Creation of Tools for Assessment of Families of Schizophrenia Patients in the Acute phase

Background Acute (short-term inpatient care) psychiatric wards are becoming established in Japan. 1) To enable patients admitted for the onset of schizophrenia to be discharged early after short-term hospital stay, provision of satisfactory care for patients' families, as primary supporters of the patients in the community, is seen as critical throughout the hospitalization period and thereafter as well. However, acute phase care for the families has not been thoroughly established. Purpose For the purpose of establishing care necessary for the families of acute phase patients admitted to psychiatric hospitals, psychiatric department nurses were interviewed about the status of the families of such patients and families of concern from the nurses' viewpoint, based on which tools for assessment of acute phase patients' families were created. Methods Ten nurses who had worked for 5 years or more in the psychiatric departments of three hospitals were interviewed about the status of families of acute phase patients and families of concern to nurses. The interviews were recorded and transcribed for qualitative analysis. Results From the interviews on the "status of families of acute phase patients as viewed by nurses," 70 phrases were extracted as attributes representing the families' status, and were ultimately divided into nine median categories. Regarding "families of concern to nurses," 54 phrases representing attributes of such families were extracted and ultimately divided into nine median categories. Based on these findings, two assessment tools were developed, one from the standpoint of how the family is coping with their situation, and the other, of the family's overall resources and recognition of their situation. Conclusions The assessment tool that was devised based on the acute phase family status enables care providers to evaluate whether the family requires care in consideration of their reactions observed during the patient's hospital stay and is believed to be useful even for nurses with little experience in the psychiatric field or in dealing with families of psychiatric patients. Another assessment tool created based on families of concern focuses on their difficulties, allowing assessment leading to timely, early intervention by nurses where necessary.