Dixon L, Lyles A, Scott J, Lehman A, Postrado L, Goldman H, McGlynn E
Center for Mental Health Services, Department of Psychiatry, University of Maryland School of Medicine, Baltimore 21201, USA.
Psychiatr Serv. 1999 Feb;50(2):233-8. doi: 10.1176/ps.50.2.233.
Data from the Schizophrenia Patient Outcomes Research Team project were examined to determine the extent to which families of adults with schizophrenia receive services and whether training staff in the provision of family services increases service availability.
For patients with a diagnosis of schizophrenia, paid claims for family therapy were identified in 1991 in a nationally representative sample of Medicare data and one state's Medicaid data. In a field study in two states, 530 patients were asked about services received by their families. A quasiexperimental dissemination of a family intervention was done at nine agencies; staff at four agencies received a standard didactic presentation, and staff at five received that standard presentation paired with intensive training.
In the representative national Medicare sample of 15,425 persons with schizophrenia, .7 percent (N=108) had an outpatient claim for family therapy. This figure was 7.1 percent in the Medicaid sample of 5,393 persons with schizophrenia in one state. Of the 530 patients in the field study who reported having contact with their families, 159 (30 percent) reported that their families had received information, advice, or support about their illness, and 40 (8 percent) responded that their families had attended an educational or support program. At the four agencies where staff received only didactic training, no changes in family services were found after one year. Three of the five agencies where staff participated in intensive training enhanced their family services.
A minority of families of persons with schizophrenia receive information about the illness from providers. Implementation of model family interventions is possible with considerable technical assistance. A gap exists between best practices and standard practices for families of persons with schizophrenia.
对精神分裂症患者结果研究团队项目的数据进行分析，以确定成年精神分裂症患者的家庭获得服务的程度，以及对提供家庭服务的工作人员进行培训是否能提高服务的可及性。
对于诊断为精神分裂症的患者，1991年在具有全国代表性的医疗保险数据样本和一个州的医疗补助数据中识别出家庭治疗的付费索赔。在两个州进行的一项实地研究中，对530名患者询问了其家庭所接受的服务情况。在九个机构对一种家庭干预措施进行了准实验性推广；四个机构的工作人员接受了标准的教学讲座，五个机构的工作人员除接受标准讲座外还接受了强化培训。
在全国具有代表性的15425名精神分裂症患者的医疗保险样本中，0.7%（N = 108）有家庭治疗的门诊索赔。在一个州的5393名精神分裂症患者的医疗补助样本中，这一数字为7.1%。在实地研究中报告与家人有联系的530名患者中，159名（30%）报告其家人收到了有关其疾病的信息、建议或支持，40名（8%）回答其家人参加了教育或支持项目。在仅接受教学培训的四个机构中，一年后家庭服务没有变化。在工作人员参与强化培训的五个机构中，有三个加强了其家庭服务。
少数精神分裂症患者的家庭从提供者那里获得了有关疾病的信息。在大量技术援助下，实施示范性家庭干预措施是可行的。精神分裂症患者家庭的最佳实践与标准实践之间存在差距。
