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Oxford Textbook of Inpatient Psychiatry最新文献

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Acute inpatient care for children and adolescents 儿童和青少年的急性住院护理
Oxford Textbook of Inpatient Psychiatry Pub Date : 2019-05-01 DOI: 10.1093/MED/9780198794257.003.0033
A. James
{"title":"Acute inpatient care for children and adolescents","authors":"A. James","doi":"10.1093/MED/9780198794257.003.0033","DOIUrl":"https://doi.org/10.1093/MED/9780198794257.003.0033","url":null,"abstract":"Inpatient treatment of children and adolescents forms an important part of modern psychiatric care. However, practices are changing with increasing demands for admission, and higher numbers of suicidal adolescents, with a greater degree of complexity and higher levels of violence and self-harm. There is also a drive for shorter admissions, partly driven by costs and resource limitations. Inpatient care is a complex activity, and understanding the dynamics and group dynamics of an inpatient unit is vital to any successful outcome. Child and adolescent units provide a variety of therapeutic approaches delivered by a multidisciplinary team. Integration of the therapeutic modalities is essential. In this age group, inpatient care is divided by age. Specialized services include eating disorder, forensic/secure, learning disability, and occasionally autism units. The outcome of inpatient care is favourable, although costly, and requires managed integration with outreach and community psychiatric services.","PeriodicalId":121860,"journal":{"name":"Oxford Textbook of Inpatient Psychiatry","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126771321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Historical and conceptual aspects 历史和概念方面
Oxford Textbook of Inpatient Psychiatry Pub Date : 2019-05-01 DOI: 10.1093/MED/9780198794257.003.0001
G. Berríos
{"title":"Historical and conceptual aspects","authors":"G. Berríos","doi":"10.1093/MED/9780198794257.003.0001","DOIUrl":"https://doi.org/10.1093/MED/9780198794257.003.0001","url":null,"abstract":"‘Inpatient treatment’ in psychiatry names a cluster of therapeutic activities whose meaning and justification have changed throughout history. Currently, an emphasis on the success of neurobiological treatment tends to give the impression that the spaces of care themselves are little more than short-term containers. This would be wrong. Best considered as dynamic environments, spaces of care have always had a profound effect on the bodies and minds of their occupants. Whether such affects have been negative or positive has depended upon the sociopolitical, economic, and theoretical factors governing their organization. To understand and improve these spaces of care it is important to realize that they sit at the intersection of various dimensions: container versus dynamic, physical versus social, custodial versus interventionistic, intramural versus extramural, institutional versus rehabilitatory, and communitarian versus societal. Throughout the centuries, a variety of therapeutic interventions have been offered within these spaces. Because their nature, ethics, and rationale have repeatedly changed, it may be more sensible to consider the current state of inpatient psychiatry not as the final stage in the evolution of the ‘science of psychiatry’ but as a mere moment in the evolution of a never-ending interpretative process about the meaning of madness.","PeriodicalId":121860,"journal":{"name":"Oxford Textbook of Inpatient Psychiatry","volume":"58 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116518539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Substance misuse disorders on the psychiatric ward 精神科病房的药物滥用障碍
Oxford Textbook of Inpatient Psychiatry Pub Date : 2019-05-01 DOI: 10.1093/MED/9780198794257.003.0013
G. Critchlow, T. Bargiotas
{"title":"Substance misuse disorders on the psychiatric ward","authors":"G. Critchlow, T. Bargiotas","doi":"10.1093/MED/9780198794257.003.0013","DOIUrl":"https://doi.org/10.1093/MED/9780198794257.003.0013","url":null,"abstract":"The focus of this chapter is the management of substance misuse and addiction on the psychiatric ward in patients who have presented with a psychiatric disorder. Some patients will display other forms of addictive behaviour such as gambling, sexual activity, or Internet use. Where this is not the primary focus, the same principles of broad-based biopsychosocial management apply. There are a number of guidelines available, such as those from the Department of Health (the ‘Orange Book’) and the National Institute for Health and Care Excellence, and prescribing advice, such as the British Association for Psychopharmacology guidelines and The Maudsley Prescribing Guidelines in Psychiatry, that are useful references for the treatment of patients with substance misuse disorders and addiction. This chapter does not seek to replicate this advice, but does include useful and common scenarios that will be encountered on the general psychiatric ward.","PeriodicalId":121860,"journal":{"name":"Oxford Textbook of Inpatient Psychiatry","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116818563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The context of inpatient mental health care in England 英国住院精神卫生保健的背景
Oxford Textbook of Inpatient Psychiatry Pub Date : 2019-05-01 DOI: 10.1093/med/9780198794257.003.0005
R. Chaplin
{"title":"The context of inpatient mental health care in England","authors":"R. Chaplin","doi":"10.1093/med/9780198794257.003.0005","DOIUrl":"https://doi.org/10.1093/med/9780198794257.003.0005","url":null,"abstract":"This chapter reviews the practice of inpatient care in relation to the provision of overall psychiatric care in England. The structure of mental health care in the UK National Health Service (NHS) is outlined and in particular the various subspecialties of inpatient care. Recent trends in the provision of inpatient psychiatric care in the UK are considered in comparison to those in Europe and North America. There follows a review of the role of public sector care under the NHS and a debate about the effectiveness of inpatient care and whether it should be a separate psychiatric subspecialty. Finally, local service developments are discussed as a type of case study to illustrate how services are currently undergoing rapid changes.","PeriodicalId":121860,"journal":{"name":"Oxford Textbook of Inpatient Psychiatry","volume":"156 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129596196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
People with personality disorders and developmental conditions on an inpatient ward 在住院病房里有人格障碍和发育障碍的人
Oxford Textbook of Inpatient Psychiatry Pub Date : 2019-05-01 DOI: 10.1093/MED/9780198794257.003.0017
S. Pearce, G. Critchlow
{"title":"People with personality disorders and developmental conditions on an inpatient ward","authors":"S. Pearce, G. Critchlow","doi":"10.1093/MED/9780198794257.003.0017","DOIUrl":"https://doi.org/10.1093/MED/9780198794257.003.0017","url":null,"abstract":"This chapter reviews research and expert guidelines on inpatient management of personality disorder, autism spectrum disorder, and adult attention deficit hyperactivity disorder. It covers use of medication, milieu approaches, other psychosocial interventions, the impact of the ward environment, quality assurance mechanisms, and the impact of institutionalization. Ways in which formal therapeutic approaches can be implemented on inpatient wards are also addressed. The effect of risky and challenging behaviours on defensive practice and staff burnout is covered, and detailed advice on managing suicidal and high-risk patients who are difficult to discharge safely is included. The chapter details specific approaches to milieu management, use of observations, personalized care plans, and communication styles in borderline personality disorder, autism spectrum disorder, and attention deficit hyperactivity disorder. Patients with these diagnoses constitute an important group of inpatients, and with careful management, iatrogenic harms can be avoided.","PeriodicalId":121860,"journal":{"name":"Oxford Textbook of Inpatient Psychiatry","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126678871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Psychological treatment on the acute ward 急症病房的心理治疗
Oxford Textbook of Inpatient Psychiatry Pub Date : 2019-05-01 DOI: 10.1093/MED/9780198794257.003.0028
I. Barkataki, L. Ross
{"title":"Psychological treatment on the acute ward","authors":"I. Barkataki, L. Ross","doi":"10.1093/MED/9780198794257.003.0028","DOIUrl":"https://doi.org/10.1093/MED/9780198794257.003.0028","url":null,"abstract":"Psychological approaches to treatment on inpatient units have been increasingly valued both by staff and service users. Such approaches have been delivered by specialist psychologists and psychotherapists but also adopted and used by the wider multidisciplinary ward team as a framework for guiding treatment. This chapter outlines both direct interventions with service users, as well as broader, more indirect psychological working with staff, families, and other external stakeholders. It also outlines the key stages of psychological working including assessment, formulation, intervention, and evaluation, and provides an overview of the types of therapies commonly delivered. The importance of staff well-being, team working, clinical supervision, and reflective practice is discussed, as are the challenges of working psychologically within an inpatient context.","PeriodicalId":121860,"journal":{"name":"Oxford Textbook of Inpatient Psychiatry","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114639305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The design and function of inpatient wards 住院病房的设计与功能
Oxford Textbook of Inpatient Psychiatry Pub Date : 2019-05-01 DOI: 10.1093/MED/9780198794257.003.0004
T. Burns
{"title":"The design and function of inpatient wards","authors":"T. Burns","doi":"10.1093/MED/9780198794257.003.0004","DOIUrl":"https://doi.org/10.1093/MED/9780198794257.003.0004","url":null,"abstract":"Inpatient wards in asylums were the cradle of modern psychiatry and have remained a central component ever since, even in the most radical services. Their configuration has evolved pragmatically but since the arrival of evidence-based practice in mental health care in the early 1980s, attempts have been made to derive guidelines and provide principles for their design. There is little in the way of experimental evidence but there is a growing international consensus. Wards now strive to be small (around 15–20 places) and to provide single en-suite accommodation. Isolated small wards emphasizing a domestic configuration have generally faced problems with caring for disturbed patients. The last decade has seen a disappointing move back to single-sex wards, with greater emphasis on security and doors often locked as bed numbers have fallen and patient acuity has increased. International observations are provided about staffing, design, and standards.","PeriodicalId":121860,"journal":{"name":"Oxford Textbook of Inpatient Psychiatry","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125614538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Eating disorders 饮食失调
Oxford Textbook of Inpatient Psychiatry Pub Date : 2019-05-01 DOI: 10.1093/med/9780198794257.003.0036
A. Ayton
{"title":"Eating disorders","authors":"A. Ayton","doi":"10.1093/med/9780198794257.003.0036","DOIUrl":"https://doi.org/10.1093/med/9780198794257.003.0036","url":null,"abstract":"There is increasing demand for inpatient treatment of severe eating disorders, both in the UK and internationally. However, hospital treatment of severe eating disorders remains controversial, mainly because of poor long-term outcomes. This chapter provides a highly relevant and clinically focused review of the complex issues involved in inpatient care of people with severe eating disorders. The main guidelines and evidence base are critically reviewed from the point of view of a real-life clinical practice dealing with people with very low body mass indexes. Evidence, or lack of it, for a range of interventions is outlined, including artificial feeding and compulsory treatment. Practical issues regarding management of weight, physical morbidity, and psychological interventions are discussed.","PeriodicalId":121860,"journal":{"name":"Oxford Textbook of Inpatient Psychiatry","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131004036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The interface with community services 与社区服务的接口
Oxford Textbook of Inpatient Psychiatry Pub Date : 2019-05-01 DOI: 10.1093/MED/9780198794257.003.0009
Christopher Morton, Arabella Norman-Nott
{"title":"The interface with community services","authors":"Christopher Morton, Arabella Norman-Nott","doi":"10.1093/MED/9780198794257.003.0009","DOIUrl":"https://doi.org/10.1093/MED/9780198794257.003.0009","url":null,"abstract":"The interface between inpatient and community services requires special attention in order to provide safe and high-quality care to patients who are significantly unwell, pose significant risks, and are transitioning between teams. This chapter provides an outline of how community services work to provide care for patients with mental health problems both in the community and in hospital. The authors describe their experience working within an adapted flexible assertive community treatment (FACT) model of care, alongside the Care Programme Approach for supporting service users and carers during their journey through services. The contribution of a community partnership between mental health services and the voluntary sector organizations is also described, with a focus on the support it provides to patients in delivering timely and safe discharge from the acute inpatient ward.","PeriodicalId":121860,"journal":{"name":"Oxford Textbook of Inpatient Psychiatry","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117274647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Multidisciplinary work, multidisciplinary team 多学科的工作，多学科的团队
Oxford Textbook of Inpatient Psychiatry Pub Date : 2019-05-01 DOI: 10.1093/MED/9780198794257.003.0006
Jean Hammond, D. Hammond
{"title":"Multidisciplinary work, multidisciplinary team","authors":"Jean Hammond, D. Hammond","doi":"10.1093/MED/9780198794257.003.0006","DOIUrl":"https://doi.org/10.1093/MED/9780198794257.003.0006","url":null,"abstract":"Putting the patient at the centre of their care is a fundamental principle of the multidisciplinary team (MDT) approach. It is generally recognized as being an effective model for delivering individualized care to patients with complex needs and is promoted in a growing number of local and national policies and best practice guidelines, in a wide range of clinical specialities. While clinical staff seem clear on the assumed benefits of MDT working, there is surprisingly little written about its clinical effectiveness. This chapter briefly explores some of the challenges presented to effective MDT working within the acute mental health inpatient ward. The key principles and characteristics of MDT working are described with an exploration of the key roles and functions within the MDT and their application to acute mental health inpatients wards.","PeriodicalId":121860,"journal":{"name":"Oxford Textbook of Inpatient Psychiatry","volume":"154 7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131114071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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