Challenges following discharge from acute psychiatric inpatient care in Japan: patients' perspectives.
WHAT IS KNOWN ON THE SUBJECT?: A lack of transitional care covering the period from psychiatric hospital discharge to community mental health care can increase the likelihood of illness recurrence or readmission of discharged patients. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The participants expressed the view that discontinuity between inpatient and community life was a post-discharge challenge after being involuntarily admitted to a psychiatric emergency ward. These challenges arose from the dissatisfaction with inpatient treatment, inability to coordinate post-discharge life WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Patients should be able to disclose their feelings about their own experiences in inpatient care settings and the current challenges in community care settings in an open manner. An advocate should be appointed in acute psychiatric inpatient care settings to reflect patients' own feelings and individual needs to transitional care without bias to inpatient and community care providers.
Introduction Psychiatric care in Japan usually comprises inpatient care provided during lengthy hospital stays. Recently, policies for shortening psychiatric hospital stays have been aggressively pursued. However, appropriate transitional care is not always provided for acute psychiatric inpatient care. Aim We elucidated patients' challenges immediately after hospital discharge following acute psychiatric inpatient care to clarify how to improve inpatient care and post-discharge follow-ups. Method This study utilized a qualitative descriptive study design and incorporated patient interviews. Participants comprised 18 patients who experienced involuntary admission following a diagnosis of schizophrenia spectrum disorder. Inductive qualitative content analysis was used to create codes and categories from interview transcripts. Findings The core category of post-discharge challenges that emerged was 'separating life as an inpatient from community life'. This comprised two subcategories: 'dissatisfaction with the inpatient care received' and 'lack of abilities to coordinate lifestyle following discharge'. Discussion Patients should be able to disclose their feelings about their experiences in inpatient care settings and the current challenges in community care settings openly. Implications for practice Advocate (e.g. peer staff) should be appointed in acute psychiatric inpatient care settings to reflect patients' feelings and individual needs to transitional care without bias to inpatient and community care providers.
Mental Health and Nursing Research Team, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
J
J
Niimura
Mental Health and Psychiatric Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
M
M
Tanoue
Mental Health and Nursing Research Team, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
M
M
Nakanishi
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006778:Hospitals, Psychiatric / Q000592:standards*; D006801:Humans; D007564:Japan; D008297:Male; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D008875:Middle Aged; D010351:Patient Discharge / Q000592:standards*; D017060:Patient Satisfaction; D036301:Qualitative Research; D000069341:Transitional Care / Q000592:standards*; D055815:Young Adult
impatient care; patient discharge; patients’ experiences; psychiatric hospital care; qualitative study; transitional care