von Maffei Christian, Görges Frauke, Kissling Werner, Schreiber Wolfgang, Rummel-Kluge Christine
Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.
Department of Psychiatry and Psychotherapy, Technische Universität München, Möhlstr. 26, 81675, München, Germany.
BMC Psychiatry. 2015 Apr 30;15:93. doi: 10.1186/s12888-015-0481-2.
Relapses and, subsequently, readmissions are common in patients with schizophrenia. Psychoeducation has been shown to reduce the number and duration of readmissions. Yet, only little more than 20% of psychiatric patients in German speaking countries receive psychoeducation. Among other reasons, costs may be considered too high by hospitals. The objective of the present study was to test the feasibility of a new cost-efficient approach in the psychoeducation of patients with schizophrenia. In this study, films were used to impart knowledge about the illness to inpatients.
A total of 113 participants were initially included in the study, eleven of which were not included in the final analyses. Six films about the symptoms, diagnosis, causes, warning signs, treatment of schizophrenia and about the influence of family members and friends were shown in a group setting in the presence of nursing staff. All films combined facts, expert opinions, and personal experiences of peers. As the main outcome criterion of this feasibility pilot study, we measured the effects on knowledge. Secondary outcome measures included compliance, insight into illness, side effects, and quality of life. Data were collected directly after the intervention and about half a year afterwards. The number and the duration of readmissions to the hospital were recorded and compared to the number and duration of prior admissions. Patients were also asked to state their subjective opinion about the films. Main data analyses were done using paired t-tests and Wilcoxon signed-rank tests. Secondary analyses also involved ANOVAs and ANCOVAs.
One hundred and two inpatients were included in the data analyses. Showing the films in the tested setting was shown to be feasible. Knowledge about schizophrenia (p < .001), compliance (ps < .01), insight into illness (p < .01), and quality of life (p < .001) all increased significantly after patients had watched the films and remained stable for at least half a year. A vast majority (84.9%) of the patients found the films to be interesting and informative.
Using films to educate inpatients about schizophrenia is a feasible method that is cost- and time-efficient and well received by the patients.
精神分裂症患者复发及随后再次入院的情况很常见。心理教育已被证明可减少再次入院的次数和时长。然而,在德语国家,只有略多于20%的精神科患者接受心理教育。除其他原因外,医院可能认为成本过高。本研究的目的是测试一种新的具有成本效益的精神分裂症患者心理教育方法的可行性。在本研究中,影片被用于向住院患者传授有关该疾病的知识。
共有113名参与者最初纳入研究,其中11名未纳入最终分析。在护理人员在场的情况下,以小组形式播放了六部关于精神分裂症的症状、诊断、病因、警示信号、治疗以及家庭成员和朋友影响的影片。所有影片都结合了事实、专家意见和同伴的个人经历。作为这项可行性试点研究的主要结果标准,我们测量了对知识的影响。次要结果指标包括依从性、对疾病的洞察力、副作用和生活质量。在干预后及大约半年后直接收集数据。记录再次入院的次数和时长,并与之前入院的次数和时长进行比较。还要求患者陈述他们对影片的主观看法。主要数据分析采用配对t检验和Wilcoxon符号秩检验。次要分析还涉及方差分析和协方差分析。
102名住院患者纳入数据分析。在测试环境中播放影片被证明是可行的。患者观看影片后,关于精神分裂症的知识(p <.001)、依从性(ps <.01)、对疾病的洞察力(p <.01)和生活质量(p <.001)均显著提高,并至少维持半年稳定。绝大多数(84.9%)患者认为影片有趣且信息丰富。
使用影片对住院患者进行精神分裂症教育是一种可行的方法,具有成本效益和时间效益,且深受患者欢迎。