Chien Wai-Tong, Chan Sally W C
Faculty of Medicine of the Chinese University of Hong Kong, 7/F Esther Lee Building, Shatin, Northern Territories, Hong Kong.
Psychiatr Serv. 2004 Nov;55(11):1276-84. doi: 10.1176/appi.ps.55.11.1276.
This study tested the effectiveness of a mutual support multiple-family-group intervention for schizophrenia in terms of improvements in patients' psychosocial functioning, use of mental health services, and rehospitalization compared with a psychoeducation intervention and standard care.
A controlled trial was conducted in a sample of 96 Chinese families who were caring for a relative with schizophrenia in Hong Kong. The families were randomly assigned to one of three groups: mutual support (N=32), psychoeducation (N=33), and standard care (N=31). The interventions were delivered at two psychiatric outpatient clinics over a six-month period. The mutual support and psychoeducation interventions consisted of 12 group sessions every two weeks, each lasting about two hours. The mutual support group was a peer-led group designed to provide information, emotional support, and coping skills for caregiving in stages. The psychoeducation group was a professional-led group designed to educate families about the biological basis of schizophrenia and treatment and to improve illness management and coping skills. The standard care group and the other two groups received routine psychiatric outpatient care during the intervention. Data analyses of multiple outcomes over one-year follow-up were conducted on an intention-to-treat basis.
Multivariate analyses of variance showed that the mutual support intervention was associated with consistently greater improvements in patients' functioning and rehospitalization and stable use of mental health services over the follow-up period compared with the other two interventions.
The study provides evidence that mutual support groups can be an effective family intervention for Chinese persons with mental illness in terms of improving patients' functioning and hospitalization without increasing their use of mental health services.
本研究旨在测试一种互助多家庭小组干预对精神分裂症患者的有效性，该干预在改善患者心理社会功能、精神卫生服务利用情况以及再住院率方面与心理教育干预和标准护理进行比较。
在香港96个照顾精神分裂症亲属的中国家庭样本中进行了一项对照试验。这些家庭被随机分配到三个组之一：互助组（N = 32）、心理教育组（N = 33）和标准护理组（N = 31）。干预在两家精神科门诊进行，为期六个月。互助和心理教育干预包括每两周进行12次小组会议，每次持续约两小时。互助组是一个由同伴主导的小组，旨在分阶段提供信息、情感支持和护理应对技巧。心理教育组是一个由专业人员主导的小组，旨在向家庭传授精神分裂症的生物学基础和治疗方法，并提高疾病管理和应对技巧。标准护理组和其他两组在干预期间接受常规精神科门诊护理。对一年随访期内的多个结果进行了意向性分析。
多变量方差分析表明，与其他两种干预相比，互助干预在随访期间与患者功能的持续更大改善、再住院率以及精神卫生服务的稳定利用相关。
该研究提供了证据，表明互助小组对于患有精神疾病的中国人来说，在改善患者功能和住院情况且不增加其精神卫生服务利用的情况下，是一种有效的家庭干预措施。
