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首次发作精神病后患者及其家属对心理教育家庭干预的体验:一项定性研究。

Patients' and family members' experiences of a psychoeducational family intervention after a first episode psychosis: a qualitative study.

作者信息

Nilsen Liv, Frich Jan C, Friis Svein, Røssberg Jan Ivar

机构信息

Oslo University Hospital, Division of Mental Health and Addiction, Oslo, Norway.

出版信息

Issues Ment Health Nurs. 2014 Jan;35(1):58-68. doi: 10.3109/01612840.2013.837992.

Abstract

The objective of this study is to explore patients' and family members' experiences of the different elements of a psychoeducational family intervention. A qualitative, explorative study was performed based on digitally recorded in-depth interviews with 12 patients and 14 family members. The interview data were transcribed in a slightly modified verbatim mode and analysed using systematic text condensation. Six themes that both patients and family members experienced as important in the family intervention were identified: alliance, support, anxiety and tension, knowledge and learning, time, and structure. A good relationship between the group leaders and participants was essential in preventing dropout. Meeting with other people in the same situation reduced feelings of shame and increased hope for the future. Hearing real life stories was experienced as being more important for gaining new knowledge about psychosis than lectures and workshops. However, many patients experienced anxiety and tension during the meetings. The group format could be demanding for patients immediately after a psychotic episode and for those still struggling with distressing psychotic symptoms. Group leaders need to recognise patients' levels of anxiety before, and during, the intervention, and consider the different needs of patients and family members in regards to when the intervention starts, the group format, and the patients' level of psychotic symptoms. The findings in the present study may help to tailor family work to better meet the needs of both patients and family members.

摘要

本研究的目的是探讨患者及其家庭成员在心理教育家庭干预不同环节的经历。基于对12名患者和14名家庭成员进行的数字录音深度访谈,开展了一项定性探索性研究。访谈数据以略有修改的逐字记录模式转录,并采用系统文本浓缩法进行分析。确定了患者和家庭成员在家庭干预中都认为重要的六个主题:联盟、支持、焦虑与紧张、知识与学习、时间和结构。小组组长与参与者之间的良好关系对于防止退出至关重要。与处于相同情况中的其他人见面减少了羞耻感,并增加了对未来的希望。对于获得有关精神病的新知识而言,听到真实生活故事比讲座和研讨会更重要。然而,许多患者在会议期间经历了焦虑和紧张。小组形式对于精神病发作后立即参与的患者以及仍在与令人痛苦的精神病症状作斗争的患者而言可能要求较高。小组组长需要在干预前和干预期间识别患者的焦虑程度,并在干预开始时间、小组形式以及患者的精神病症状水平方面考虑患者和家庭成员的不同需求。本研究的结果可能有助于调整家庭工作,以更好地满足患者和家庭成员的需求。

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