in Projekten blättern
Angaben zum Forschungsprojekt
Wiedereingliederung von Patienten mit chronischen psychischen Erkrankungen in die Gemeinde (Berliner Enthospitalisierungsstudie)
Im Follow-Up wurden weiter in demselben Krankenhaus stationär behandelte Patienten nach 1,5 Jahren, in andere Settings entlassene Patienten ein Jahr nach Entlassung befragt. Objektive Variablen, Fremdbeurteilung und subjektive Sicht der Patienten wurden mittels standardisierter Methoden erfasst. Die Lebensqualität der Patienten wurde mit dem Berliner Lebensqualitätprofil (BeLP), einer deutschen Version des Lancashire Quality of Life Profile beurteilt.
(Kongreßbeitrag ECRR 1998)
REINTEGRATION OF PATIENTS WITH LONG TERM MENTAL ILLNESS INTO THE COMMUNITY
Purpose In most western industrialised countries, reforms in mental health care have led to closure or down-sizing of psychiatric hospitals, and a further reduction of hospital beds is either planned or considered. In particular, treatment and rehabilitation of patients with long-term mental illnesses is to be carried out in the community rather than in special hospital settings. While the empirical evidence available in the literature favours community care to hospital care, longitudinal studies are necessary to evaluate which patients benefit from which community placements and rehabilitation settings in which way. The Berlin de-institutionalisation study is the first prospective study for a systematic and comprehensive assessment of outcome in long-term hospitalised patients who are discharged into the community. Method In an initial base line survey all adult psychiatric patients from a catchment area of approximately 550,000 inhabitants in Berlin who had been continuously hospitalised for at least 6 months, were examined.
Follow-up investigations were done after one and a half years in those patients who were still in the same hospital setting, and one year after discharge in all other patients. Objective data, oberserver ratings and subjective views of the patients were obtained using standardised methods. Quality of life was assessed on the Berliner Lebensqualitätsprofil, a German version of the Lancashire Quality of Life Profile. Results Baseline psychopathology and disabilities were moderate on average. Patients' satisfaction and subjective quality of life were generally relatively high, but varied greatly in sub groups and individuals. At follow-up, the situation in those patients who had not been discharged was more or less unchanged. Other patients showed significant improvement in quality of life depending on the setting they had been discharged to. Outcome seemed particularly good in patients in sheltered accommodation. Prognoses of clinicians turned out to be of little validity. Discussion Reintegration of patients with long-term mental illnesses in the community may lead to an improvement of quality of life. In interpretation of the paper it should be taken into account that the study had no experimental controlled design, but was naturalistic. Conclusions Rehabilitation planning should not only or mainly be based on clinicians' prognoses. Care and interpretation of patients with long-term mental illnesses in the community is feasible, and can be more effective than rehabilitation in traditional hospital settings. The high variation of base-line scores and changes over time points at the importance of individual care planning.