Последние достижения амбулаторной психиатрической помощи в Японии: нарративный обзор

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.

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