精神科病人於醫院跟社區的轉銜－出院準備服務計畫

Hospital Discharge Planning for Inpatients with Psychosis

周煌智(Frank Huang-Chih Chou)

《醫療品質雜誌》 16卷1期 (2022/01) Pp. 24-28

https://doi.org/10.53106/199457952022011601004

摘要

2007年版的精神衛生法第38條，已經將「出院準備服務計畫」入法，因此，面對不同類型的住院精神病人出院，應有不同的處理方式，但幾乎都會有一項是持續性的追蹤關懷，包括藥物治療及社會心理支持。「出院準備服務計畫」的內容包括：提醒病人按時回診、評估病人是否有病識感、可否持續藥物治療，必要時給予長效針劑及心理支持與關懷，並且定期檢查以預防及治療生理疾病。另外，影響個案可以長期在社區生活的因素還包括：1.評估病人目前可用的資源多寡、2.家庭關係結構及支持度、3.復健資源的可近性，以及4.若是潛在危險性個案治療後或涉案的精神病人監護處分後準備出院，還應該考量是否有物質濫用、人格因素、出院後與環境及家庭社會情境的互動。

關鍵字

精神病人 ； 出院準備服務計畫 ； 長效針劑

並列摘要

Patient discharge planning requirements were legislated in 2007 (Article 38, Mental Health Act). Patient discharge plans must be tailored to the individual characteristics of patients with mental health disorders, but most planning pertains to continued follow-up, including medication and psychosocial support. Patients should be reminded to attend scheduled follow-up visits to have their level of insight assessed, determine whether they can continue medication, undergo regular checkups (to prevent and treat physical diseases) and, when necessary, receive long-acting injectable antipsychotics and mental support and care. Furthermore, other psychosocial factors determine a patient's long-term outcomes in community life, such as available patient resources, family relationships and structure, and rehabilitation resource access. In addition, cases of patients with violent potential who have received treatment and of convicted patients with psychosis who have been discharged after protective custody, along with the personality factors, substance use habits, environmental interactions, and family situation of such patients after discharge shall be considered.

並列關鍵字

patients with psychosis ； discharge planning ； long-acting injectable