Implementing psychiatric interventions on a medical ward: effects on patients' quality of life and length of hospital stay

The authors investigated the effects of implementing psychiatric interventions on a general medical ward by means of a stepped detection and treatment strategy conducted by a consultation-liaison (CL) nurse in terms of reducing length of hospital stay (LOS) and improving quality of life (QOL) at dis...

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Bibliographic Details
Published in:Psychosomatic medicine 2003-11, Vol.65 (6), p.997-1002
Main Authors: de Jonge, Peter, Latour, Corine H M, Huyse, Frits J
Format: Article
Language:English
Subjects:
Adult
Aftercare
Aged
Female
Gastroenterology
Humans
Internal Medicine
Interview, Psychological
Length of Stay - statistics & numerical data
Male
Middle Aged
Patients - psychology
Patients' Rooms
Psychotherapeutic Processes
Quality of Life
Referral and Consultation
Risk
Severity of Illness Index
Surveys and Questionnaires
Urology Department, Hospital
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Summary:The authors investigated the effects of implementing psychiatric interventions on a general medical ward by means of a stepped detection and treatment strategy conducted by a consultation-liaison (CL) nurse in terms of reducing length of hospital stay (LOS) and improving quality of life (QOL) at discharge. One hundred ninety-three patients participated in a controlled trial, in which patients were screened with COMPRI and INTERMED. A nurse under supervision of a CL psychiatrist conducted interventions, consisting of simple psychiatric interventions by herself, referral to auxiliary services, or initiation of postdischarge care. Intervention patients were compared with historic controls on LOS and QOL (SF36) at discharge. In multivariate analysis of variance, a significant effect of the intervention on QOL (p = 0.037) was found, which diminished after controlling for confounders (p = 0.28). No significant effect on LOS was found for the whole sample (p = 0.72), but in patients age 65 years or older, a reduction in LOS (p = 0.05) was found. This effect remained after controlling for confounders (p = 0.06). These data suggest that screening for risk of increased health care might improve outcomes in general medical inpatients. Because of the design of the study, however, these findings should be considered preliminary and confirmed in a larger, multicenter, randomized controlled trial.
ISSN:1534-7796
DOI:10.1097/01.PSY.0000097332.77685.C8