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标题：Engagement-focused care during transitions from inpatient and emergency psychiatric facilities
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作者：Dawn I Velligan ; Megan M Fredrick ; Cynthia Sierra 等
期刊名称：Patient Preference and Adherence
印刷版ISSN：1177-889X
电子版ISSN：1177-889X
出版年度：2017
卷号：11
页码：919-928
DOI：10.2147/PPA.S132339
语种：English
出版社：Dove Medical Press Ltd
摘要：Objectives: As many as 40% of those with serious mental illness (SMI) do not attend any outpatient visits in the 30 days following discharge. We examined engagement-focused care (EFC) versus treatment as usual in a university-based transitional care clinic (TCC) with a 90-day program serving individuals with SMI discharged from hospitals and emergency rooms. EFC included a unique group intake process (access group) designed to get individuals into care rapidly and a shared decision-making coach. Methods: Assessments of quality of life, symptomatology, and shared decision-making preferences were conducted at baseline, at 3 months corresponding to the end of TCC treatment and 6 months after TCC discharge. Communication among the patients and providers was assessed at each visit as was service utilization during and after TCC. Results: Subjective quality of life improved in EFC. Prescribers and patients saw communication more similarly as time went on. Ninety-one percent of patients wanted at least some say in decisions about their treatment. Conclusions: SDM coaching and improved access improve quality of life. Most people want a say in treatment decisions.
关键词：shared decision making; mental illness; community mental health; patient education