Davis Louanne W, Lysaker Paul H
Roudebush VA Medical Center, Psychiatry Department, Indianapolis, Indiana 46202, USA.
J Nerv Ment Dis. 2007 Apr;195(4):353-7. doi: 10.1097/01.nmd.0000261954.36030.a1.
While therapeutic alliance (TA) in schizophrenia has been linked with treatment adherence and outcome, less is known about its relationship to rehabilitation outcome. To examine this issue, we classified persons who had been enrolled in a rehabilitation study as having higher or lower levels of TA based on an observer assessment midway through treatment and compared their work performance at weeks 1, 11, and 23. Repeated measures analysis of variance found group effects for Work Quality and Personal Presentation with the higher TA group having better overall performance on both. Time effects were found for Work Quality and Personal Presentation with the sample overall showing improvement over the course of rehabilitation. Interactions were found for Cooperativeness and Work Quality with the higher TA group showing steady increases, whereas the lower TA group showed initial improvement followed by a decline. Results suggest that forming a strong TA may enhance rehabilitation among persons with schizophrenia.
虽然精神分裂症患者的治疗联盟（TA）与治疗依从性及治疗效果相关，但对于其与康复效果之间的关系却知之甚少。为了探究这一问题，我们根据治疗中期的观察者评估，将参加康复研究的人员分为TA水平较高或较低两组，并比较了他们在第1周、第11周和第23周的工作表现。重复测量方差分析发现，工作质量和个人表现存在组间效应，TA水平较高的组在这两方面的总体表现更好。工作质量和个人表现存在时间效应，样本总体在康复过程中有所改善。合作性和工作质量存在交互作用，TA水平较高的组表现出稳步提升，而TA水平较低的组则先有改善，随后下降。结果表明，建立强大的治疗联盟可能会增强精神分裂症患者的康复效果。
