McCann Terence V, Lubman Dan I
Centre for Chronic Disease Prevention and Management, Discipline of Mental Health Nursing and Aged Care, College of Health and Biomedicine, Victoria University, PO Box 1428, Melbourne 8001, VIC, Australia.
BMC Psychiatry. 2014 Jun 6;14:168. doi: 10.1186/1471-244X-14-168.
Caring for a young person experiencing first-episode psychosis is challenging and can affect carers' well-being adversely. While some face-to-face approaches have achieved promising outcomes, they are costly and resource-intensive to provide, restricting their reach and penetration. Guided self-help in book-form (or bibliotherapy) is an alternative but untested approach in these circumstances. In this study, we aimed to evaluate carers' beliefs about the usefulness of problem-solving guided self-help manual for primary carers of young people with first-episode psychosis.
A qualitative process evaluation nested in a randomised controlled trial, conducted across two early intervention psychosis services in Melbourne, Australia. 124 carers were randomised to problem-solving guided self-help intervention or treatment as usual. We also undertook a qualitative process evaluation, using individual interviews, with a random sample of 24 of the intervention group. A thematic analysis of the qualitative data was undertaken, which is the subject of this paper. Interviews were conducted between January 2009 and September 2010.
Three themes were abstracted from the data, reflecting carers' beliefs about the usefulness of the manual: promoting carers' well-being, increasing carers' understanding of and support for the young person with first-episode psychosis, and accessibility and delivery modes of the programme.
This process evaluation highlights that guided self-help is useful in informing and supporting carers of affected young people. While there is scope for broadening the delivery modes, the approach is easy to use and accessible, and can be used as a cost-effective adjunct to standard support provided to carers, by community mental health nurses and other clinicians.
ACTRN12609000064202.
照顾首次发作精神病的年轻人具有挑战性，可能会对照顾者的幸福感产生不利影响。虽然一些面对面的方法取得了可喜的成果，但提供这些方法成本高昂且资源密集，限制了它们的覆盖范围和渗透率。以书籍形式提供的自助指导（或阅读疗法）在这种情况下是一种替代方法，但尚未经过测试。在本研究中，我们旨在评估照顾者对解决问题的自助指导手册对首次发作精神病年轻人的主要照顾者的有用性的看法。
在澳大利亚墨尔本的两个早期干预精神病服务机构进行了一项嵌套在随机对照试验中的定性过程评估。124名照顾者被随机分配到解决问题的自助指导干预组或常规治疗组。我们还对干预组中的24名随机样本进行了定性过程评估，采用个人访谈的方式。对定性数据进行了主题分析，这是本文的主题。访谈于2009年1月至2010年9月进行。
从数据中提取了三个主题，反映了照顾者对手册有用性的看法：促进照顾者的幸福感、增强照顾者对首次发作精神病年轻人的理解和支持，以及该项目的可及性和提供方式。
该过程评估强调，自助指导有助于为受影响年轻人的照顾者提供信息并给予支持。虽然在扩大提供方式方面仍有空间，但该方法易于使用且可及，可以作为社区精神卫生护士和其他临床医生为照顾者提供的标准支持的一种具有成本效益的辅助手段。
ACTRN12609000064202。
