Intervenções promotoras da transição e continuidade de cuidados em contexto psiquiátrico: scoping review

Autores

DOI:

https://doi.org/10.29352/mill0216e.35345

Palavras-chave:

sintomatologia psicótica, intervenções ponte, alta, transição, ambulatório, enfermagem

Resumo

Introdução: A transição entre o internamento e o ambulatório, em serviços de psiquiatria, é um período de elevada vulnerabilidade, particularmente quando existe sintomatologia psicótica. São recomendadas intervenções para garantir a transição segura e promover a continuidade dos cuidados, nomeadamente intervenções tipo ponte.

Objetivo: Mapear as intervenções realizadas durante a transição de cuidados entre o internamento e o ambulatório, para pessoas com sintomatologia psicótica.

Métodos: Revisão scoping segundo metodologia do JBI. Realizada em bases de dados, desde 2010, em inglês, português e espanhol. Seleção de estudos e extração de dados concretizada por dois autores independentes.

Resultados: Foram identificadas 12 intervenções classificadas relativamente às características (formato, tipo de abordagem, setting e duração) e às componentes (conteúdos, estratégias de transição e consulta pós-alta) promotoras da transição de cuidados após internamento de psiquiatria a pessoas com sintomatologia psicótica.

Conclusão: É consensual que intervenções ponte devem integrar intervenções educativas e relacionais, mediadas por um gestor de transição, papel maioritariamente desempenhado por enfermeiros. É importante a conceção de orientações a implementar nos serviços para facilitar a transição entre o internamento e o ambulatório.

Downloads

Referências

Batscha, C., McDevitt, J., Weiden, P., & Dancy, B. (2011). The effect of an inpatient transition intervention on attendance at the first appointment postdischarge from a psychiatric hospitalization. Journal of the American Psychiatric Nurses Association, 17(5), 330–338. https://doi.org/10.1177/1078390311417307

Chiverton, P., Tortoretti, D., La Forest, M., & Walker, P. H. (1999). Bridging the gap between psychiatric hospitalization and community care: Cost and quality outcomes. Journal of the American Psychiatric Nurses Association, 5(2), 46–53. https://doi.org/10.1016/S1078-3903(99)90019-8

Corrigan, P., Talluri, S., & Shah, B. (2022). Formal peer-support services that address priorities of people with psychiatric disabilities: A systematic review. American Psychologist, 77(9), 1104–1116. https://doi.org/10.1037/amp0001039

Cuffel, B. J., Held, M., & Goldman, W. (2002). Predictive models and the effectiveness of strategies for improving outpatient follow-up under managed care. Psychiatric Services, 53(11), 1438–1443. https://doi.org/10.1176/appi.ps.53.11.1438

Dixon, L., Goldberg, R., Lannone, V., Lucksted, A., Brown, C., Kreyenbuhl, J., Fang, L., & Potts, W. (2009). Use of a critical time intervention to promote continuity of care after psychiatric inpatient hospitalization. Psychiatric Services, 60(4), 451–458. https://doi.org/10.1176/ps.2009.60.4.451

Forchuk, C., Martin, M. L., Chan, Y. L., & Jensen, E. (2005). Therapeutic relationships: From psychiatric hospital to community. Journal of Psychiatric and Mental Health Nursing, 12(5), 556–564. https://doi.org/10.1111/j.1365-2850.2005.00873.x

Habit, N., Johnson, E., & Edlund, B. (2018). Appointment reminders to decrease 30-day readmission rates to inpatient psychiatric hospitals. Professional Case Management, 23(2), 70–74. https://doi.org/10.1097/NCM.0000000000000248

Hansen, L. O., Young, R. S., Hinami, K., Leung, A., & Williams, M. V. (2011). Interventions to reduce 30-day rehospitalization: A systematic review. Annals of Internal Medicine, 155(8), 520–528. https://doi.org/10.7326/0003-4819-155-8-201110180-00008

Healthcare Effectiveness Data and Information Set (HEDIS). (2021). Follow-up after hospitalization for mental illness. https://www.ncqa.org/hedis/measures/follow-up-after-hospitalization-for-mental-illness

Hegedüs, A., Kozel, B., Richter, D., & Behrens, J. (2020). Effectiveness of transitional interventions in improving patient outcomes and service use after discharge from psychiatric inpatient care: A systematic review and meta-analysis. Frontiers in Psychiatry, 10, 969. https://doi.org/10.3389/fpsyt.2019.00969

Kasprow, W. J., & Rosenheck, R. A. (2007). Outcomes of critical time intervention case management of homeless veterans after psychiatric hospitalization. Psychiatric Services, 58(7), 929–935. https://doi.org/10.1176/ps.2007.58.7.929

Khaleghparast, S., Ghanbari, B., Kahani, S., Malakouti, K., SeyedAlinaghi, S., & Sudhinaraset, M. (2013). The effectiveness of discharge planning on the knowledge, clinical symptoms, and hospitalization frequency of persons with schizophrenia: A longitudinal study in two hospitals in Tehran, Iran. Journal of Clinical Nursing, 23(15–16), 2215–2221. https://doi.org/10.1111/jocn.12499

Lam, M., Li, L., Anderson, K. K., Shariff, S. Z., & Forchuk, C. (2019). Evaluation of the transitional discharge model on use of psychiatric health services: An interrupted time series analysis. Journal of Psychiatric and Mental Health Nursing, 27(2), 172–184. https://doi.org/10.1111/jpm.12562

Lin, L. E., Lo, S. C., Liu, C. Y., Chen, S. C., Wu, W. C., & Liu, W. I. (2018). Effectiveness of needs-oriented hospital discharge planning for caregivers of patients with schizophrenia. Archives of Psychiatric Nursing, 32(2), 180–187. https://doi.org/10.1016/j.apnu.2017.10.013

Maples, N. J., Copeland, L. A., Zeber, J. E., Li, X., Moore, T. A., Dassori, A., Velligan, D. I., & Miller, A. L. (2012). Can medication management coordinators help improve continuity of care after psychiatric hospitalization? Psychiatric Services, 63(6), 554-560. https://doi.org/10.1176/appi.ps.201100264

Meleis, A. I. (Ed.). (2010). Transitions theory: Middle range and situation-specific theories in research and nursing practice. Springer Publishing Company.

Moitra, E., Park, H., & Gaudiano, B. (2021). Development and initial testing of an mHealth transitions of care intervention for adults with schizophrenia-spectrum disorders immediately following a psychiatric hospitalization. The Psychiatric Quarterly, 92(1), 259–272. https://doi.org/10.1007/s11126-020-09792-9

Olfson, M., Mechanic, D., Boyer, C. A., & Hansell, S. (1998). Linking inpatients with schizophrenia to outpatient care. Psychiatric Services, 49(7), 911–917. https://doi.org/10.1176/ps.49.7.911

Owusu, E., Oluwasina, F., Nkire, N., Lawal, M. A., & Agyapong, V. I. O. (2022). Readmission of patients to acute psychiatric hospitals: Influential factors and interventions to reduce psychiatric readmission rates. Healthcare (Basel, Switezerland), 10(9):1808. https://doi.org/10.3390/healthcare10091808

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71

Peters, M. D. J., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C., & Khalil, H. (2020). Chapter 11: Scoping Reviews. In E. Aromataris & Z. Munn (Eds.), JBI Manual for Evidence Synthesis. JBI. https://doi.org/10.46658/JBIMES-20-12

Price, L. M. (2007). Transition to community: A program to help clients with schizophrenia move from inpatient to community care; A pilot study. Archives of Psychiatric Nursing, 21(6), 336-344. https://doi.org/10.1016/j.apnu.2006.11.005

Raluthaga, N., Shilubane, H. N., & Lowane, M. P. (2023). Relapse among MHCUs after a short-term admission in an acute psychiatric unit: Primary caregivers' perspective. International Journal of Environmental Research and Public Health, 20(2), 1384. https://doi.org/10.3390/ijerph20021384

Reynolds, W., Lauder, W., Sharkey, S., Maciver, S., Veitch, T., & Cameron, D. (2004). The effects of a transitional discharge model for psychiatric patients. Journal of Psychiatric and Mental Health Nursing, 11(1), 82-88. https://doi.org/10.1111/j.1365-2850.2004.00692.x

Shaw, H., Mackie, C. A., & Sharkie, I. (2000). Evaluation of effect of pharmacy discharge planning on medication problems experienced by discharged acute admission mental health patients. The International Journal of Pharmacy Practice, 8(2), 144-153. https://doi.org/10.1111/j.2042-7174.2000.tb00999.x

Smith, T. E., Haselden, M., Corbeil, T., Wall, M. M., Tang, F., Essock, S. M., Frimpong, E., Goldman, M. L., Mascayano, F., Radigan, M., Schneider, M., Wang, R., Dixon, L. B., & Olfson, M. (2020). Effect of scheduling a post-discharge outpatient mental health appointment on the likelihood of successful transition from hospital to community-based care. The Journal of Clinical Psychiatry, 81(5), 20m13344. https://doi.org/10.4088/JCP.20m13344

Tyler, N., Wright, N., & Waring, J. (2019). Interventions to improve discharge from acute adult mental health inpatient care to the community: Systematic review and narrative synthesis. BMC Health Services Research, 19(1), 883. https://doi.org/10.1186/s12913-019-4658-0

Vigod, S. N., Kurdyak, P. A., Dennis, C. L., Leszcz, T., Taylor, V. H., Blumberger, D. M., & Seitz, D. P. (2013). Transitional interventions to reduce early psychiatric readmissions in adults: Systematic review. The British Journal of Psychiatry, 202(3), 187–194. https://doi.org/10.1192/bjp.bp.112.115030

Virgolesi, M., Pucciarelli, G., Colantoni, A. M., D'Andrea, F., Di Donato, B., Giorgi, F., Landi, L., Salustri, E., Turci, C., & Proietti, M.G. (2017). The effectiveness of a nursing discharge programme to improve medication adherence and patient satisfaction in the psychiatric intensive care unit. Journal of Clinical Nursing, 26(23-24), 4456-4466. https://doi.org/doi: 10.1111/jocn.13776

Xiao, S., Tourangeau, A., Widger, K., & Berta, W. (2019). Discharge planning in mental healthcare settings: A review and concept analysis. International Journal of Mental Health Nursing, 28(4), 816–832. https://doi.org/10.1111/inm.12599

Downloads

Publicado

2025-02-14

Como Citar

Nunes, L., Fernandes, S., Fonseca, V., Pereira, F., Grácio, J., Santos, D., & Melo, C. (2025). Intervenções promotoras da transição e continuidade de cuidados em contexto psiquiátrico: scoping review. Millenium - Journal of Education, Technologies, and Health, 2(16e), e35345. https://doi.org/10.29352/mill0216e.35345

Edição

Secção

Ciências da vida e da saúde