-
Akhtar S,Halfrich J,Mestayer RF(1981).AMA discharge from a psychiatric inpatient unit.Int J Soc Psychiatry,27,143-150.
-
Aliyu Z(2002).Discharge against medical advice: sociodemographic, clinical and financial perspectives.Int J Clin Pract,56,325-327.
-
Fulop G(1990).Anxiety disorders in general hospital setting.Psychiatr Med,8,187-195.
-
Glick ID,Braff DL,Johnson G,Showstack JA(1981).Outcome of irregularly discharged psychiatric patients.Am J Psychiatry,138,1472-1476.
-
Greenwald AF,Bartemeier LH(1963).Psychiatric discharges against medical advice.Arch Gen Psychiatry,8,117-119.
-
Harper DW,Elliott-Harper C,Weinerman R,Anderson NJ,Nelson TA(1982).A comparison of AMA and non-AMA patients on a short-term crisis unit.Hosp Comm Psychiatry,33,46-48.
-
Heinssen RK,McGlashan TH(1988).Predicting hospital discharge status for patients with schizophrenia, schizoaffective disorder, borderline personality disorder, and unipolar affective disorder.Arch Gen Psychiatry,45,353-360.
-
Honigfeld G,Klett CJ(1965).The nurses` observation scale inpatient evaluation: a new scale for measuring improvement in chronic schizophrenia.J Clin Psychol,21,65-71.
-
Jankowski CB,Drum DE(1977).Diagnostic correlates of discharge against medical advice.Arch Gen Psychiatry,34,153-155.
-
Kecmanovic D(1975).Patients discharged against medical advice from a lock-and-key psychiatric institution.Int J Soc Psychiatry,21,274-281.
-
LaWall JS,Jones R(1980).Discharges from a ward against medical advice: search for a profile.Hosp Comm Psychiatry,31,415-416.
-
Louks J,Mason J,Backus F(1989).AMA discharges: prediction and treatment outcome.Hosp Comm Psychiatry,40,299-301.
-
Miles JE,Adlersberg M,Reith G,Cumming J(1976).Discharges against medical advice from voluntary psychiatric units.Hosp Comm Psychiatry,27,859-864.
-
Pages KP,Russo JE,Wingerson DK,Ries RK,Roy-Byrne PP,Cowley DS(1998).Predictors and outcome of discharge against medical advice from the psychiatric units of a general hospital.Psychiatr Serv,49,1187-1192.
-
Planasky K,Johnston R(1976).A survey of patients leaving a mental hospital against medical advice.Hosp Comm Psychiatry,27,865-867.
-
Raynes AE,Patch VD(1971).Distinguishing features of patients who discharge themselves from psychiatric ward.Compr Psychiatry,12,473-479.
-
Scheer N,Barton GM(1974).A comparison of patients discharged against medical advice with a matched control group.Am J Psychiatry,131,1217-1220.
-
Smith DB,Telles JL(1991).Discharges against medical advice at regional acute care hospitals.Am J Public Health,81,210-213.
-
Steinglass P,Grantham CE,Hertzman M(1980).Predicting which patients will be discharged against medical advice: a pilot study.Am J Psychiatry,137,1385-1389.
-
Targum SD,Capodanno AE,Hoffman HA,Foundraine C(1981).An intervention to reduce the rate of hospital discharges against medical advice.Am J Psychiatry,139,657-659.
-
Withersty DJ(1977).Patient responsibility and the AMA discharge: a one-year follow-up study.Am J Psychiatry,134,1442-1444.
-
財團法人醫院評鑑暨醫療品質策進會(2001)。台灣醫療品質指標計畫(Taiwan Quality Indicator Project, TQIP)。
-
楊延光、葉宗烈、陳永成、柯慧貞(1990)。影響綜合醫院精神科病患自動出院因素之研究。中華精神醫學,4,273-279。
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