PREVALENCE AND ASSOCIATED FACTORS WITH MISSED FIRST APPOINTMENTS AFTER DISCHARGE AMONG PATIENTS WITH SCHIZOPHRENIA

Abstract

Objective: To determine the prevalence and associated factors with missed first appointments after discharge among patients with schizophrenia.

Material and Methods: The study used mixed methods. The sample was 331 Schizophrenic patients with missed first appointments after discharge from Somdet Chaopraya Institute of Psychiatry between January 1st to December 31st, 2017. Semi-structured interview and questionnaires were used to interview while frequency, percentage, mean, and multiple regression were used to analyze quantitative data.

Results: Majority of the participants were male (67.4%) with age ranging 40.7 + 11.9 years old and lived in the area of health service network region 13, Bangkok (68.6%). They mostly were non-educated to primary school education (34.7%), being unemployed (67.7%), self-payment (57.4%), taking to hospital by parents (44.4%) and average duration of illness was 10.8 + 9.2 years. Prevalence of missed first appointments after discharge among patients with schizophrenia at Somdet Chaopraya Institute of Psychiatry was 22.1%. The significant factors associated with missing the first appointment after discharge (p<0.05) were secondary school education / vocational certificate, symptoms of agitation and aggression before hospital admission and the causes of default included; insufficient knowledge ofabout mental illness, poor medication adherence and social support.

Conclusion: Therefore, research outcome should be utilized for health care provider. In their roles, they can promote caregivers or patient readiness preparing before hospital discharge in the advantage of attending the outpatient clinic for follow-up. In addition, this disadvantages from missed appointment should be explained. The workers also should provide knowledege in medication compliance to patients.