社區精神居家護理之現況與展望

Current Status and Prospects of Community Psychiatric Home Care

社區精神居家護理為針對無法到精神醫療機構持續就醫或復健的社區精神病人，由護理師至其居住所提供行動照護服務，是有效治療或預防疾病復發、減少再住院並促進復元之社區照護模式。本文描繪臺灣精神居家護理的三種模式：精神醫療為主之精神居家治療、公衛預防疾病復發之居家關懷訪視及延緩並預防失能之長期照顧居家護理，繼而推估精神居家護理需求，最後闡述精神居家護理問題困境及未來展望，藉由推展居家個案管理實證實務及精神個案管理護理師專業認證，建置可近、完整的精神居家照護網絡，以提升社區精神病人照護品質。

Psychiatric home care is an effective model for providing care to community-based patients with psychosocial needs who are unable to receive continuous treatment / rehabilitation in mental health hospitals. Moreover, this model has been shown to effectively reduce rehospitalization and promote recovery in these patients. Three psychiatric home care models are described in this article: medicalbased home care; prevent recurrence public health home care; and preventing disability long-term care home care. Furthermore, the resources required to provide psychiatric home care are estimated and current psychiatric home care-related problems, dilemmas, and prospects are summarized. Building an accessible psychiatric home care network may be accomplished by promoting evidence-based home care case management practices and ensuring psychiatric case management nurses are properly certified. This network will help improve significantly the quality of care received by communitydwelling patients with mental illness.