Yanos P T, Primavera L H, Knight E L
Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey 08901, USA.
Psychiatr Serv. 2001 Apr;52(4):493-500. doi: 10.1176/appi.ps.52.4.493.
This study examined the relationship between participation in consumer-run services and recovery of social functioning among persons diagnosed as having serious mental illness. It also assessed the role of psychological factors in mediating this relationship.
Research questions investigated were whether involvement in consumer-run services is positively associated with recovery when premorbid and demographic factors are controlled for, whether psychological factors are positively associated with recovery irrespective of involvement in consumer-run services, and whether the relationship between involvement in consumer-run services and recovery is mediated by the psychological factors. The factors examined were self-efficacy, hopefulness, and active coping strategies. Sixty participants with a past or present diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder and at least one past psychiatric hospitalization were recruited from a community mental health center and two consumer-run programs. Data were collected on hopefulness, self-efficacy, coping strategies, social functioning, and premorbid and demographic characteristics.
Findings indicated that participants involved in consumer-run services had better social functioning than those involved only in traditional mental health services, that psychological variables were significantly associated with social functioning, and that the relationship between involvement in consumer-run services and social functioning was partly mediated by the use of more problem-centered coping strategies. Premorbid and demographic factors did not account for the relationship between psychosocial variables and social functioning, although education was a significant predictor of social functioning.
The findings support the view that psychosocial factors may play a role in facilitating good community adjustment for individuals diagnosed as having serious mental illness.
本研究探讨了参与消费者主导服务与被诊断患有严重精神疾病者社会功能恢复之间的关系。同时还评估了心理因素在介导这种关系中所起的作用。
研究问题包括,在控制病前因素和人口统计学因素的情况下,参与消费者主导服务是否与康复呈正相关;无论是否参与消费者主导服务,心理因素是否与康复呈正相关;以及参与消费者主导服务与康复之间的关系是否由心理因素介导。所考察的因素包括自我效能感、希望感和积极应对策略。从一个社区心理健康中心和两个消费者主导项目中招募了60名曾被诊断或目前被诊断患有精神分裂症、分裂情感性障碍或双相情感障碍且至少有过一次精神科住院史的参与者。收集了关于希望感、自我效能感、应对策略、社会功能以及病前和人口统计学特征的数据。
研究结果表明,参与消费者主导服务的参与者比仅参与传统心理健康服务的参与者具有更好的社会功能;心理变量与社会功能显著相关;参与消费者主导服务与社会功能之间的关系部分由更多以问题为中心的应对策略的使用所介导。病前因素和人口统计学因素并不能解释心理社会变量与社会功能之间的关系,尽管教育程度是社会功能的一个重要预测因素。
研究结果支持这样一种观点,即心理社会因素可能在促进被诊断患有严重精神疾病的个体实现良好的社区适应方面发挥作用。