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      The effects of a transitional discharge model for psychiatric patients.

      Journal of Psychiatric and Mental Health Nursing

      Acute Disease, Aftercare, organization & administration, Community Mental Health Services, Continuity of Patient Care, Health Services Research, Hospitals, Psychiatric, Humans, Interinstitutional Relations, Length of Stay, Mental Disorders, therapy, Models, Nursing, Models, Organizational, Nurse's Role, Nursing Evaluation Research, Patient Discharge, standards, statistics & numerical data, Patient Readmission, Pilot Projects, Program Evaluation, Psychiatric Nursing, Quality of Life, Scotland, Severity of Illness Index

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          This pilot randomized control trial was motivated by the discovery that many individuals with mental health problems are re-hospitalized within a year, with many being unable to fully adjust to community living. A solution was proposed in the form of an intervention called transitional discharge. The transitional discharge model included: (1) peer support, which is assistance from former patients who provide friendship, understanding and encouragement; and (2) overlap of inpatient and community staff in which the inpatient staff continue to work with the discharged patient until a working relationship is established with a community care provider. The overall aim of this study was to test the discharge model designed to assist patients discharged from acute admission wards to adjust to community living. This aim was tested through a number of related hypotheses, which suggest that, 5 months following discharge from an acute admission ward of a psychiatric hospital, individuals participating in a transitional discharge model: (1) report fewer symptoms; (2) report better levels of functioning; (3) have better quality of life; (4) are less likely to have been re-admitted to hospital. The study used a randomized experimental design with two conditions: experimental and usual treatment. In general, both the control and the experimental group demonstrated significant improvements in symptom severity and functional ability after 5 months. Usual treatment subjects in the control group were more than twice as likely to be re-admitted to hospital. This study needs to be replicated in Scotland with a larger sample and with a modified variation of the intervention called the Transitional Care Intervention.

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