Development of a Care Model for Psychiatric Patients with Substance Use Disorders In the Acute Phase: Inpatient Services at Thawatchaburi Hospital
Keywords:
Substance-related psychiatric disorders, Acute phase care, Care model, Inpatient serviceAbstract
Purposes: This study aimed to assess the current situation and problems related to the care of patients with substance-induced psychiatric disorders in the acute phase, to develop an appropriate care model, implement it in practice, and evaluate and refine the model for use in inpatient settings.
Study Design: Research and Development (R&D).
Materials and Methods: A research and development design was employed. Data on 108 patients admitted with acute psychiatric complications related to substance abuse were collected from medical records. Focus group discussions were conducted with 19 key informants. The developed model was then implemented with 13 registered nurses and 43 purposively selected acute psychiatric patients. Data were collected through questionnaires and record forms and analyzed using frequency, percentage, mean, and standard deviation.
Main findings: Problems in acute care were identified at four levels: patients and their relatives, service providers, service systems, and medical equipment and supplies. The care model developed for acute substance-related psychiatric patients consisted of five steps: (1) preparation of personnel and readiness, (2) triage and admission, (3) area modification, (4) treatment process, and (5) admission to inpatient ward and discharge. Implementation of the model resulted in a reduced number of acute-phase hospitalization days (minimum = 3 days; maximum = 12 days), with 29 patients (44.18%) remaining in the acute phase for 7 days. A total of 32 patients (74.41%) successfully completed both the acute and IMC treatment phases. Overall, nurses’ satisfaction with the care model was at the highest level (Mean = 4.52, SD. = 0.44).
Conclusion and recommendations: The developed model effectively reduced the length of acute-phase hospital stay and enhanced treatment success, while yielding high satisfaction among service providers. Therefore, the model should be expanded to network hospitals and supported with adequate equipment and system resources. Continuous monitoring and evaluation are recommended to ensure suitability and sustainability in different contexts.
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