安大略省法医精神病学系统中老年人风险制定、护理计划和处置决定因素的探索:实践意义。

IF 3.4 3区 医学 Q2 CLINICAL NEUROLOGY
Mark M Kaggwa, Joan Abaatyo, Arianna Davids, Angela Li, Rebecca Marsh, Precious Agboinghale, John M W Bradford, Gary A Chaimowitz, Andrew T Olagunju
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引用次数: 0

摘要

背景:医学的进步导致预期寿命的提高,从而增加了刑事司法系统内的老年人人口。本研究调查了加拿大安大略省老年法医患者(OAFP)的风险制定、护理计划和处置的决定因素。方法:本回顾性分析利用安大略省审查委员会数据库,重点关注161例55岁及以上的OAFP。使用层次回归分析风险变化与六大变量之间的关系:社会人口学特征(第1块)、指数犯罪期间的情况(第2块)、目前的临床情况(第3块)、过去的精神病史和行为模式(第4块)、犯罪史和法律地位(第5块)和最近的暴力事件(第6块)。结果:患者中位年龄61岁(IQR 58 ~ 67),男性占83.4%。精神分裂症是最常见的诊断(68.3%),9.3%患有神经认知障碍。这个由6个因素组成的模型解释了风险变化中92%的可变性。模型2(区块1和2)和4(区块1-4)具有统计学显著性,分别解释了公共安全威胁风险变化的34% (p = 0.010)和22% (p = 0.018)的方差。对公共安全有重大风险的OAFP更有可能是住院病人,在他们的主要犯罪期间不太可能醉酒。结论:资源、政策和有监督的护理模式可以减少OAFP的行为风险。提出了创新的OAFP风险管理模型。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An exploration of the determinants of risk formulation, care plan and disposition among older adults in the Ontario forensic psychiatry system: implication for practice.

Background: Advances in medicine have led to an improvement in life expectancy, thus increasing the population of older individuals within the criminal justice system. This study investigates the determinants of risk formulation, care plan, and disposition among older adult forensic patients (OAFP) in Ontario, Canada.

Methods: This retrospective analysis utilized the Ontario Review Board database, focusing on 161 OAFP, aged 55 years and older. Hierarchical regression was used to analyze the relationship between changes in risk and six blocks of variables: sociodemographic characteristics (Block 1), circumstances during the index offense (Block 2), current clinical profile (Block 3), past psychiatric history and behavioral patterns (Block 4), criminal history and legal status (Block 5), and recent violent events (Block 6).

Results: The median age of patients was 61 years (IQR 58-67), with 83.4% being male. Schizophrenia was the most common diagnosis (68.3%), and 9.3% had neurocognitive disorders. The model with six blocks of factors explained 92% of the variability in risk change. Models 2 (blocks 1 and 2) and 4 (blocks 1-4) were statistically significant, explaining 34% (p = 0.010) and 22% (p = 0.018) of the variance in the change in risk of threat to public safety, respectively. OAFP with a significant risk to public safety were more likely to be inpatients and less likely intoxicated during their index offense.

Conclusion: Resources, policies, and a supervised model of care to curtail behavioral risks are relevant to the care of OAFP. Innovative risk management models for OAFP are indicated.

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来源期刊
CNS Spectrums
CNS Spectrums 医学-精神病学
CiteScore
6.20
自引率
6.10%
发文量
239
审稿时长
>12 weeks
期刊介绍: CNS Spectrums covers all aspects of the clinical neurosciences, neurotherapeutics, and neuropsychopharmacology, particularly those pertinent to the clinician and clinical investigator. The journal features focused, in-depth reviews, perspectives, and original research articles. New therapeutics of all types in psychiatry, mental health, and neurology are emphasized, especially first in man studies, proof of concept studies, and translational basic neuroscience studies. Subject coverage spans the full spectrum of neuropsychiatry, focusing on those crossing traditional boundaries between neurology and psychiatry.
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