精神科急性期治療病棟入院患者において3ヵ月間で退院できなかった理由と対策

Reasons and countermeasures of hospitalization for over three months for patients at an acute psychiatric care ward

要旨：この研究の目的は，精神科急性期治療病棟の入院患者において3ヵ月間で退院できなかった28名の特徴と入院が継続した理由を調べ，その対策を検討することである．3ヵ月間で退院できなかった患者は，妄想・幻覚や感情の不安定さにより入院した30代・50代の統合失調症患者が多かった．退院ができなかった理由は，入院中の症状悪化と退院時の環境変化であり，作業療法への参加も遅れたことであった．3ヵ月後，患者は他の病棟へ転棟し，治療が継続された．これらの患者の退院を促進するには，症状を迅速に改善することと退院時の環境を調整することが重要であることがわかった．

　The purpose of this study is to investigate the reasons and countermeasures of hospitalization for over three months for patients at a psychiatric acute care ward. We investigated the personality characteristics and reasons of admission of 28 patients for over three months at a psychiatric acute care ward. The subjects were aged 30 or 50, suffered from schizophrenia, and were admitted for delusions and emotional disturbance. If their symptoms continued and their home environments became unsuitable during their hospital stay, they had to move to another ward and continue therapy. This suggests that early improvement of the symptoms and adjustment of the home environment by occupational therapists are important for patients who have been discharged after a short-term hospital stay.