CONTINUITY OF CARE & OUTCOME OF SEVERE MENTAL DISORDERS

护理的连续性

• 批准号: 6528089
• 负责人: RAMIN MOJTABAI
• 金额: $ 16.82万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-01 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6528089
• 关键词: bipolar depression; clinical research; comprehensive care; health care service evaluation; health care service utilization; health services research tag; human data; major depression; mental health services; military personnel; outcomes research; psychosis; schizophrenia; veterans

A five-year research and educational program is proposed to prepare the principal investigator a career in mental health services research with a focus on patients with severe mental disorders. The candidate's long-term research goal is to apply the rigorous methods and analytic tools of epidemiology in services research for these patient groups and to investigate the optimal approaches to their care, especially in the early phases of the illness. Such knowledge will be essential for planning empirically-based services for this population. The program has two major components: an educational plan and a research project. The educational plan involves course work in epidemiology, biostatistics and mental health services research. In addition a group of highly experienced experts in psychiatric epidemiology, mental health services research, early intervention and schizophrenia research will provide tutorials, supervision and consultation. The research and educational programs will be pursued at the Department of Psychiatry, Columbia University, in collaboration with researchers in a number of other institutions. The research project aims to investigate the impact of continuity of care on the course and outcome of the first admission patients with schizophrenia and affective psychoses. The impact of early treatment career on the subsequent course and outcome of psychotic of psychotic disorders has attracted much attention in recent years. This project focuses continuity of care which is an essential element of the early treatment career. Continuity of care is defined here as the degree to which the service system links episodes of treatment in a seamless whole. The impact of continuity of care on the short- and medium term course and outcome of patients in two samples will be examined: a) the Suffolk County Mental Health Project (SCMHP), an epidemiological longitudinal study of first admission psychotic patients in Suffolk County, New York, and b) the National Collaborative Study of Early Psychosis and Suicide (NCSEPS), a large- scale study of first admission patients with schizophrenia and affective psychoses among US military personnel with follow-up through VA services. The project has four specific aims, the first three pertain to the SCMHP sample and the fourth to the NCSEPS. The specific aims are, 1) to describe the treatment career of patients with schizophrenia and affective psychoses; 2) to study the impact of continuity of care in the early course of illness on the 24- and 48-month outcomes; 3) To determine whether the impact of continuity of care on outcomes is similar for different diagnostic groups; and 4) in the NCSEPS sample, toe examine the impact of discontinuity in the care of servicemen and -women who are admitted for the first time in the military hospitals with a diagnosis of schizophrenia or affective psychosis and are referred to the VA system for continuation of treatment after discharge.

建议开展一项为期五年的研究和教育计划，为主要研究者从事精神卫生服务研究的职业做好准备，重点关注严重精神障碍患者。候选人的长期研究目标是在针对这些患者群体的服务研究中应用流行病学的严格方法和分析工具，并研究他们的护理的最佳方法，特别是在疾病的早期阶段。这些知识对于为这一人群规划基于经验的服务至关重要。该计划有两个主要组成部分：教育计划和研究项目。教育计划涉及流行病学、生物统计学和心理健康服务研究方面的课程。此外，一批在精神流行病学、心理健康服务研究、早期干预和精神分裂症研究方面经验丰富的专家将提供指导、监督和咨询。研究和教育项目将在哥伦比亚大学精神病学系与许多其他机构的研究人员合作进行。该研究项目旨在调查连续性护理对首次入院的精神分裂症和情感精神病患者的病程和结果的影响。近年来，早期治疗生涯对精神障碍精神病患者后续病程和结局的影响引起了广泛关注。该项目侧重于护理的连续性，这是早期治疗生涯的重要组成部分。护理的连续性在这里定义为服务系统将治疗片段无缝地连接起来的程度。将检查两个样本中连续性护理对患者短期和中期病程和结果的影响：a) 萨福克县心理健康项目 (SCMHP)，这是一项针对萨福克县首次入院精神病患者的流行病学纵向研究，纽约，以及 b) 早期精神病和自杀国家合作研究 (NCSEPS)，这是一项针对美国军事人员中首次入院的精神分裂症和情感精神病患者的大规模研究通过 VA 服务进行跟进。该项目有四个具体目标，前三个目标涉及 SCMHP 样本，第四个目标涉及 NCSEPS。具体目的是，1）描述精神分裂症和情感性精神病患者的治疗生涯； 2) 研究病程早期持续护理对 24 个月和 48 个月结果的影响； 3) 确定不同诊断组的护理连续性对结果的影响是否相似； 4) 在 NCSEPS 样本中，旨在检查对首次入院、诊断为精神分裂症或情感性精神病并被转介至 VA 系统继续治疗的军人和妇女的护理中断的影响出院后的治疗情况。