Departmental Bulletin Paper 精神科病院長期入院者の退院に至る変化に関する研究 ―精神科病院長期入院者が退院支援者からの働きかけに よって退院していくプロセス―
A Study on the Changes toward Discharge of Long-term Inpatients in Mental Hospital

杉原, 努

It is hard to find out articles concerning about the changes toward discharge of long-term inpatients in mental hospital. Author carried out interviews to 16 inpatients who had been stayed at mental hospital for over for 2 years. Thus author clarified the process of discharge, and to analyze by M-GTA(Modified Grounded Theory Approach). Author clarified the changes and the process toward discharge from Mental Hospital in this article, and shows the story line as summery. There are many reasons to stay in the hospital, long-term inpatients are easily fallen into the situation of the following: ≪admission let inpatients be powerless≫. After being in hospital for long term, they change to ≪advancement of forfeited chance≫. In hospital, they become the persons as <deprivation of sociality> and <impracticable situation though inpatients have discharge will>, and this two items are influential each other.【 advancement of undignified situation】 is shaped thought this process. Social Workers, Medical Specialties, and Discharge Workers outside of hospital practice <first approach to discharge> to help both of <deprivation of sociality> and <impracticable situation though inpatients have discharge will>. Inpatients in the stage of <first approach to discharge> change to <training for living capacity>. By <first approach to discharge>, ≪advancement of forfeited chance≫ changes to ≪practices for rehabilitation≫ entirely. Therefore ≪practices for rehabilitation≫ in hospital carried out,【 progression of chance and self-appearance】 begins through the situation during inpatients are still in hospital. Inpatients gain arranged environment and living capacities, through the experiment of <training for living capacity>, they strongly changes to ≪identification as a member of society≫. They can discharge from hospital at that time. This changing is caused under the background that inpatients change to ≪identification as a member of society≫ by ≪practices for rehabilitation≫ Living in the community starts through the stage of <groping for community living>, this experiment has the influence to <acquiring myself> and <birth of self efficacy>. <acquiring myself> influences <birth of self efficacy>.

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