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针对心理健康问题的疾病管理与康复项目:减轻症状并提高社会功能。

Illness management and recovery program for mental health problems: reducing symptoms and increasing social functioning.

作者信息

Tan Chay Huang Sharon, Ishak Rohaida Binte, Lim Tan Xiong Gentatsu, Marimuthusamy Palaniappan, Kaurss Kuldip, Leong Jern-Yi Joseph

机构信息

Institute of Mental Health, Community Mental Health Team, Singapore, Singapore.

Nanyang Technological University, Singapore, Singapore.

出版信息

J Clin Nurs. 2017 Nov;26(21-22):3471-3485. doi: 10.1111/jocn.13712. Epub 2017 Feb 19.

Abstract

AIMS AND OBJECTIVES

To evaluate the effectiveness of the Illness Management and Recovery Program in comparison with the current standard of care in terms of reduction of symptoms, rehospitalisation rates and social functioning in Asia.

BACKGROUND

Focus of treatment for Mental Health had been shifted from mere management of symptoms to that of achievement of recovery. In the recovery process, strategies to achieve higher level of functioning were used (Psychiatric Services 2014, 65, 171). However, two main factors hindered clients from attaining recovery: first, the lack of Mental Health resources in the community and second the negative attitudes of healthcare professionals towards mental illness (American Journal of Psychiatric Rehabilitation 2012, 15, 131). Hence, it is essential to implement an effective programme that will train mental health professionals to use more effective techniques and materials in helping the clients to better integrate into society by achieving skills in their attempt to work towards recovery.

DESIGN

This study adopts a time series experimental quantitative design.

METHODS

Fifty participants who consented to the study were randomly assigned to two groups. Participants in the experimental group received the experimental management and recovery programme, while the control group received standard care management by the community psychiatric nurses for a period of 12 months.

RESULTS

Participants in the experimental group reported significantly lower number of admissions, shorter length of stay, lower Brief Psychiatric Rating Scale scores, and also reported significantly higher scores on both the Illness Management and Recovery Scale and the Global Assessment Scale.

CONCLUSION

This study demonstrated the effectiveness of IMR in helping Asian people with mental illness to not only reduce symptoms and hospitalisations but also improve social functioning. They have benefitted from the program although they are living in a different cultural setting from where IMR was developed.

RELEVANCE TO CLINICAL PRACTICE

The success of this study has raised the standard of care in the community intervention and led more people to their recovery.

摘要

目的与目标

评估疾病管理与康复计划相较于当前标准护理,在减轻亚洲患者症状、降低再住院率及改善社会功能方面的有效性。

背景

心理健康治疗的重点已从单纯的症状管理转向实现康复。在康复过程中,采用了实现更高功能水平的策略(《精神科服务》,2014年,第65卷,第171页)。然而,有两个主要因素阻碍患者实现康复:一是社区心理健康资源匮乏,二是医护人员对精神疾病的消极态度(《美国精神科康复杂志》,2012年,第15卷,第131页)。因此,实施一项有效的计划至关重要,该计划将培训心理健康专业人员使用更有效的技术和材料,帮助患者通过掌握康复所需技能更好地融入社会。

设计

本研究采用时间序列实验性定量设计。

方法

五十名同意参与研究的参与者被随机分为两组。实验组参与者接受疾病管理与康复计划,而对照组在12个月内接受社区精神科护士的标准护理管理。

结果

实验组参与者报告的住院次数显著减少、住院时间缩短、简明精神病评定量表得分降低,同时在疾病管理与康复量表及总体评估量表上的得分也显著更高。

结论

本研究证明了疾病管理与康复计划在帮助患有精神疾病的亚洲人减轻症状、减少住院次数以及改善社会功能方面的有效性。尽管他们生活在与该计划研发地不同的文化环境中,但仍从该计划中受益。

与临床实践的相关性

本研究的成功提高了社区干预的护理标准,并使更多人走向康复。

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