A recovery-oriented day hospital in psychiatry: A springboard for reintegration.

IF 1.2 4区医学 Q4 NEUROSCIENCES Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique Pub Date : 2024-05-23 DOI:10.1016/j.encep.2024.02.004

Ghita Dadi, Lucie Venet-Kelma, Mauricette Mendy, Laurence Kern, Pierre-Alain Hauseux, Valérie Dauriac-Le Masson, Raphaël Gaillard, Marion Plaze, Yannick Morvan, Mona Moualla, Isabelle Amado

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Abstract

Psychiatric disorders are common and can cause psychological disabilities. While the creation of day hospitals (DHs) was intended to direct psychiatric care towards community settings, they may have paradoxically contributed to a form of chronicity. Furthermore, the heterogeneity and lack of evaluation of care within DHs prevent the availability needed to collect objective data on users outcomes. In this article, we aim to describe and measure the effects of a transformation of practice within a sector-based DH initially focused on traditional institutional psychiatry towards a rehabilitation model of care which offers different therapeutic tools, structured in three stages, and whose main objective is professional integration. This retrospective mirror study compares, before and after the transformation of this DH, several indicators including the rate of professional integration and its maintenance after two years. We found that this psychosocial rehabilitation model for care allowed a very clear increase in the professional integration rate and its maintenance at two years while reducing the length of stay to around 18 months. These promising results therefore highlight the pivotal role of DHs as "stepping stones" in addressing psychological disabilities towards recovery.

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精神病学中以康复为导向的日间医院：重新融入社会的跳板。

精神病是一种常见病，可导致心理残疾。虽然建立日间医院（DHs）的初衷是将精神病治疗引向社区环境，但矛盾的是，日间医院可能助长了一种慢性病。此外，由于日间医院内的护理存在异质性且缺乏评估，因此无法收集到有关使用者疗效的客观数据。在这篇文章中，我们旨在描述和衡量一个以部门为基础的卫生院内的实践转变所产生的影响，该卫生院最初以传统的精神病院为重点，向康复护理模式转变，该模式提供不同的治疗工具，分为三个阶段，其主要目标是专业融合。这项回顾性镜像研究比较了该卫生院转型前后的几项指标，包括专业融合率及其两年后的维持情况。我们发现，这种社会心理康复护理模式明显提高了专业融合率，并在两年后保持了这一比率，同时将住院时间缩短至 18 个月左右。因此，这些充满希望的结果凸显了保健院作为 "垫脚石 "在解决心理残疾问题、实现康复方面的关键作用。

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来源期刊

Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique 医学-精神病学

CiteScore

4.60

自引率

7.40%

发文量

162

审稿时长

6-12 weeks

期刊介绍： Une revue française de renommée internationale. - Un comite de rédaction représentant tous les aspects de la prise en charge psychiatrique du patient. - Une sélection rigoureuse d''articles faisant l''objet de plusieurs expertises. - Des travaux d''auteurs et de chercheurs de renommée internationale. - Des indexations dans les grandes bases de données (Current Contents, Excerpta Medica, etc.). - Un facteur d''impact qui témoigne de la grande notoriété de la revue. La tribune des publications originales de haut niveau. - Une très grande diversité des sujets traités, rigoureusement sélectionnés à travers des sommaires dynamiques : - des éditoriaux de médecins référents, - une revue de presse sur les actualités internationales, - des articles originaux pour approfondir vos connaissances, - des mises au point et des cas cliniques pour engager votre réflexion sur les indications et choix possibles au travers de mises en situation clinique, - des dossiers thématiques pour faire le tour d''une question. - L''actualité de l''AFPB : L''Encéphale publie régulièrement des comptes rendus de l''Association française de psychiatrie clinique.