Failure to keep psychiatric appointments at primary healthcare facilities: Mental health care users missed ongoing clinical visits in Ekurhuleni district in Gauteng province, South Africa

Felicity Xaba, M. Lowane, P. Chelule, Hilda Nwahohova Shilubane
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Abstract

The study aimed to describe the characteristics and reasons why mental healthcare users miss clinical appointments in primary healthcare psychiatric facilities. Missing clinical appointments is a problem in primary healthcare facilities and has received attention in recent years. It is important to establish the extent of its occurrence in order to minimize it. However, there is limited research globally and in Africa about the prevalence of MHCUs missing clinical appointments and its contributory factors. A quantitative, simple descriptive cross-sectional approach using researcher-administered questionnaires at nine Primary Health Care (PHC) facilities was adopted. Of the 427 samples, only 404 participated in the study. Males were 54.2% dominant as compared to their female counterparts. Those found to have missed appointments were mostly among participants aged 41-55 years. The findings revealed that the most common challenge of missing appointments is related to patient factors. Participants with secondary diagnoses, particularly substance abuse disorders, were significantly more likely to miss appointments (χ2 = 12.52, df = 1, p < 0.000), compared to those with depression and schizophrenia. The findings provide target points for the establishment of guidelines that will aid in reducing risk factors for missed appointments and call for mental healthcare providers to identify patients who are at risk of not attending their psychiatric clinical appointments and intervene accordingly. Patients who miss appointments run a risk of relapsing and being readmitted. This study established factors related to missed appointments among MHCUs and is limited to Ekurhuleni District in Gauteng Province.
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不遵守初级医疗机构的精神科预约:南非豪登省 Ekurhuleni 地区的精神疾病患者错过了正在进行的门诊时间
本研究旨在描述基层医疗精神科机构中精神科用户错过临床预约的特点和原因。临床预约缺席是基层医疗机构的一个问题,近年来已受到关注。必须确定其发生程度,以便将其降到最低。然而,在全球和非洲范围内,有关医疗保健单位缺席门诊预约的发生率及其诱因的研究十分有限。本研究采用了一种定量、简单描述的横断面方法,在九个初级卫生保健(PHC)机构中使用研究人员发放的调查问卷。在 427 个样本中,只有 404 个参与了研究。与女性相比,男性占 54.2%。被发现错过预约的参与者大多在 41-55 岁之间。研究结果显示,最常见的失约问题与患者因素有关。与抑郁症和精神分裂症患者相比,患有继发性诊断(尤其是药物滥用障碍)的参与者更容易失约(χ2 = 12.52, df = 1, p < 0.000)。研究结果为制定有助于减少失约风险因素的指南提供了目标点,并呼吁精神医疗服务提供者识别有可能不参加精神科临床预约的患者,并采取相应的干预措施。失约患者有复发和再次入院的风险。本研究确定了精神卫生保健单位中与失约有关的因素,并仅限于豪登省的埃库尔胡莱尼区。
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