Pickett-Schenk Susan A, Cook Judith A, Steigman Pamela, Lippincott Richard, Bennett Cynthia, Grey Dennis D
Department of Psychiatry, University of Illinois at Chicago, 1601 W. Taylor, Chicago, IL 60612, USA.
Arch Gen Psychiatry. 2006 Sep;63(9):1043-50. doi: 10.1001/archpsyc.63.9.1043.
Family members of adults with mental illness often experience emotional distress and strained relationships.
To test the effectiveness of a family-led educational intervention, the Journey of Hope, in improving participants' psychological well-being and relationships with their ill relatives.
A randomized controlled trial using a waiting list design was conducted in the community in 3 southeastern Louisiana cities.
A total of 462 family members of adults with mental illness participated in the study, with 231 randomly assigned to immediate receipt of the Journey of Hope course and 231 assigned to a 9-month course waiting list. Intervention The Journey of Hope intervention consisted of 8 modules of education on the etiology and treatment of mental illness, problem-solving and communication skills training, and family support.
Participants' psychological well-being and relationships with their ill relatives were assessed at study enrollment, 3 months after enrollment (at course termination), and 8 months after enrollment (6 months after course termination). Mixed-effects random regression analysis was used to predict the likelihood of decreased depressive symptoms, increased vitality, and overall mental health, and improved relationship ratings.
Intervention group participants reported fewer depressive symptoms, greater emotional role functioning and vitality, and fewer negative views of their relationships with their ill relatives compared with control group participants. These improved outcomes were maintained over time and were significant (P<.05 for all) even when controlling for participant demographic and relative clinical characteristics.
Results show that family-led educational interventions are effective in improving participants' psychological well-being and views of their relationships with ill relatives.
患有精神疾病的成年人的家庭成员经常经历情绪困扰和关系紧张。
测试一种由家庭主导的教育干预措施“希望之旅”在改善参与者心理健康以及与患病亲属关系方面的有效性。
采用等待列表设计的随机对照试验在路易斯安那州东南部的3个城市的社区中进行。
共有462名患有精神疾病的成年人的家庭成员参与了该研究,其中231人被随机分配立即接受“希望之旅”课程,231人被分配到9个月的课程等待列表中。干预措施“希望之旅”干预包括8个模块,内容涉及精神疾病的病因和治疗、解决问题和沟通技巧培训以及家庭支持。
在研究入组时、入组后3个月(课程结束时)和入组后8个月(课程结束后6个月)评估参与者的心理健康以及与患病亲属的关系。采用混合效应随机回归分析来预测抑郁症状减轻、活力增加、整体心理健康改善以及关系评分提高的可能性。
与对照组参与者相比,干预组参与者报告的抑郁症状更少,情感角色功能和活力更强,对与患病亲属关系的负面看法更少。这些改善的结果随着时间的推移得以维持,并且即使在控制了参与者的人口统计学和亲属临床特征后仍具有显著性(所有P值均<0.05)。
结果表明,由家庭主导的教育干预措施在改善参与者的心理健康以及对与患病亲属关系的看法方面是有效的。