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精神分裂症患者的日常活动、认知与社区功能

Daily activities, cognition and community functioning in persons with schizophrenia.

作者信息

Aubin Ginette, Stip Emmanuel, Gélinas Isabelle, Rainville Constant, Chapparo Christine

机构信息

Centre hospitalier de l'Université de Montréal (CHUM) Hôpital Notre-Dame, and School of Physical & Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montreal, QC, Canada, H3G 1Y5.

出版信息

Schizophr Res. 2009 Feb;107(2-3):313-8. doi: 10.1016/j.schres.2008.08.002. Epub 2008 Sep 27.

Abstract

OBJECTIVE

This cross-sectional study explored the relationships between daily activity performance, attention, memory, executive functions and community functioning in people with schizophrenia. More specifically, this study attempted to verify the hypothesis that functional limitations in the performance of daily activities negatively affect community functioning in people with schizophrenia.

METHODS

Eighty-two individuals with schizophrenia living in the community were recruited for the study. The Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis was used to assess participants' functional capacity during a meal preparation task. Visuo-spatial associative memory, spatial working memory, planning, visuo-motor coordination, and selective attention were evaluated as well. Community functioning was assessed with the Independent Living Skills Survey (ILSS) and the Multnomah Community Ability Scale (MCAS).

RESULTS

Correlations revealed significant associations between functional capacity and visuo-spatial associative learning, spatial working memory, planning and negative symptoms. Planning skills during meal preparation were found to be associated with MCAS. After regression analyses, only visuo-spatial memory, negative symptoms, education and familiarity with meal preparation explained variation in functional capacity.

CONCLUSIONS

The findings of the current study suggest that visuo-spatial associative learning, negative symptoms, education and familiarity with task are among the important factors for functional capacity. Planning skills necessary for efficient task performance were also found to be those most determinant for community functioning. Rehabilitation interventions should consider these underlying strength and deficits when developing strategies to help people with schizophrenia build functional skills essential for community living.

摘要

目的

本横断面研究探讨了精神分裂症患者的日常活动表现、注意力、记忆力、执行功能与社区功能之间的关系。更具体地说,本研究试图验证以下假设:日常活动表现中的功能限制会对精神分裂症患者的社区功能产生负面影响。

方法

招募了82名居住在社区的精神分裂症患者参与本研究。采用任务分析的感知、回忆、计划和执行(PRPP)系统来评估参与者在准备膳食任务期间的功能能力。还评估了视觉空间联想记忆、空间工作记忆、计划能力、视觉运动协调能力和选择性注意力。使用独立生活技能调查(ILSS)和摩特诺玛社区能力量表(MCAS)评估社区功能。

结果

相关性分析显示,功能能力与视觉空间联想学习、空间工作记忆、计划能力和阴性症状之间存在显著关联。发现准备膳食期间的计划技能与MCAS相关。经过回归分析,只有视觉空间记忆、阴性症状、教育程度和对准备膳食的熟悉程度能够解释功能能力的差异。

结论

本研究结果表明,视觉空间联想学习、阴性症状、教育程度和对任务的熟悉程度是影响功能能力的重要因素。高效任务执行所需的计划技能也是对社区功能最具决定性的因素。康复干预在制定帮助精神分裂症患者建立社区生活所需功能技能的策略时,应考虑这些潜在的优势和不足。

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