Department of Psychotic Disorders, GGZ Drenthe, Assen, The Netherlands.
Br J Clin Psychol. 2010 Jun;49(Pt 2):259-74. doi: 10.1348/014466509X467828. Epub 2009 Sep 5.
Many people with schizophrenia have severe cognitive impairments that hamper their activities. The effect of pharmacological and behavioural interventions on cognitive functioning has been demonstrated, but even after successful intervention considerable impairments can remain. Therefore, we sought for alternative ways to help patients cope with the effects of their cognitive impairments. In the present study, we have evaluated the efficacy of short message service (SMS) text messages to compensate for the effects of cognitive impairments in schizophrenia in daily life.
A waiting list controlled trial was conducted: patients were quasi-randomly assigned to an A-B-A (baseline-intervention-follow-up) condition or an A-A-B-A condition that included an additional 7-week waiting list. The waiting list was included to control for the effect of time on relevant outcome.
Sixty-two people with schizophrenia or related psychotic disorders were included in the study. All patients showed impaired goal-directed behaviour in daily life-situations. Patients were prompted with SMS text messages to improve their everyday functioning. The primary outcome measure was the percentage of goals achieved.
The overall percentage of goals achieved increased with prompting, while performance dropped to baseline level after withdrawing the prompts. Keeping appointments with mental health workers and carrying out leisure activities increased with prompting, while medication adherence and attendance at training sessions remained unchanged. A majority of the patients enjoyed receiving the SMS text messages.
Prompting can significantly improve achievement of a number of relevant goals. For other goals, combining prompting with interventions that enhance motivation seems indicated.
许多精神分裂症患者存在严重的认知障碍，这会妨碍他们的日常活动。已证明药物和行为干预对认知功能有一定效果，但即使干预成功，认知障碍仍可能存在。因此，我们寻求替代方法来帮助患者应对认知障碍的影响。本研究旨在评估短信息服务（SMS）文本消息在补偿精神分裂症患者日常生活中认知障碍方面的疗效。
本研究采用等待名单对照试验：患者被准随机分配到 A-B-A（基线-干预-随访）条件或 A-A-B-A 条件，后者包括额外的 7 周等待名单。纳入等待名单是为了控制时间对相关结果的影响。
本研究共纳入 62 名精神分裂症或相关精神病患者。所有患者在日常生活情境中均表现出目标导向行为受损。通过 SMS 文本消息提示来改善患者的日常功能。主要结局指标为目标达成的百分比。
提示可使整体目标达成率提高，而停止提示后，表现又降至基线水平。与心理健康工作者的预约和休闲活动的参与度随着提示而增加，而药物依从性和培训课程的出勤率则保持不变。大多数患者喜欢接收 SMS 文本消息。
提示可显著提高多项相关目标的达成率。对于其他目标，提示与增强动机的干预相结合可能是必要的。
