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Persons who frequently visit the psychiatric emergency room: who are they and what are their needs?
Kristianstad University, School of Health and Society. Kristianstad University, Research Platform for Collaboration for Health. Lunds universitet.ORCID iD: 0000-0002-3113-6432
2018 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Persons who frequently visit psychiatric emergency rooms (PERs) account for a disproportionately high number of total visits to PERs. They have needs just as any other human beings do. Yet in addition, they also have specific daily function needs, service needs, and needs for professional healthcare.  The overall aim of this thesis was to investigate who persons frequently visiting PERs in Sweden are and what needs they have. Both studies I and II were conducted in southern Sweden. Study I is a quantitative mapping study describing who persons who frequently visit PERs are, what characterizes them, and what characterizes their visits, while study II investigates their self-expressed and selfassessed needs using a mixed-methods design.  For data collection, a large-scale registry was used in study I, while in study II an interviewer-administered manual was applied consisting of open-ended questions and validated instruments covering the person-in-care’s needs assessment, alcohol and drug use, exposure to violence, and social network. Quantitative data were analysed using descriptive statistics and non-parametric tests (I, II) and qualitative data were analysed using qualitative content analysis (II).  The results indicate that persons who frequently visit PERs represented 8.1% of the total number of PER visitors but accounted for 38.3% of the total number of PER visits (I). They differed significantly from the rest of the PER visitors in terms of gender, diagnoses, hospital admissions, and temporal patterns of visits. Differences were also found in the distance between the PERs and the home municipalities of the visitors (I). In addition, they reported problems in many need areas in life, involving physical and psychiatric health problems as well as financial, emotional, and social problems (II). Results also indicate that they are often subject to violence and have limited social networks (II).  The results may be used for planning, developing, and evaluating interventions targeting the needs of persons who frequently visit PERs, which is in line with a person-centred approach. Such an approach might eventually address their needs better, reduce their suffering, and consequently result in fewer PER visits.  

Place, publisher, year, edition, pages
Lund: Media Tryck, Lund University , 2018. , p. 65
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:hkr:diva-19024OAI: oai:DiVA.org:hkr-19024DiVA, id: diva2:1284625
Available from: 2019-02-07 Created: 2019-02-01 Last updated: 2019-02-15Bibliographically approved
List of papers
1. Clinical profiles and temporal patterns of psychiatric emergency room visitors in Sweden
Open this publication in new window or tab >>Clinical profiles and temporal patterns of psychiatric emergency room visitors in Sweden
2018 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 72, no 3, p. 197-204Article in journal (Refereed) Published
Abstract [en]

AIMS: To describe persons visiting the psychiatric emergency room (PER) in Sweden and to compare persons who frequently (PFV) and infrequently (PIFV) visit PERs in terms of group size, age, gender, PER location inside versus outside the home municipality, diagnosis (ICD 10), temporal patterns of visits and hospital admissions.

METHODS: This register study included all visits to PERs in one Swedish county over 3 years, 2013-2015 (N = 67,031 visits). The study employed descriptive statistics as well as Chi-square tests combined with Bonferroni correction to compare PFV with PIFV.

RESULTS: Of the total of 27,282 visitors, 2201 (8.1%) were identified as PFV (five or more visits within 12 months) and they accounted for 38.1% of the total visits. The study found differences between PFV and PIFV in gender, diagnostic profile, hospital admissions and temporal patterns. Differences were also detected with regard to distance between PERs and home municipalities. However, no age-related differences were found between the two groups.

CONCLUSIONS: PFV and PIFV have different clinical profiles and temporal patterns. These results may be important when planning, developing and evaluating interventions targeting the needs of each group, which is in accordance with a person-centred approach. Such an approach might eventually result in fewer visits to PERs.

Keywords
Visitors, diagnosis, hospital admissions, psychiatric emergency, temporal patterns
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-17722 (URN)10.1080/08039488.2017.1417477 (DOI)000424948600007 ()29254427 (PubMedID)
Available from: 2017-12-20 Created: 2017-12-20 Last updated: 2019-02-01Bibliographically approved
2. Self-reported needs for care, support and treatment of persons who frequently visit psychiatric emergency rooms in Sweden
Open this publication in new window or tab >>Self-reported needs for care, support and treatment of persons who frequently visit psychiatric emergency rooms in Sweden
2018 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIM: To investigate self-reported needs for care, support and treatment among persons who frequently visit psychiatric emergency rooms (PERs).

DESIGN: A cross-sectional design. Qualitative and quantitative data were collected using an interview-based manual. Qualitative data were analysed using content analysis, whereas quantitative data were analysed using descriptive, non-parametric statistical tests.

RESULTS: Persons who frequently visit PERs self-reported unmet needs for care, support and treatment in life domains such as health, socialisation, daytime activities, and emotional and financial security.

CONCLUSION: To meet the needs of persons who frequently visit PERs, close cooperation between concerned welfare actors should be implemented.

National Category
Other Medical Sciences
Identifiers
urn:nbn:se:hkr:diva-18566 (URN)10.1080/01612840.2018.1481471 (DOI)30111203 (PubMedID)
Available from: 2018-08-21 Created: 2018-08-21 Last updated: 2019-02-01Bibliographically approved

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34567896 of 23
CiteExportLink to record
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