Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1399
10
1
gregorian
2021
1
1
35
1
online
1
fulltext
en
Discharge of psychiatric patients against psychiatrist’s advice
Physiology
Physiology
Original Research
Original Research
<strong>Background: </strong>Discharge from the hospital against the doctor’s advice and refusal of receiving treatment is one of the significant issues at the time of hospitalization, which is especially crucial in relation to psychiatric patients. It can exacerbate the disorder and the subsequent complications and increase further hospital admissions. The present study was designed to evaluate the causes of discharge from the hospital and the refusal of receiving treatment against medical advice in hospitalized patients in Iran Psychiatric Hospital.<br>
<strong>Methods:</strong> The present study was a descriptive cross-sectional study. One hundred patients hospitalized in Iran Psychiatric Hospital discharged with personal consent against medical advice from July to December 2018 were studied. Two methods were used for assessment; the fulfillment of a routine ministry-approved checklist by the dischargers themselves and the face-to-face interview with both the patient and discharger based on a researcher-made checklist. Cohen’s Kappa coefficient was used to assess the agreement of the answers of patients to both routine ministry-approved and researcher-made checklists by SPSS software version 16.0 with an overall accuracy of 95%.<br>
<strong>Results:</strong> Based on the results extracted from the researcher-made checklist, 43 (43%) of the discharges were generally based on patient-related factors. The personal insistence to discharge by the patient was cited as the main reason for discharge. Cohen’s Kappa coefficient showed no significant agreement between the patient’s answers to the interview and what they have previously filled in the routine ministry-approved checklist. More specifically, the measure of agreement for answers of patients to questions in the standard checklist and the questions asked by the interviewer was 0.078 (p=0.167).<br>
<strong>Conclusion:</strong> From the results of this study, it can be concluded that the face-to-face interview based on the researcher-made checklist can more effectively determine the reasons for discharge of patients due to the accuracy of the interview.
Discharge against medical advice (DAMA), Psychiatric patient, Hospitalization
727
731
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-5746-1&slc_lang=en&sid=1
Shiva
Soraya
soraya.sh@iums.ac.ir
200319475328460063073
200319475328460063073
No
School of Medicine, & Spiritual Health Research Center, Iran University of Medical Sciences, Tehran, Iran
Mohaddese
Zolfi
zolfi.m@iums.ac.ir
200319475328460063074
200319475328460063074
Yes
School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Ruohollah
Seddigh
seddeigh.r@iums.ac.ir
200319475328460063075
200319475328460063075
No
School of Medicine, & Spiritual Health Research Center, Iran University of Medical Sciences, Tehran, Iran
Homa
Mohammadsadeghi
Mohammadsadeghi.h@iums.ac.ir
200319475328460063076
200319475328460063076
No
School of Medicine, & Spiritual Health Research Center, Iran University of Medical Sciences, Tehran, Iran
Fatemeh
Hadi
hadi.f@iums.ac.ir
200319475328460063077
200319475328460063077
No
School of Medicine, & Spiritual Health Research Center, Iran University of Medical Sciences, Tehran, Iran