{"title":"如何记录和处理重症精神病患者的睡眠情况及其对服务参与的影响","authors":"Aviva Stafford , Sheri Oduola , Sarah Reeve","doi":"10.1016/j.sleep.2024.09.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Sleep and mental health share a bidirectional relationship whereby problems in one exacerbate the other. Accordingly, sleep problems are frequent and severe in serious mental illness (SMI) populations, exacerbating SMI symptoms. This study examined the documentation and treatment of sleep problems within anonymised clinical records of SMI patients, and their association with attendance rates and number of appointments scheduled.</p></div><div><h3>Methods</h3><p>Patient records between 01.09.2021 and 31.08.2022 were identified and relevant records (<em>n</em> = 229) extracted from an NHS Trust database. Content analysis was used to assess documentation and treatment of sleep problems and Chi-square tests were used to assess demographic differences. Mann-Whitney U tests were used to compare attendance rates and number of appointments scheduled between patients with/without sleep problems.</p></div><div><h3>Results</h3><p>Most (<em>n</em> = 170; 84 %) patients with sleep problems had no or minimal assessment of the sleep problem within their records. Patients were primarily offered no (<em>n</em> = 115; 57 %) or non-recommended (<em>n</em> = 69; 34 %) sleep treatment. More outpatients were offered no sleep treatment (<em>n</em> = 89; 64 %) than inpatients (<em>n</em> = 26; 41 %) (<em>p</em> = .002) whilst more inpatients were offered non-recommended sleep treatments (n = 33; 52 %) than outpatients (<em>n</em> = 36; 26 %) (<em>p</em> < .001). No significant associations were found between sleep and attendance or appointments scheduled.</p></div><div><h3>Conclusions</h3><p>There is a lack of routine clinical attention to sleep assessment and treatment in SMI groups. Where sleep is addressed, treatment often conflicts with guidelines. Improved sleep assessment and treatment could significantly enhance current SMI patient care.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 58-69"},"PeriodicalIF":3.8000,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1389945724004131/pdfft?md5=f19dfe8684d81ce0527b23714d0c023b&pid=1-s2.0-S1389945724004131-main.pdf","citationCount":"0","resultStr":"{\"title\":\"How sleep in patients with serious mental illness is recorded and treated, and its impact on service engagement\",\"authors\":\"Aviva Stafford , Sheri Oduola , Sarah Reeve\",\"doi\":\"10.1016/j.sleep.2024.09.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Sleep and mental health share a bidirectional relationship whereby problems in one exacerbate the other. Accordingly, sleep problems are frequent and severe in serious mental illness (SMI) populations, exacerbating SMI symptoms. This study examined the documentation and treatment of sleep problems within anonymised clinical records of SMI patients, and their association with attendance rates and number of appointments scheduled.</p></div><div><h3>Methods</h3><p>Patient records between 01.09.2021 and 31.08.2022 were identified and relevant records (<em>n</em> = 229) extracted from an NHS Trust database. Content analysis was used to assess documentation and treatment of sleep problems and Chi-square tests were used to assess demographic differences. Mann-Whitney U tests were used to compare attendance rates and number of appointments scheduled between patients with/without sleep problems.</p></div><div><h3>Results</h3><p>Most (<em>n</em> = 170; 84 %) patients with sleep problems had no or minimal assessment of the sleep problem within their records. Patients were primarily offered no (<em>n</em> = 115; 57 %) or non-recommended (<em>n</em> = 69; 34 %) sleep treatment. More outpatients were offered no sleep treatment (<em>n</em> = 89; 64 %) than inpatients (<em>n</em> = 26; 41 %) (<em>p</em> = .002) whilst more inpatients were offered non-recommended sleep treatments (n = 33; 52 %) than outpatients (<em>n</em> = 36; 26 %) (<em>p</em> < .001). No significant associations were found between sleep and attendance or appointments scheduled.</p></div><div><h3>Conclusions</h3><p>There is a lack of routine clinical attention to sleep assessment and treatment in SMI groups. Where sleep is addressed, treatment often conflicts with guidelines. Improved sleep assessment and treatment could significantly enhance current SMI patient care.</p></div>\",\"PeriodicalId\":21874,\"journal\":{\"name\":\"Sleep medicine\",\"volume\":\"124 \",\"pages\":\"Pages 58-69\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1389945724004131/pdfft?md5=f19dfe8684d81ce0527b23714d0c023b&pid=1-s2.0-S1389945724004131-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1389945724004131\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1389945724004131","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
How sleep in patients with serious mental illness is recorded and treated, and its impact on service engagement
Background
Sleep and mental health share a bidirectional relationship whereby problems in one exacerbate the other. Accordingly, sleep problems are frequent and severe in serious mental illness (SMI) populations, exacerbating SMI symptoms. This study examined the documentation and treatment of sleep problems within anonymised clinical records of SMI patients, and their association with attendance rates and number of appointments scheduled.
Methods
Patient records between 01.09.2021 and 31.08.2022 were identified and relevant records (n = 229) extracted from an NHS Trust database. Content analysis was used to assess documentation and treatment of sleep problems and Chi-square tests were used to assess demographic differences. Mann-Whitney U tests were used to compare attendance rates and number of appointments scheduled between patients with/without sleep problems.
Results
Most (n = 170; 84 %) patients with sleep problems had no or minimal assessment of the sleep problem within their records. Patients were primarily offered no (n = 115; 57 %) or non-recommended (n = 69; 34 %) sleep treatment. More outpatients were offered no sleep treatment (n = 89; 64 %) than inpatients (n = 26; 41 %) (p = .002) whilst more inpatients were offered non-recommended sleep treatments (n = 33; 52 %) than outpatients (n = 36; 26 %) (p < .001). No significant associations were found between sleep and attendance or appointments scheduled.
Conclusions
There is a lack of routine clinical attention to sleep assessment and treatment in SMI groups. Where sleep is addressed, treatment often conflicts with guidelines. Improved sleep assessment and treatment could significantly enhance current SMI patient care.
期刊介绍：
Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without.
A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry.
The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.
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