Psychiatric Emergency and Outcome among Patients with Mental Disorders

• Main Authors: Wu, Hsiu-Yueh, 吳秀悅
• Other Authors: Yang Mei-Sang
• Format: Others
• Language: zh-TW
• Published: 1998
• Online Access: http://ndltd.ncl.edu.tw/handle/12081738842879744812

碩士 === 高雄醫學院 === 護理學研究所 === 86 === ABSTRACT This study aims to evaluate reasons for emergency ofpatients with mental disorders and the outcome related to the degree of problems being solved at the emergency service. A purpose sampling of all cases visiting the emergency service in a medical center for psychiatric purposes during a three-month period from March 12 to June 12,1998were included for the study. Altogether, there were 306subjects (356 visits; average 1.6 visits in 3 months), with mean age of 34.7 years and 10.4 years in educationallevel. Fifty-five percent of them were females, and majority was single. Among them, schizophrenia were themost frequent diagnosis, followed by adjustment disordersand affective disorders. Among the 237 subjects and 229 of their family members who had been successfully completed the inquiries, a discrepancy over their reported and recorded reasonsfor emergency was found. Medical or surgical problems, insomnia and suicidal behavior were the main reasons reported by the subjects, while families accounted for psychotic symptoms, insomnia and medical or surgical complaints. Only 43.8% of the subjects complied with medication after discharged. Non-compliance was mainly due to refusal of medication because of subjects'' lack of insight. Only half of the subjects and their familiesfelt that the problems were solved while leaving at the emergency service. However, about 70% of the problems had been resolved during the follow-up at 3-7 days afterdischarge. Those subjects with elder ages, widowhood,jobless, problems preceded with longer time and less- satisfaction with emergency service had poor outcome. Factors related to favorable outcome included living with families and had good rapport with medical personnel.Inadequacy of medical information over follow-up and management were the complaints given by most families. In general, 69.1% subjects and 77.7% family members were satisfied with the emergency service that had been provided. The above findings could serve as a useful information in providing better and effective crisis intervention service for patients and their families who sought for psychiatric emergency.