Predictors of Discharge from Hospital to Supported Accommodation and Support Needs Once in Supported Accommodation for People with Serious Mental Illness in Scotland: A Linked National Dataset Study

IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Michele Harrison, Linda Irvine Fitzpatrick, Donald Maciver
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引用次数: 0

Abstract

Background. Many individuals with serious mental illness live in supported accommodation. Decisions regarding type of supported accommodation required and level of support to meet individual’s needs are crucial for continuing rehabilitation and recovery following admission to hospital. This study aimed to identify personal and contextual predictive factors for (1) discharge from hospital to different levels of supported accommodation and (2) self-directed support needs of individuals with serious mental illness once they are in supported accommodation in Scotland. Method. Linked data from the Scottish Morbidity Record-Scottish Mental Health and Inpatient Day Case Section and the Scottish Government Social Care Survey were analysed using multinomial regression and multivariable logistic regression to identify personal and contextual factors associated with accommodation destination at the time of discharge and four self-directed support needs: personal care; domestic care; healthcare; and social, educational, and recreational. Results. Personal factors (age and having a diagnosis of schizophrenia, schizotypal, or delusional disorder) were associated with individuals moving to supported accommodation with higher levels of support. One contextual factor, compulsory detention when admitted to hospital, decreased the likelihood of moving to any type of supported accommodation. The personal and contextual factors associated with identified self-directed support needs varied by need. Support provided by the local authority was associated with all self-directed support needs, with having a diagnosis of schizophrenia, schizotypal, or delusional disorder associated with identifying domestic care, healthcare, and social, educational, and recreational needs, while living in the most deprived areas was associated with identifying healthcare needs. Advancing age and being compulsorily detained decreased the likelihood of identifying social, educational, and recreational needs. Conclusion. The study highlights that older men with a diagnosis of schizophrenia, schizotypal, or delusional disorder require higher levels of support upon discharge from hospital. When living in supported accommodation, having this diagnosis increases the likelihood of identifying support with looking after the home, looking after their health, and social and recreational activities; however, being older decreases the likelihood of identifying support with social and recreational activities.

苏格兰严重精神疾病患者从医院出院到辅助住宿的预测因素以及入住辅助住宿后的支持需求:关联国家数据集研究
背景。许多患有严重精神疾病的人都住在辅助住宿设施中。决定所需的辅助住宿类型和支持水平以满足个人需求,对于入院后的持续康复和恢复至关重要。本研究旨在确定以下方面的个人和环境预测因素:(1) 出院后入住不同级别的辅助住宿;(2) 苏格兰重性精神病患者入住辅助住宿后的自主支持需求。研究方法使用多项式回归和多变量逻辑回归分析了苏格兰发病率记录-苏格兰精神健康和住院病人日间病例部分以及苏格兰政府社会护理调查的关联数据,以确定与出院时的住宿目的地和四种自主支持需求(个人护理、家庭护理、医疗保健以及社交、教育和娱乐)相关的个人和环境因素。研究结果个人因素(年龄和被诊断为精神分裂症、分裂型或妄想型障碍)与患者搬到支持水平更高的辅助性住所有关。一个环境因素(入院时被强制拘留)降低了患者搬到任何类型的辅助性住所的可能性。与已确定的自主支持需求相关的个人和环境因素因需求而异。地方当局提供的支持与所有自主支持需求相关,被诊断为精神分裂症、分裂型或妄想型障碍与确定家庭护理、医疗保健以及社会、教育和娱乐需求相关,而居住在最贫困地区与确定医疗保健需求相关。年龄增大和被强制拘留会降低确定社会、教育和娱乐需求的可能性。结论这项研究强调,被诊断患有精神分裂症、精神分裂症或妄想症的老年男性在出院后需要更多的支持。当居住在辅助性住所时,如果被诊断出患有精神分裂症,那么在照顾家庭、照顾健康以及社交和娱乐活动方面获得支持的可能性就会增加;但是,如果年龄较大,那么在社交和娱乐活动方面获得支持的可能性就会降低。
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来源期刊
CiteScore
4.50
自引率
8.30%
发文量
423
期刊介绍: Health and Social Care in the community is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health economy, primary health care and the promotion of health. It is an international peer-reviewed journal supporting interdisciplinary collaboration on policy and practice within health and social care in the community. The journal publishes: - Original research papers in all areas of health and social care - Topical health and social care review articles - Policy and practice evaluations - Book reviews - Special issues
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