针对精神病性障碍患者的心理教育：对知识和应对方式的影响
Psychoeducation for patients with a psychotic disorder: effects on knowledge and coping.
作者信息
Bossema Ercolie R, de Haar Cynthia A J, Westerhuis Willemijn, Beenackers Bas P F, Blom Bernadette C E M, Appels Melanie C M, van Oeveren Chris J
机构信息
Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.
出版信息
Prim Care Companion CNS Disord. 2011;13(4). doi: 10.4088/PCC.10m01116.
OBJECTIVE
Psychoeducation is an essential and promising element in the nonpharmacologic treatment of patients with a psychotic disorder. This study examined the effects of patient-directed psychoeducation on knowledge and coping.
METHOD
This study included 99 primary care patients with a psychotic disorder according to DSM-IV-TR criteria who completed a knowledge questionnaire before and a knowledge and coping questionnaire halfway through, immediately after, and 6 months after a 20-session group psychoeducation program. The first time the program was given was between April and October 2007, and the final time the program was given was between October 2009 and April 2010. Results were analyzed with multilevel analysis.
RESULTS
Knowledge increased significantly from the beginning of the program to halfway through the program (P < .001), even after correction for baseline scores, but not any further thereafter. Coping improved from halfway through the program to the end of the program (P = .02), also after correction for baseline scores, but not thereafter. Only at 6 months after the program was knowledge related to coping (P = .01). There were no differences in knowledge and coping between male and female patients. Halfway through (P = .001) and at the end of the program (P = .02), the increase in knowledge was significantly lower for patients taking atypical antipsychotic medication than for patients taking typical antipsychotic medication.
CONCLUSIONS
In patients with a psychotic disorder, psychoeducation results in more knowledge immediately and several months after the program and contributes to better coping only immediately after the program. Patients with more knowledge several months after psychoeducation may also be patients who then cope better with the disorder.
目的
心理教育是精神病性障碍患者非药物治疗中至关重要且前景广阔的要素。本研究考察了以患者为导向的心理教育对知识和应对方式的影响。
方法
本研究纳入了99名符合《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）标准的初级保健精神病性障碍患者，他们在一个为期20节的团体心理教育项目开始前完成了一份知识问卷，并在项目进行到一半时、结束后即刻以及结束后6个月分别完成了知识与应对方式问卷。该项目首次实施时间为2007年4月至10月，最后一次实施时间为2009年10月至2010年4月。结果采用多水平分析进行分析。
结果
从项目开始到进行到一半时，知识水平显著提高（P < .001），即使校正了基线分数后依然如此，但此后未再进一步提高。应对方式从项目进行到一半时到项目结束时有所改善（P = .02），同样校正基线分数后也是如此，但此后未再改善。仅在项目结束6个月后，知识与应对方式相关（P = .01）。男性和女性患者在知识和应对方式方面没有差异。在项目进行到一半时（P = .001）以及项目结束时（P = .02），服用非典型抗精神病药物的患者知识增加幅度显著低于服用典型抗精神病药物的患者。
结论
对于精神病性障碍患者，心理教育在项目实施后即刻及几个月后能带来更多知识，且仅在项目实施后即刻有助于更好地应对。心理教育几个月后知识水平较高的患者可能也是随后能更好应对该疾病的患者。
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