Abstract：
UNASSIGNED: Extensive psychiatric hospitalization due to repeated severe self-harm (SH), is a poorly researched area, but a challenge within health services (HS). Recent studies have demonstrated high levels of involuntary treatment among patients with severe personality disorder (PD) and complex comorbidity. Keeping focus on extensively hospitalized SH patients, this study aimed to investigate patients\' and clinicians\' evaluation of HS and treatment alliance.
UNASSIGNED: A cross-sectional study with an inpatient sample (age >18 years) with frequent (>5) or long (>4 weeks) psychiatric hospital admissions last year due to SH or SA recruited from 12 hospitals across health regions (N = 42). Evaluation included patient and clinician report.
UNASSIGNED: A minority of the patients (14%) were satisfied with HS before the current admission, 45% (patients) and 20% (clinicians) found the current admission helpful, and 46% (patients) and 14% (clinicians) worried about discharge. Treatment complaints were received in 38% of the cases. Outpatient mental HS were available after discharge for 68% and a majority of clinicians indicated satisfactory contact across HS. More intensive or specialized formats were unusual (structured outpatient treatment 35%, day treatment 21%, ambulatory services 32%, planned inpatient services 31%). Mutual problem understanding, aims, and confidence in therapists during the hospital stay were limited (patient-rated satisfactory mutual problem understanding: 39%, aims of stay: 50%, confidence: 50%). Patient and therapist alliance-ratings were in concordance for the majority.
UNASSIGNED: The study highlights poor HS satisfaction, poor patient-therapist coherence, limited treatment alliance and limited follow-up in structured treatments addressing SH or intermediary supportive ambulatory/day/inpatient services.
UNASSIGNED: A cross-sectional study with an inpatient sample (age >18 years) with frequent (>5) or long (>4 weeks) psychiatric hospital admissions last year due to SH or SA recruited from 12 hospitals across health regions (N = 42). Evaluation included patient and clinician report.
UNASSIGNED: A minority of the patients (14%) were satisfied with HS before the current admission, 45% (patients) and 20% (clinicians) found the current admission helpful, and 46% (patients) and 14% (clinicians) worried about discharge. Treatment complaints were received in 38% of the cases. Outpatient mental HS were available after discharge for 68% and a majority of clinicians indicated satisfactory contact across HS. More intensive or specialized formats were unusual (structured outpatient treatment 35%, day treatment 21%, ambulatory services 32%, planned inpatient services 31%). Mutual problem understanding, aims, and confidence in therapists during the hospital stay were limited (patient-rated satisfactory mutual problem understanding: 39%, aims of stay: 50%, confidence: 50%). Patient and therapist alliance-ratings were in concordance for the majority.
UNASSIGNED: The study highlights poor HS satisfaction, poor patient-therapist coherence, limited treatment alliance and limited follow-up in structured treatments addressing SH or intermediary supportive ambulatory/day/inpatient services.
摘要：
■由于反复严重的自我伤害（SH）而导致的精神科住院，是一个研究不足的领域，但在卫生服务（HS）的挑战。最近的研究表明，严重人格障碍（PD）和复杂合并症患者的非自愿治疗水平很高。关注广泛住院的SH患者，本研究旨在调查患者和临床医生对HS和治疗联盟的评估。
■一项横断面研究，其中包括住院患者样本（年龄>18岁），去年因SH或SA而频繁（>5）或长期（>4周）精神病医院入院。从健康地区的12家医院招募（N=42）。评估包括患者和临床医生报告。
■少数患者（14%）在入院前对HS感到满意，45%(患者)和20%(临床医生)认为目前的入院有帮助，46%(患者)和14%(临床医生)担心出院。38%的案件收到治疗投诉。出院后有68％的门诊精神性HS，大多数临床医生表示在整个HS之间有令人满意的联系。更密集或更专业的形式是不寻常的(结构化门诊治疗35%，日治疗21%，门诊服务32%,计划住院服务31%)。相互的问题理解，目标,并且在住院期间对治疗师的信心有限（患者评分满意的相互问题理解：39％，住宿目标：50%，置信度：50%）。大多数患者和治疗师联盟的评级是一致的。
■这项研究强调了HS满意度差，患者-治疗师的一致性差，有限的治疗联盟和有限的结构化治疗随访，解决SH或中间支持性门诊/日间/住院服务。
■一项横断面研究，其中包括住院患者样本（年龄>18岁），去年因SH或SA而频繁（>5）或长期（>4周）精神病医院入院。从健康地区的12家医院招募（N=42）。评估包括患者和临床医生报告。
■少数患者（14%）在入院前对HS感到满意，45%(患者)和20%(临床医生)认为目前的入院有帮助，46%(患者)和14%(临床医生)担心出院。38%的案件收到治疗投诉。出院后有68％的门诊精神性HS，大多数临床医生表示在整个HS之间有令人满意的联系。更密集或更专业的形式是不寻常的(结构化门诊治疗35%，日治疗21%，门诊服务32%,计划住院服务31%)。相互的问题理解，目标,并且在住院期间对治疗师的信心有限（患者评分满意的相互问题理解：39％，住宿目标：50%，置信度：50%）。大多数患者和治疗师联盟的评级是一致的。
■这项研究强调了HS满意度差，患者-治疗师的一致性差，有限的治疗联盟和有限的结构化治疗随访，解决SH或中间支持性门诊/日间/住院服务。
