住院精神障碍患者个案管理的实践

Practice of case management for inpatients with psychological disorders

目的探讨精神病患者住院期间实行个案管理模式的效果。方法按入院先后顺序将467例住院的精神障碍患者分为对照组(235例)与观察组(232例)。对照组患者入院后按常规进行治疗和护理,出院按常规嘱其定期复诊和用药指导。观察组在此基础上实行个案管理,由个案管理员对患者评估建档,协调各方人员,利用多种资源,对患者实施管理干预。结果实施个案管理后,观察组住院时间、服务满意度、SDSS评分及病耻感与对照组比较,差异有统计学意义(均P<0.01)。结论个案管理有助于缩短住院患者的住院时间及提高患者满意度,消除或减低病耻感,改善精神病患者社会功能。

Objective To explore the effect of case management for inpatients with psychological disorders.Methods A total of 467 inpatients with psychological disorders were divided into a control group of 235 and an observation group of 232 according to chronological order of their admission dates.The control group were subjected to routine treatment and nursing care.At discharge,they were asked to make regular rechecks and were given medication guidance.In addition to those measures,medical staff provided case management for the observation group.A case manager assessed patients′ condition and built up patient profiles.The manager coordinated the efforts of all sorts of personnel,utilized multiple resources,and gave intervention to the patients.Results After the implement of case management,the length of hospital stay,satisfaction with medical service,scores of Social Disability Screening Schedule,and perceived stigma between the 2 groups had significant differences（P0.01 for all）.Conclusion Case management helps shorten the length of hospital stay of inpatients with psychological disorders,upgrade their satisfaction level,eliminate sense of stigma,and improve their social function.