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精神分裂症患者的疾病解释模型和教育干预的作用。

Explanatory model of illness of the patients with schizophrenia and the role of educational intervention.

机构信息

Department of Psychiatry, Lady Reading Hospital, Peshawar, Pakistan.

University of Peshawar, Peshawar, Pakistan.

出版信息

Schizophr Res. 2017 Dec;190:68-73. doi: 10.1016/j.schres.2017.03.006. Epub 2017 Mar 10.

Abstract

This randomized controlled trial was conducted at Department of Psychiatry, Lady Reading Hospital, Peshawar from February to August 2015 to explore beliefs and concepts of patients with schizophrenia about their illness and to find out the effectiveness of structured educational intervention in changing the explanatory models of illness of the patients and in their symptoms reduction. One hundred and three patients were recruited in the trial who were randomly assigned to two groups i.e., Experimental (n=53) and Control i.e., Treatment As Usual, TAU (n=50). Intervention was applied to experimental group only, once a month for three months. Short Explanatory Model Interview (SEMI), Brief Psychiatric Rating Scale (BPRS), Positive And Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF) and Compliance Rating Scale were applied on all patients at baseline and at 3months follow up. Scores on PANSS (Total), BPRS and GAF showed improvement in the experimental group as compared to TAU group, at follow up, with the p values of 0.000, 0.002 and 0.000, respectively. On follow up, 44 (95.6%) patients of experimental group achieved complete compliance as compared to 17 (47.2%) patients of TAU group [p=0.000]. On baseline analysis of SEMI, in the experimental group, only 3.8% (n=2) knew about name of the illness, which increased to 54.3% (n=25) on follow up, while in TAU group it improved to 5.6% (n=2) as compared to 0% at baseline (p=0.000). The result suggest that Structured educational intervention can be effective in modifying the beliefs of the patients regarding their illness.

摘要

这项随机对照试验于 2015 年 2 月至 8 月在白沙瓦莱迪夫人医院的精神病科进行,旨在探讨精神分裂症患者对自身疾病的信念和观念,并发现结构化教育干预在改变患者疾病的解释模式和减轻其症状方面的有效性。该试验共招募了 103 名患者,随机分为两组:实验组(n=53)和对照组(即常规治疗,TAU,n=50)。仅对实验组进行干预,每月一次,共三个月。所有患者在基线和 3 个月随访时均接受简短解释模型访谈(SEMI)、简明精神病评定量表(BPRS)、阳性和阴性综合征量表(PANSS)、总体功能评估(GAF)和依从性评定量表的评估。与 TAU 组相比,实验组的 PANSS(总分)、BPRS 和 GAF 评分在随访时有所改善,p 值分别为 0.000、0.002 和 0.000。在随访时,实验组 44 名(95.6%)患者完全依从,而 TAU 组仅 17 名(47.2%)患者完全依从[p=0.000]。在基线时的 SEMI 分析中,实验组中只有 3.8%(n=2)知道疾病的名称,而在随访时增加到 54.3%(n=25),而 TAU 组则从基线时的 0%提高到 5.6%(n=2)(p=0.000)。结果表明,结构化教育干预可以有效地改变患者对自身疾病的信念。

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