Network coordination following discharge from psychiatric inpatient treatment: a study protocol

BMC Psychiatry - Tập 13 - Trang 1-7 - 2013
Agnes von Wyl1, Gisela Heim2, Nicolas Rüsch3,4, Wulf Rössler3, Andreas Andreae2
1Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Zurich, Switzerland
2Integrated Psychiatric Clinic of Winterthur and Zurich Unterland (ipw), Winterthur, Switzerland
3Psychiatric University Hospital Zürich, Zürich, Switzerland
4Department of Psychiatry II, University of Ulm, Ulm, Germany

Tóm tắt

Inadequate discharge planning following inpatient stays is a major issue in the provision of a high standard of care for patients who receive psychiatric treatment. Studies have shown that half of patients who had no pre-discharge contact with outpatient services do not keep their first outpatient appointment. Additionally, discharged patients who are not well linked to their outpatient care networks are at twice the risk of re-hospitalization. The aim of this study is to investigate if the Post-Discharge Network Coordination Program at ipw has a demonstrably significant impact on the frequency and duration of patient re-hospitalization. Subjects are randomly assigned to either the treatment group or to the control group. The treatment group participates in the Post-Discharge Network Coordination Program. The control group receives treatment as usual with no additional social support. Further outcome variables include: social support, change in psychiatric symptoms, quality of life, and independence in daily functioning. The study is conducted as a randomized controlled trial. Subjects are randomly assigned to either the control group or to the treatment group. Computer generated block randomization is used to assure both groups have the same number of subjects. Stratified block randomization is used for the psychiatric diagnosis of ICD-10, F1. Approximately 160 patients are recruited in two care units at Psychiatrie-Zentrum Hard Embrach and two care units at Klinik Schlosstal Winterthur. The proposed post-discharge network coordination program intervenes during the critical post-discharge period. It focuses primarily on promoting the integration of the patients into their social networks, and additionally to coordinating outpatient care and addressing concerns of daily life. ISRCTN: ISRCTN58280620

Tài liệu tham khảo

Salize H, Rössler W, Becker T: Mental health care in Germany: current state and trends. Eur Arch Psychiatry Clin Neurosci. 2007, 257: 92-103. 10.1007/s00406-006-0696-9. Qin P, Nordentoft M: Suicide risk in relation to psychiatric hospitalization: evidence based on longitudinal registers. Arch Gen Psychiatry. 2005, 62: 427-432. 10.1001/archpsyc.62.4.427. Bonsack C, Schaffter M, Singy P, Charbon Y, Eggimann A, Guex P: Etude qualitative des attentes d’un réseau sanitaire et social pour le suivi des troubles psychiatriques sévères dans la communauté. Encéphale. 2007, 33: 751-761. Olfson M, Mechanic D, Boyer CA, Hansell S: Linking inpatients with schizophrenia to outpatient care. Psychiatr Serv. 1998, 49: 911-917. Bonsack C, Pfister T, Conus P: Insertion dans les soins après une première hospitalisation dans un secteur pour psychose. Encéphale. 2006, 32: 679-685. Nelson EA, Maruish ME, Axler JL: Effects of discharge planning and compliance with outpatient appointments on readmission rates. Psychiatr Serv. 2000, 51: 885-889. 10.1176/appi.ps.51.7.885. Meisler N, Santos AB, Rowland MD, Smith S, Molloy M, Tyson S: Bridging the gap between inpatient and outpatient providers using organizational elements of assertive community treatment. Adm Policy Ment Health. 1997, 25: 141-152. 10.1023/A:1022234904523. Steffen S, Kösters M, Becker T, Puschner B: Discharge planning in mental health care: a systematic review of the recent literature. Acta Psychiatr Scand. 2009, 120: 1-9. 10.1111/j.1600-0447.2009.01373.x. Puschner B, Steffen S, Völker KA, Spitzer C, Gaebel W, Janssen B, Klein HE, Spiessl H, Steinert T, Grempler J, Muche R, Becker T: Needsoriented discharge planning for high utilisers of psychiatric services: multicenter randomised controlled trial. Epidemiology and Psychiatric Sciences. 2011, 20: 181-192. 10.1017/S2045796011000278. Warnke I, Nordt C, Ajdacic-Gross V, Haug A, Salize HJ, Rössler W: Klinische und soziale Risikofaktoren für Wiederaufnahmen in die stationäre Psychiatrie bei Patienten mit Schizophrenie: Eine Langzeitanalyse. Neuropsychiatr. 2010, 24: 243-251. Bonsack C, Gibellini G, Ferrari P, Dorogi Y, Morgan C, Morandi S, Koch N: Le case management de transition: Une intervention à court terme dans la communauté après une hospitalisation psychiatrique. Schweiz Arch Neurol Psychiatr. 2009, 160: 246-252. Roick C, Kilian R, Matschinger H, Bernert S, Mory C, Angermeyer MC: Die deutsche Version des Client Sociodemographic Service Receipt Inventory (CSSRI-EU). Psychiatr Prax. 2001, 28: 84-90. Saß H, Wittchen H-U, Zaudig M: Diagnostisches und Statistisches Manual Psychischer Störungen DSM-IV. 1998, Göttingen: Hogrefe, 4 Goldman HH, Skodol AE, Lave TR: Revising Axis V for DSM-IV: a review of measures of social functioning. Am J Psychiatry. 1992, 149: 1148-1156. Fydrich T, Sommer G, Brähler E: Fragebogen zur sozialen Unterstützung (F-SOZU). 2007, Göttingen: Hogrefe Wing JK, Beevor AS, Curtis RH, Park SB, Hadden S, Burns A: Health of the Nation outcome scales (HoNOS),BJP. Res Dev. 1998, 172: 11-18. Clinical global impressions. ECDEU Assessment for psychopharmacology (Revised). Edited by: Guy W. 1976, Rockville, MD: National Institute of Mental Health, 217-222. Lambert MJ, Hannöver W, Nisslmüller K, Richard M, Kordy H: Fragebogen zum Ergebnis von Psychotherapie: Zur Reliabilität und Validität der deutschen Übersetzung des Outcome Questionnaire 45.2 (OQ-45.2). Z Klin Psychol Psychother. 2002, 31 (1): 40-47. 10.1026//1616-3443.31.1.40. Priebe S, Huxley P, Knight S, Evans S: Applications and results of the Manchester short assessment of quality of life (MANSA). Int J Soc Psychiatry. 1999, 45 (1): 7-12. 10.1177/002076409904500102. Kaiser W, Isermann M, Hoffmann K, Huxley P, Priebe S: Zur Kurzerfassung subjektiver Lebensqualität. Fortschritte der Neurologie und Psychiatrie. 1999, 67: 413-425. 10.1055/s-2007-994991. Morisky DE, Green LW, Levine DM: Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986, 24 (1): 67-74. 10.1097/00005650-198601000-00007. Ritsher JB, Otilingam PG, Grajales M: Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Res. 2003, 121: 31-49. 10.1016/j.psychres.2003.08.008. Corrigan PW, Giffort D, Rashid F, Leary M, Okeke I: Recovery as a psychological construct. Community Ment Health J. 1999, 35: 231-239. 10.1023/A:1018741302682. Corrigan PW, Salzer M, Ralph RO, Sangster Y, Keck L: Examining the factor structure of the recovery assessment scale. Schizophr Bull. 2004, 30: 1035-1041. 10.1093/oxfordjournals.schbul.a007118. Cohen J: Statistical power analysis for the behavioral sciences. 1988, Hillsdale, NJ: Erlbaum, 2 Dixon MD, Goldberg R, Iannone V, Luchsted A, Brown C, Kreyenbuhl J, Fang L, Potts W: Use of a critical time intervention to promote continuity of care after psychiatric inpatient hospitalization. Psychiatr Serv. 2009, 60 (4): 451-458. 10.1176/appi.ps.60.4.451. Kallert TW, Schützwohl M: Randomisierte kontrollierte Studien in der psychiatrischen Versorgungsforschung: Probleme der Durchführungspraxis. Fortschr Neurol Psychiatr. 2002, 70: 647-656. 10.1055/s-2002-35856. Rössler W, Löffler W, Fätkenheuer B, Riecher-Rössler A: Does case management reduce the rehospitalization rate?. Acta Psychatrica Scandinavica. 1992, 86: 445-449. 10.1111/j.1600-0447.1992.tb03295.x. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-244X/13/220/prepub