Risk factors for psychiatric re-hospitalization: an exploration.
Predecessor research suggests that anything from 37% to 53% of hospitalized service users are readmitted within 12 months of discharge. This cycle of frequent admissions represents a serious challenge to clinicians and service users alike. Critically, much of the research in this field has relied exclusively on professional attributions for readmission with little acknowledgement of service user or patient viewpoints. This paper reports on a phenomenological study which used multiple data collection approaches to explore service user and clinician attributions for frequent hospitalization to an identified psychiatric unit over a 24-month index period. Methods included a retrospective review of multi-professional case notes, clinician and service user semi-structured interviews, and focus groups. Service users cited 'situational circumstances', rather than medically accepted relapse indicators such as 'non-adherence with prescribed medication' as the main reasons for readmission. Notable disagreement existed between clinician and service user data sources. Hospitalization is a complex, individually determined experience. Clinicians and service users have differing perspectives on the causal risk factors and this presents complications for those developing relapse prevention strategies. However, a shared appreciation of the multiple realities paves the way for the development of a conceptual risk-factor identification model which may serve as a guide to practitioners in relapse prevention.
Mgutshini
Tennyson
T
Department of Baccalaureate Nursing Completion, Indiana State University, Indiana State University, Terre Haute, Indiana, USA. Tennyson.mgutshini@indstate.edu
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003156:Community Mental Health Services / Q000458:organization & administration; D005260:Female; D017144:Focus Groups; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D008960:Models, Psychological; D015404:Nursing Methodology Research; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology