James Clerk Maxwell Bldg, King's College London, 57 Waterloo Rd, London SE1 8WA England
J Clin Psychiatry. 2013 Dec;74(12):e1145-62. doi: 10.4088/JCP.12r08308.
This systematic review investigates the effectiveness of psychoeducation in improving the well-being of family members of people with schizophrenia and identifies the common ingredients, implementation considerations, and participants' feedback.
Published articles in either English or Chinese which reported psychoeducational intervention studies that targeted family members of people with schizophrenia as participants, were searched with the keywords schizophrenia and/or psychosis and psychoeducation/psychoeducational interventions in 8 databases (MEDLINE, PsycINFO, CINAHL, EMBASE, Web of Science, Applied Social Sciences Index and Abstracts [ASSIA], Cochrane Reviews Library, and CENTRAL), from the time of inception of the various databases to March 2012.
Fifty-eight articles reporting 44 research studies met all the inclusion criteria and the quality assessment requirement and were included in the review.
Data from trials, quantitative studies, and qualitative research were extracted to address 3 parallel syntheses, following the Evidence for Policy and Practice Information Coordination Centre mixed-method systematic approach.
Psychoeducation was found to be consistently effective in improving family members' knowledge and coping. However, it was less successful in changing family members' psychological morbidities, burden, or expressed emotion. Common ingredients across interventions included coverage of common coping strategies and problem-solving strategies to enhance communication or coping. Particularly valued by family carers were a group format to share experiences with other carers, skillful facilitation by professionals, and knowledge and skill development.
This review indicates that psychoeducation should be routinely provided to family members as early as possible following contact with health services. Suggestions are made for optimal psychoeducational intervention design and its successful implementation, and for further research to establish the enhanced effect of booster sessions, between-session practice, and online delivery.
本系统评价研究了心理教育对改善精神分裂症患者家属幸福感的效果，并确定了常见的干预内容、实施注意事项和参与者的反馈。
使用“schizophrenia”和/或“psychosis”以及“psychoeducation”和“psychoeducational interventions”这两个关键词，在 8 个数据库（MEDLINE、PsycINFO、CINAHL、EMBASE、Web of Science、Applied Social Sciences Index and Abstracts [ASSIA]、Cochrane Reviews Library 和 CENTRAL）中搜索发表的英文或中文文献，检索时间从各数据库建立时间至 2012 年 3 月，以调查针对精神分裂症患者家属的心理教育干预研究。
58 篇报告 44 项研究的文章均符合所有纳入标准和质量评估要求，被纳入综述。
采用循证卫生保健政策和实践信息协调中心混合方法系统评价方法，从试验、定量研究和定性研究中提取数据，以解决 3 个平行综合分析。
心理教育一直被证明能有效提高家属的知识水平和应对能力，但在改变家属的心理病态、负担或表达情感方面效果较差。干预措施的共同内容包括涵盖常见的应对策略和解决问题策略，以加强沟通或应对能力。团体形式与其他护理人员分享经验、专业人员的熟练辅导以及知识和技能的发展，尤其受到护理人员的重视。
本综述表明，应在患者及其家属与卫生服务机构接触后尽快向其提供常规心理教育。为优化心理教育干预设计及其成功实施提出了建议，并进一步开展研究以确定强化课程、课程间实践和在线授课的增强效果。
