马耳他危机解决家庭治疗(CRHT)小组的全国性实施:马耳他危机解决家庭治疗小组的全国性实施:头两年运作的启示》。

Francesca Sammut, Doreen Calleja, Manwel Abela, Giovanni Grech
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摘要

危机解决家庭治疗(CRHT)小组已成为精神病住院治疗的一种普遍替代方式。尽管危机排解家庭治疗小组已得到普及,但马耳他直到最近才引入该小组。本研究旨在调查 (i) 患者特征,(ii) 影响患者随访时间(LoFU)的因素,以及 (iii) 临床结果的预测因素。研究收集并分析了在 CRHT 运营头两年内使用该服务的患者(n = 643)的描述性和不可识别的定量数据。单因素方差分析检验调查了影响LoFU的因素,而二元逻辑回归则推导出了临床结果的预测因素。没有急性精神障碍的患者的LoFU最短,这表明该团队收到了不适当的转诊。如果患者被诊断为强迫症及相关障碍,则最有可能延长LoFU;如果患者被诊断为焦虑症及恐惧症,则最有可能被诊断为潜在的人格障碍。持续护理有助于制定出院计划。在马耳他,接受 CRHT 服务的患者与那些更倾向于将风险较高的患者送入医院治疗的医疗系统最为相似。人格障碍的高发率要求工作人员具备跨学科知识和适当的技能组合。
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National Implementation of a Crisis Resolution Home Treatment (CRHT) Team in Malta: Insights From the First Two Years of Operation.

Crisis Resolution Home Treatment (CRHT) teams have become a widespread alternative to psychiatric hospitalisation. Despite their popularisation, Malta has only recently introduced a CRHT team. The aims of the current study were to investigate (i) patient characteristics, (ii) factors influencing patients' length of follow-up (LoFU) and (iii) predictors of clinical outcomes. Descriptive and quantitative non-identifiable data were collected and analysed for patients utilising the CRHT service within its first 2 years of operation (n = 643). One-way ANOVA tests investigated influencing factors for LoFU, whereas binary logistic regressions deduced predictive factors for clinical outcomes. Patients without acute psychiatric disorders had the shortest LoFU, indicating that the team received inappropriate referrals. Patients were most likely to have extended LoFU if they were diagnosed with OCD & related disorders and were most likely to be diagnosed with an underlying personality disorder if they were diagnosed with anxiety & phobic disorders. Continuity of care facilitates discharge planning. Patients receiving the CRHT service in Malta are most comparable with health systems that prefer to hospitalise patients with a higher risk profile. The high occurrence of personality disorders necessitates staff to have interdisciplinary knowledge and an appropriate skill mix.

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