Nursing care delivery in Japanese psychiatric units

Abstract

Japan has the largest number of psychiatric beds per population in the world. At the same time, little research had been done to describe nursing care delivered in psychiatric units. To describe contents of nursing care, the framework for care classification and measuring methods must be examined. The purpose of this study was to develop a nursing intervention classification and examine the correlation between amount of care and patients' mental states. Data were collected from 39 patient care records from 4 randomly selected psychiatric hospitals. Patients' function and condition were evaluated by their doctors using the Global Assessment of Functioning (GAF) and the Brief Psychiatric Rating Scale (BPRS). Six care categories were extracted: basic activities of daily living, psychological support/interpersonal skills, medical support, monitoring, family support and miscellaneous. By examining three cases with this classification, there were significant correlations between the GAF and BPRS scores and amount of care for two acutely ill psychotic patients.

Association between length of hospital stay and implementation of discharge planning in acute psychiatric inpatients in Japan

“…These domains and items were reviewed by a working group that included researchers and practitioners from a psychiatric hospital. The domains were developed based on categories of the psychiatric nursing intervention classification system in Japan [ 21 ]. The items were intended to cover a variety of discharge planning [ 22 ], the concept of the therapeutic nurse-client relationship [ 23 ], and family involvement [ 24 ].…”

Nursing care complexity in a psychiatric setting: results of an observational study

“…A Japanese study (Sawada et al . ) documented a significant correlation between the amount of care provided and patients’ mental states. The patients’ mental states were measured using two validated scales: the GAF scale (Global Assessment of Functioning) (American Psychiatric Association ), which is used to assess the psychosocial and professional performance of patients, and the BPRS (Brief Psychiatric Rating Scale) (Overall & Gorham ), which is used to provide a measurement for identifying patients’ dysfunctional attitudes.…”

The Development of the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS<sup>©</sup>)

“…A study by Sawada et al [31] reported that the roles of psychiatric nursing care as "basic activities of daily living, psychological support/interpersonal skills, medical support, monitoring, family support and miscellaneous" may be required interventions for patients in acute psychiatric hospitals in Japan.…”