South African Journal of Psychiatry - Volume 8, Issue 3, 2002
Volume 8, Issue 3, 2002
Source: South African Journal of Psychiatry 8, pp 71 –77 (2002)More Less
Objectives. Deinstitutionalisation and shortage of psychiatric beds worldwide has led to extensive research into the risk factors and interventions associated with rapid and recurrent admission to hospital. Little research of this nature has taken place in South Africa, particularly with regard to acute hospital admissions. This study attempted primarily to assess the effect of length of stay and administration of depot antipsychotics in hospital on time to readmission. <br>Design. A retrospective cohort of 180 admissions was followed up for 12 months, after an index discharge, by means of multiple hospital and community-based record reviews. Each readmission was analysed as an event using a survival analysis model. <br>Setting. Chris Hani Baragwanath Hospital, Gauteng. <br>Subjects. A random sample of patients admitted during a 6-month period in 1996. <br>Outcome measures. Time to readmission. <br>Results. Two hundred and eighty-four admissions were analysed. The only factor that provided a significant protective effect was being married or cohabiting (P = 0.015). Clinic attendance showed a slight protective effect early on but conferred a significantly higher risk of readmission on those who had been out of hospital for a long period (P = 0.001). Only 21% of discharged patients ever attended a clinic. The overall risk of readmission was significantly higher in the first 90 days post discharge. <br>Conclusions. The lack of impact of length of hospital stay and use of depot neuroleptics on time to readmission may indicate that patients are being kept for appropriate duration and that the most ill patients are receiving depot medication. Several sampling and statistical artefacts may explain some of our findings. These results confirm the worldwide difficulty in finding consistent and accurate predictors of readmission. Low rates of successful referral to community aftercare need to be addressed before their effectiveness can be reasonably assessed. The inherent instability of the post-discharge period is a potential area for further investigation and intensive management.
Source: South African Journal of Psychiatry 8, pp 79 –84 (2002)More Less
Introduction. Excessive alcohol consumption among students is cause for concern, not only because medical students themselves may suffer in the long term but also because of the potential negative impact this may have on their effectiveness as tomorrow's doctors. <br>Objectives. The aim of the study was to investigate alcohol use among 6th-year medical students at the University of the Free State (UFS) and reasons for their alcohol use. <br>Methods. After a compulsory lecture on an unrelated topic, the 6th-year medical students at the UFS were given a demographic questionnaire, the self-rated Alcohol Use Disorders Identification Test (AUDIT) and a shortened version of the selfrated Inventory of Drug-taking Situations (IDTS) to complete. <br>Conclusion. From the results of this study it is clear that a significant number of 6th-year medical students at the UFS 28.3%) use alcohol in a harmful way. Most students use alcohol when they are with friends or in some kind of social setting. However, a number of students use alcohol to cope with stressful situations. It is therefore important that the prevention of harmful use of alcohol should receive attention in medical schools.