Последние достижения амбулаторной психиатрической помощи в Японии: нарративный обзор

18

Аннотация

ВВЕДЕНИЕ: С 1950-х годов психиатрическая помощь в Японии была главным образом сосредоточена в стационарах. В 1995 г. в законодательство был внесен ряд изменений, которые подчеркнули важность амбулаторной психиатрической помощи. Однако, несмотря на попытки развития системы амбулаторной психиатрической помощи, уровень стационарного лечения остается высоким, а переход от больничного лечения к амбулаторному так и не осуществился в полной мере.
ЦЕЛЬ: Целью данного исследования является обзор доступной литературы, посвященной развитию амбулаторной психиатрической помощи в Японии в период с 2010 по 2020 гг.
МЕТОДЫ: Мы провели стандартизированный литературный поиск в электронной базе данных Igaku Chuo Zasshi с целью найти оригинальные исследования об амбулаторной психиатрической помощи в Японии, опубликованные в период с 2010 по 2020 гг. Результаты выбранных исследований были классифицированы как опросы эффективности, отчеты пользователей услуг, отчеты поставщиков услуг и образовательные мероприятия. В настоящем обзоре использован описательно-аналитический метод.
РЕЗУЛЬТАТЫ: Всего включено 25 исследований. В шести исследованиях сообщалось об опросах, оценивающих эффективность амбулаторной психиатрической помощи в проведении ассертивной амбулаторной терапии, принудительного лечения, сестринского ухода на дому, соматических осложнений и социально-медицинском сотрудничестве на отдаленных островах. В четырех исследованиях изучали представления потребителей услуг или их семей о сестринском уходе на дому, социализацию, общественные программы и изменения в законодательстве. Десять исследований были посвящены социальному отчуждению, представлениям поставщиков услуг о потребностях населения, навыкам обслуживания, программам ухода и профессиональному росту психиатрических социальных работников. Пять исследований были посвящены подходам к обучению будущих медицинских работников и мерам по повышению грамотности подростков в вопросах психического здоровья.
ЗАКЛЮЧЕНИЕ: В данной статье представлен первый всеобъемлющий обзор амбулаторной психиатрической помощи в Японии. В период с 2010 по 2020 гг. в Японии наблюдалось развитие амбулаторной психиатрической помощи во многих областях благодаря растущему пониманию необходимости удовлетворения существующей потребности. Наиболее изученными и разработанными видами помощи можно считать сестринский уход на дому и ассертивную амбулаторную терапию (AАT). Исследования, в которых используется строгая методология, такая как рандомизированные контролируемые испытания, необходимы, если целью является получение надежных выводов.

Общая информация

Ключевые слова: амбулаторные условия, добровольность, принудительное лечение лиц с психическими расстройствами, уход

Рубрика издания: Специальные статьи

Тип материала: научная статья

DOI: https://doi.org/10.17816/CP199

Получена: 30.06.2022

Принята в печать:

Для цитаты: Иватани Д., Ито Д., Тагучи Ю., Акияма Ц. Последние достижения амбулаторной психиатрической помощи в Японии: нарративный обзор // Consortium Psychiatricum. 2022. Том 3. № 4. С. 63–74. DOI: 10.17816/CP199

Литература

  1. Thornicroft G, Alem A, Dos Santos RA, et al. WPA guidance on steps, obstacles and mistakes to avoid in the implementation of community mental health care. World Psychiatry. 2010 Jun; 9(2):67–77. doi: 10.1002/j.2051-5545.2010.tb00276.x. PMID: 20671888. PMCID: PMC2911080.
  2. Semrau M, Barley EA, Law A, Thornicroft G. Lessons learned in developing community mental health care in Europe. World Psychiatry. 2011 Oct;10(3):217–25. doi: 10.1002/j.2051-5545.2011.tb00060.x. PMID: 21991282. PMCID: PMC3188777.
  3. Thornicroft G, Tanella M. Better mental health care. New York: Cambridge University Press; 2009. 178 р.
  4. Rose N. Historical changes in mental health practice. In: Oxford textbook of community mental health. New York: Oxford University Press; 2011. p. 9–18.
  5. Goffman E. Stigma: notes on the management of spoiled identity. New York: Simon & Schuster; 1963.
  6. Green G. The end of stigma? Changes in the social experience of long-term illness. Oxford: Routledge; 2009. 176 р.
  7. Thornicroft G, Deb T, Henderson C. Community mental health care worldwide: current status and further developments. World Psychiatry. 2016 Oct;15(3):276–286. doi: 10.1002/wps.20349. PMID: 27717265. PMCID: PMC5032514.
  8. Slade M, Davidson L. Recovery as an integrative paradigm in mental health. In: Oxford textbook of community mental health. New York: Oxford University Press; 2011. p. 26–33.
  9. Gaebel W, Kerst A, Janssen B, et al. EPA guidance on the quality of mental health services: A systematic meta-review and update of recommendations focusing on care coordination. European Psychiatry. 2020 Jul;63(1):e75. doi: 10.1192/j.eurpsy.2020.75. PMID: 32703326. PMCID: PMC7443789.
  10. Junichiro Ito. Seishinka byouin o dete machi e — ACT ga tsukuru chiiki seishin iryou [Out of the psychiatric hospital and into the city — community mental health system built up with ACT]. 5th printing. Tokyo: Iwanami Shoten, Publishers; 2022. Japanese.
  11. National Institute of Mental Health, National Center of Neurology and Psychiatry [Internet]. ‘Visions in reform of mental health and medical welfare’ research page. Tokyo; 2009 [cited 2021 Oct 14]. Available from: https://www.ncnp.go.jp/nimh/keikakuold/old/archive/vision/index_e.html. Japanese.
  12. Boland M, Cherry MG, Dickson R. Defining my review question and identifying inclusion and exclusion criteria. Doing a systematic review. 2nd ed. London: Sage publications; 2017.
  13. Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation. Int J Evid Based Healthc. 2015 Sep;13(3):179–87. doi: 10.1097/XEB.0000000000000062. PMID: 26262565.
  14. Yoshida K, Setoya Y, Setoya N, et al. Functional differentiation of psychiatric community outreach services for people with severe mental illness in Japan. Comparison of services between assertive community treatment and visiting nursing. Japanese Journal of Psychiatric Rehabilitation. 2011 Jan;15(1): 54–63. Japanese.
  15. Yoshida K, Setoya Y, Setoya N, et al. Functional differentiation of psychiatric community outreach services for people with severe mental illness in Japan. Comparison of services between assertive community treatment and visiting nursing: 1 year follow-up study. Japanese Journal of Psychiatric Rehabilitation. 2013 Jan;17(1):39–49. Japanese.
  16. Nagata T, Hirabayashi N, Tachimori H, et al. Outcomes of Forensic Patients Post-discharge from Designated Facilities under the MTS Act in Japan. Clinical Psychiatry. 2016 Jul;58(7):633–43. Japanese.
  17. Tsujimoto T, Harada S, Nakahara Y, et al. Transition from medical treatment under medical treatment and supervision act to community health and welfare support activities under mental health and welfare act: from the standpoint of public health center/mental health and welfare center. Japanese Journal of Forensic Mental Health. 2017;12(1):83–9. Japanese.
  18. Noguchi M. Psychiatric disorder and physical illness from the viewpoint of community mental health. Japanese Journal of Psychiatric Treatment. 2014;29(2):187–92. Japanese.
  19. Hanashiro S, Morita Y. The concept of multi-agency outreach support. The practice of community life support for the mentally ill in a remote island area. Japanese Bulletin of Social Psychiatry. 2016;25(3):213–20. Japanese.
  20. Narita T, Yamazaki Y. Viewpoints on Community Mental Health Services among Persons with Schizophrenia: Focus on Municipal Public Health Nurse’s Individual Care. Yamanashi Nursing Journal;2014;12(2):1–6. Japanese.Narita T, Yamazaki Y. Viewpoints on community mental health services among persons with schizophrenia: Focus on municipal public health nurse’s individual care. Yamanashi Nursing Journal. 2014;12(2):1–6. Japanese.
  21. Inoue C, Sasaki Y, Komagata M, et al. Evaluation of volunteer activities conducted by Community living mentally disabled persons: effects of participation and environmental requirements for such effects. Japanese Journal of Human Sciences of Health-Social Services. 2011;17(2):39–49. Japanese.
  22. Komatsu Y. Stigma kara no kokufuku o mezashita jusou teki group program: Touji-sha to kazoku to shien-sha ga tsudou chiiki seishin hoken program no pilot study [A multilayered group program heading for overcoming stigma: pilot study of community mental health program gathering the users, their families, and the suppoters]. The Japanese Journal of Psychiatric Nursing. 2020;47(7):49–55. Japanese.
  23. Matsushita T. The evaluation of the family members of the mentally disabled on the Revision of guardianship system and hospitalization system in mental health care. Japanese Journal of Study in Addiction Nursing. 2018;15(2):31–45. Japanese.
  24. Tsujimoto T, Shirakawa N, Harada Y, et al. Current situation and challenges of community support services for Hikikomori individuals in cooperation with public health centers and mental health and welfare centers: A nationwide questionnaire survey. Psychiatria et neurologia Japonica. 2019;121(7):527–39. Japanese.
  25. Hirokawa S, Oyama S, Oshima I, et al. Outreach for people with mental health assistance: Needs of change in community mental health outreach support. Journal of health care, medicine and Community. 2013;22(4):343–57. Japanese.
  26. Yoshioka-Maeda K, Kuroda M. Assessment strategies used by clinical supervisors focusing on community mental health care: A cross-sectional study. Asian Pacific J Dis Management. 2017;8(3-4):35–44.
  27. Okada T. Structure and characteristics of technical support that psychiatric social workers of prefectural governments provide for municipalities. Japanese Journal Public Health. 2017;64(10): 607–18. Japanese.
  28. Suzuki Y, Fukasawa M, Kim Y. Preparedness for disaster mental health among public health nurses in Japan. Japanese Journal of Traumatic Stress. 2010;8(1):45–53. Japanese.
  29. Fujisawa M, Otsuka K, Nakamura H, et al. Relationship between experience of support of clinical psychologists in mental health and welfare activities in disaster-stricken areas and skill proficiency level. J Iwate Med Assiociation. 2019;71(5):162–82. doi: 10.24750/iwateishi.71.5_162.
  30. Taneda A, Suzuki Y, Fukasawa M, et al. Rebuilding community mental health system and external support after the Great East Japan Earthquake: Focus group interviews on external supports among local caregivers. Japanese Journal Family Therapy. 2016;33(3):74–82. Japanese.
  31. Yamamoto A, Mizusaki Y, Ono Y. Implications for roles of psychiatrists in child welfare center: Child welfare center’s support for a boy with attention-dificit/hyperactivity disorder and conduct disorder. Japanese Journal Psychiatric Treatment. 2010;25(10):1391–5. Japanese.
  32. Yoshino K, Komatsu Y, Nagae M. Meriden-ban houmon kazoku shien jissen no furikaeri o tooshite no manabi: Shien no kouka no ichi kousatsu [Learning through the reflextion of practice of Meriden Family Programme: A discussion on effectiveness of the support]. The Japanese Psychiatric Nursing Society. 2018;61(2):253–7. Japanese.
  33. Shiomitsu T. Chiiki seishin hoken fukushi kikan de hataraku PSW no seichou katei ni kansuru kenkyu: Riyou-sha ni taisuru enjo-sha yakuwari ni chakumoku shite [A study on the growing process of PSW working at community mental health welfare institutions: Focusing on the role of suppoters for the users]. Japanese Journal Psychiatric Social Work. 2012;43(2):125–33. Japanese.
  34. Hisai S. A study of dicuational methods based on learning from the working-support institution practicum of the nursing student. Hyogo University Journal. 2010(15):253–60. Japanese.
  35. Higashi H, Hisai S. A study of nursing practice to deepen learning of community mental health. Japanese Journal of Inernational Nursing Care Research. 2012;11(3):159–66. Japanese.
  36. Arai N. Chiiki seishin hoken fukushi shisetsu ni okeru jisshuu naiyou no jujitsu to kyouiku teki igi no haaku ni mukete [Toward the grasp and improvement of practical training at the community mental health welfare institutions]. The Japanese Psychiatric Nursing Society. 2011;54(2):121–5. Japanese.
  37. Omori M, Etoh T, Tamada A, et al. Nursing students’ characteristics after participating in community horticultural activities for four years. Journal of Japanese Society for the Study of Nursing and Social Work. 2011;16(2):141–50. Japanese.
  38. Uematsu T, Matsushita T, Katayama N, et al. Practice report for the school mental health literacy education. Japanese Journal of Study in Addiction Nursing. 2017;14(1):19–24. Japanese.
  39. Mizuno M. Koutou gakkou gakushu shidou youkou kaitei to seishin hoken kyouiku [Revision of the high school curriculum guidelines and mental health education]. Psychiatric Neurology Japonica. 2018;(120)11:979. Japanese.
  40. Aikawa S. Autoriichi no kihon gijutu I: Autoriichi ni okeru rinshou rinri [Basic outreach skills I: Clinical ethics in outreach]. Seishinka Rinshou Sabisu [Psychiatric Clinical Services]. 2018;18(3):237–241. Japanese.
  41. Noguchi M. Current situation of community mental health and public health nurses in Japan. Clinical Psychiatry. 2018;60(6): 657–672. Japanese.
  42. Inoue M. Integrated care system and the role of nurses for elderly patients with dementia — the case in Denmark. Japanese Journal Inernational Nursing Care Research. 2017;16(2):111–9. Japanese.
  43. Nakamura M. Vietnum A shou sougou-byouin seishin-ka no seishin iryou ni kansuru kenkyu [A study on psychiatric services offered by psychiatric department of province A general hospital in Vietnum]. Psychiatric Mental Health Nursing. 2010;41:69–72. Japanese.
  44. Nakamura M. Vietnum A shou no chiiki seishin hoken ni kansuru saikin no doukou [Latest trends in community mental health in Province A of Vietnum]. Nihon kango gakkai ronbun-shu, Chiiki-kango [Community care, Collected papers of academic meeting Japanese Nursing Association]. 2010;41:70–2. Japanese.
  45. Tanaka E, Tanaka C. A qualitative analysis of news reports on mental health after the Sichuan earthquake in China. Japanese Bulletin Traumatic Stress Studies. 2018;13:1–10. Japanese.
  46. Fujii T. Various peer supports promotion in community mental health and welfare: The proposal based on the case research of the social cooperative of Verona and literature research. Sophia University Studies Social Services. 2012;36:19–51. Japanese.
  47. Tanaka N, Inoue S. The trends and issues of football movement for people with mental health problems in Italy: Mental health policies and systems which enable to promote football movement: A case study of Rome City. Japanese Journal Sports Psychiatry. 2012;9:44–53. Japanese.
  48. Wahlbeck K. Public mental health: the time is ripe for translation of evidence into practice. World Psychiatry. 2015 Feb;14(1):36–42. doi: 10.1002/wps.20178. PMID: 25655149. PMCID: PMC4329888.
  49. Reiwa gan nen iryou-shisetsu (dou-tai) tyousa & byouin houkoku [Internet]. [Dynamic survey of medical institutions and hospital report 2019]. Tokyo: Health Statistics Office, Ministry of Health, Labour and Welfare [cited 2021 Oct 14]. Available from: https://www.mhlw.go.jp/toukei/saikin/hw/iryosd/19/. Japanese.
  50. Heisei 29 nen iryou-shisetsu (dou-tai & sei-tai) tyousa & byouin houkoku [Internet]. [Static/dynamic surveys of medical institutions and hospital report 2017]. Tokyo: Health Statistics Office, Ministry of Health, Labour and Welfare [cited 2021 Oct 14]. Available from: https://www.mhlw.go.jp/toukei/saikin/hw/iryosd/17/. Japanese.
  51. Reiwa gan nen kaigo service shisetsu & jigyousho tyousa [Internet]. [Survey of institutions and establishments for long-term care 2019]. Tokyo: Social Statistics Office, Ministry of Health, Labour and Welfare [cited 2021 Oct 14]. Available from: https://www.mhlw.go.jp/toukei/saikin/hw/kaigo/service19/index.html. Japanese.
  52. Hokensho suu no suii [Internet]. [Number of Health Centers]. Tokyo: Japanese Association of Public Health Center Directors [cited 2022 Dec 15]. Available from:http://www.phcd.jp/03/HCsuii/pdf/suii_temp02.pdf?2022.
  53. Heisei 30 nen-do kokumin iryou-hi no gaikyou [Internet]. [Estimates of national medical care expenditure 2018]. Tokyo: Health Statistics Office, Ministry of Health, Labour and Welfare [cited 2021 Oct 14]. Available from: https://www.mhlw.go.jp/toukei/saikin/hw/k-iryohi/18/index.html. Japanese.

Информация об авторах

Иватани Дзюн, MD, PhD, Visiting associate professor, Department of Psychiatry, Токийский медицинский университет , Токио, Япония, ORCID: https://orcid.org/0000-0002-1730-409X, e-mail: jun.iwatani.rd@gmail.com

Ито Дзюнъитиро, MD, PhD, Director, Клиника психического здоровья Си По Фэйр , Япония, e-mail: junichiro11@gmail.com

Тагучи Юкико, Staff psychologist, Department of Neuropsychiatry, Медицинский центр NTT , Япония, e-mail: yukiko.taguchi.mt@east.ntt.co.jp

Акияма Цуёси, MD, PhD, Director, Department of Quality Improvement, Медицинский центр NTT, Япония, ORCID: https://orcid.org/0000-0001-7434-3100, e-mail: akiyama@east.ntt.co.jp

Метрики

Просмотров

Всего: 41
В прошлом месяце: 7
В текущем месяце: 5

Скачиваний

Всего: 18
В прошлом месяце: 1
В текущем месяце: 4