Intervention Review

Day centres for severe mental illness

  1. Jocelyn Sarah Catty1,*,
  2. Tom Burns2,
  3. Adelina Comas3,
  4. Zoe Poole1

Editorial Group: Cochrane Schizophrenia Group

Published Online: 24 JAN 2007

Assessed as up-to-date: 13 NOV 2006

DOI: 10.1002/14651858.CD001710.pub2


How to Cite

Catty JS, Burns T, Comas A, Poole Z. Day centres for severe mental illness. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD001710. DOI: 10.1002/14651858.CD001710.pub2.

Author Information

  1. 1

    St. George's Hospital Medical School, Division of Mental Health, London, UK

  2. 2

    Warneford Hospital, Oxford, UK

  3. 3

    London School of Economics, PSSRU, London, UK

*Jocelyn Sarah Catty, Division of Mental Health, St. George's Hospital Medical School, Jenner Wing, Cranmer Terrace, London, SW17 ORE, UK. jcatty@sgul.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 24 JAN 2007

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要
  6. 摘要

Background

The number of people with severe mental illness who receive treatment whilst living at home has increased greatly over the last 30 years. Day centres and day hospitals frequently supplement this treatment.

Objectives

To determine the effects of non-medical day centre care for people with severe mental illness.

Search methods

We updated our search in September 2005. All databases and searches are detailed in the body of the text.

Selection criteria

We would have included all randomised controlled trials where seriously mentally ill people were allocated to non-medical day centre care.

Data collection and analysis

We reliably selected studies, quality rated them and extracted data. For dichotomous data, it had been hoped to estimate the fixed effects Relative Risk (OR) with 95% confidence intervals (CI) and the number needed to treat statistic (NNT). Analysis was to have been by intention-to-treat. Normal continuous data were to have been summated using the weighted mean difference (WMD) and scale data presented only for those tools that had attained pre-specified levels of quality.

Main results

Electronic searches identified over 300 citations but none were relevant to this review. We found no trials of non-medical day centres.

Authors' conclusions

We feel that the inclusion of any studies less rigorous than randomised trials would result in misleading findings and that it is not unreasonable to expect well designed, conducted and reported randomised controlled trials of day centre care. More precise nomenclature would greatly help identify relevant work. At present non-randomised comparative studies give conflicting messages about the roles provided by day centres and the clinical and social needs they are able to meet. It is therefore probably best that people with serious mental illness and their carers, if given the choice, take a pragmatic decision on which type of unit best meets their needs. There is a clear need for randomised controlled trials of day centre care compared to other forms of day care, and when resources are limited, day centre care within the context of a pragmatic randomised trial may be the only way of ensuring equity of provision.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要
  6. 摘要

Day centres for severe mental illness

The last 30 years have seen a large increase in the number of people with severe mental illness receiving treatment whilst living at home. Community care of the severely mentally ill is frequently enhanced by care provided by day centres run by non-medical services (Social Services in the UK, or the charitable sector). In this review we sought, but could not find, any evidence from well-conducted randomised trials of the effects of non-medical day centres. Day centres are currently becoming prominent in service planning, but this is not based on good evidence as to their effectiveness for people suffering from severe mental illness. If a choice between facilities is available, people with serious mental illnesses and their carers are currently left to make their own judgements based on the evidence of experience and a few non-randomised studies.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要
  6. 摘要

日间照护中心对于严重精神疾病患者的效果

研究背景

过去30年来,严重精神疾病患者住在自己家中并接受治疗的人数显著增加,而日间照护中心和日间病房则是担任配角的角色。

研究目的

确定非医疗机构的日间照护中心对严重精神疾病患者的效果。

检索方法

我们检索了截止到2005年9月发表的文献,所有的数据库和检索策略都详列在正文中。

纳入标准

纳入所有关于严重精神疾病患者在非医疗机构日间照护中心接受看护的随机对照试验。

数据收集与分析

我们严格地筛选研究,评估其质量,并提取数据。对于二分类变量资料,计算其固定效应模型RR值及其95%可信区间,以及NNT(需治疗例数),并进行意向性分析。对于正态分布的连续变量,使用WMD(加权均数差)来合并统计量;量表数据则只分析那些达到预设质量标准的测量工具所得的数据。

主要结果

电子检索到超过300条记录,但没有一篇跟本研究主题相关,即未检索到任何关于非医疗机构日间照护中心的报道。

作者结论

我们担心纳入不够严谨的研究可能会产生误导性的结果,因此期望纳入设计、实施和报告良好且针对日间照护中心的随机对照试验。虽然事与愿违,不过或许选择更精确的检索词能有助于找到符合条件的研究。目前,对于日间照护中心所担任的角色以及满足临床和社会需求方面,非随机的对比研究结论不一致。因此,严重精神疾病患者及家属最好还是根据本身的需求来选择最适当且实用的照护场所。对于比较日间照护中心和其他形式日间照护的效果,仍迫切需要相关的随机对照试验,如果资源有限,以实用为前提的随机试验或许是一个确保提供服务公平性的唯一方式。

 

概要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要
  6. 摘要

日间照护中心对于严重精神疾病患者的效果

日间照护中心对于严重精神疾病患者的效果

过去30年来,严重精神疾病患者住在自己家中并接受治疗的人数显著增加,这些患者的社区照护经常由非医疗机构日间照护中心来提供(在英国是属于一种社会服务或是隶属于慈善部门)。本系统评价未能检索到质量合格的随机试验来提供有关日间照护中心疗效的证据。目前,虽然日间照护中心正在成为重要的服务项目,但这并非是基于其为严重精神疾病患者提供了有效服务的可靠证据。因此,严重精神疾病患者和照顾者在选择照护机构时,恐怕只能根据经验和少数非随机研究自己做决定了。

翻译注解

本摘要由重庆医科大学中国循证卫生保健协作网(China Effective Health Care Network)翻译。

翻译注解":本摘要由重庆医科大学中国循证卫生保健协作网(China Effective Health Care Network)翻译。: China Effective Health Care Network

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. 概要
  6. 摘要

背景

嚴重精神疾病的日間照護

過去30年來,嚴重精神疾病患者住在自己家中並接受治療的人數顯著地增加,而日間照護中心和日間病房則是擔任配角的角色

目標

瞭解非醫療場所的日間照護中心對於嚴重精神疾患者的效果如何

搜尋策略

我們更新了2005年9月的搜尋結果。所有的資料庫和搜索經過都詳列在正文中

選擇標準

凡是嚴重精神疾病的患者被分派到非醫療場所的日間照護中心的所有隨機對照試驗都被納入

資料收集與分析

我們確實地選擇研究報告、評定它們的品質並同時擷取資料。對於二元變項資料,會去估計固定效應模式(fixed effects)下的相對危險值(relative risk)以及95%信賴區間(CI),同時也會計算出需要被治療的病人數目(NNT)這個統計數值;分析是採用只要被隨機指派的病人都必須要分析的方式來進行。對於連續變項則是使用加權平均差(WMD)來總結資料,而對於那些達到原先預設標準的測量工具則會呈現它的尺度資料

主要結論

使用電腦搜尋到超過300篇的文獻,但是沒有一篇跟這次的回顧文章主題相關,也就是說找不到針對非醫療機構的日間照護中心所做的研究試驗

作者結論

我們擔心如果選擇較不嚴謹的研究可能會產生誤導性的結果,因此希望可以找的到設計良好且針對日間照護中心的隨機對照試驗,雖然事與願違,不過或許選擇較精確的關鍵字詞能有助於進一步找到相關的研究報告。目前,對於日間照護中心所擔任的角色以及滿足臨床和社會需求上面,非隨機的比較性研究提供了不一致的訊息。因此,嚴重精神疾病患者及家屬最好還是根據本身的需求來選擇最適當且實用的照護場所。對於比較日間照護中心和其他形式的日間照護效果,目前仍迫切需要相關的隨機對照試驗,如果資源有限,以實用為前提的隨機試驗或許是一個確保提供服務正當性的唯一方式

翻譯人

本摘要由彰化基督教醫院胡淑惠翻譯

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

過去30年來,嚴重精神疾病患者住在自己家中並接受治療的人數顯著地增加,這些患者的社區照護經常由非醫療單位的日間照護中心來提供(在英國是屬於一種社會服務或是隸屬於慈善部門)。在這篇回顧文獻中,我們希望有但是卻找不到好的隨機試驗來提供有關日間照護中心療效的證據。目前,雖然日間照護中心在整個患者服務計畫中所佔的角色越來越重,但並非是根據它的療效證據。職是之故,嚴重精神疾病患者和照顧者在選擇照護機構時,恐怕只能根據經驗和少數非隨機研究來幫忙。