某醫學中心精神科門診初診病患未返診原因之探討

Non-attendance at Second Psychiatric Outpatient Appointment after Initial Consultation: An Exploration of Reasons

謝杏玲(Hsing-Ling Heish) ； 蔡岑瑋(Tsen-Wei Tsai) ； 許玲女(Ling-Nu Hsu) ； 徐雅慧(Ya-Hui Hsu) ； 林明雲(Ming-Yun Lin) ； 劉嘉玉(Chia-Yuh Lin)

《精神衛生護理雜誌》 2卷1期 (2007/03) Pp. 21-26

https://doi.org/10.6847/TJPMHN.200703_2(1).0004

摘要

門診初診未返診者是嚴重的臨床與經濟問題，精神科門診初診未返診可能影響疾病預後。本研究的目的在瞭解醫學中心精神科門診初診病患未返診者的特徵及其原因。研究採立意取樣，對象為民國91年11月1日至11月30日，中部某醫學中心精神科門診的所有初診個案(N=340)。由病歷回顧，比較初診不返診者(N=124)與初診會返診者(N=216)兩者的性別、年齡別與臨床診斷，再由護理人員以電話訪談，以了解初診未返診原因。結果發現精神科一個月的初診未返診率為36.5%。初診未返診者與初診有返診者在性別(χ^2=2.509, p=0.113)、年齡別(χ^2=7.006, p=0.072)、精神醫學診斷(χ^2=1.580,p=0.664)上沒有顯著差異。初診未返診原因最多的是有事無法前來(38.9%)，其他依次是等候時間過長(20.5%)、服藥後無效果 (20.5%)、服藥後產生副作用(16.1%)、病情未改善(14.3%)、不敢來醫院(12.5%)。針對初診未返診因素作改進，應可改善初診未返診率。

關鍵字

未返診 ； 精神科門診 ； 初診

並列摘要

Non-attendance at an appointment following an initial consultation is a serious clinical and economic problem. Among psychiatric outpatients, it may result in poor outcomes. This study aimed to examine the etiologies of such missed appointments among psychiatric outpatients at a certain medical center. All the patients (N=340) were recruited between December 1 and December 30, 2002. Chart reviews were carried out to compare, in terms of age, sex, and psychiatric disorder, those subjects who returned (n=216) within one month and those who did not (n=124). Telephone interviews were then conducted of those patients who had missed appointments. Our results showed a 36.5% rate of non-attendance at second psychiatric outpatient appointment after initial consultation. There were no differences between patients who returned and those who did not return as far as sex (χ^2=2.509, p=0.113), age (χ^2=7.006, p=0.072), and psychiatric diagnosis (χ^2=1.580, p=0.664) were concerned. The most common etiologies of missed appointments were having other business to attend to (38.9%), waiting too long (20.5%), non-response to medication (20.5%), side effects of medications (16.1%), lack of improvement in symptoms (14.3%), and fearing to visit the hospital (12.5%). Improvements in relation to these factors may help to reduce the incidence of missed appointments.

並列關鍵字

missed appointment ； psychiatric outpatients ； first visit