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家庭功能和药物依从性在精神分裂症患者症状与精神残疾之间的中介作用:一项横断面研究。

The mediating effect of family function and medication adherence between symptoms and mental disability among Chinese patients with schizophrenia: a cross-sectional study.

机构信息

a Nursing Department , Harbin Medical University Daqing Campus , Daqing , Heilongjiang province , China.

b Medical College of Chifeng University , China.

出版信息

Psychol Health Med. 2019 Jun;24(5):559-569. doi: 10.1080/13548506.2018.1533248. Epub 2018 Oct 17.

Abstract

Schizophrenia is a debilitating, chronic, and high-refractory mental illness. Researchers should focus considerable attention to patients with mental disability. This study aims to explore the mediating effect of family function and medication adherence between symptoms and mental disability among Chinese patients with schizophrenia during the convalescent stage. Data from a cross-sectional sample of 499 Chinese patients with schizophrenia were used in this study. The participants were recruited and independently interviewed using the General Information Sheet, Positive and Negative Syndrome Scale (PANSS), World Health Organization Disability Assessment Schedule II (WHO-DAS II), Family APGAR Index (APGAR), and Morisky Medication Adherence Scale (MMAS-8) as outcome measures. A structural equation modeling strategy was used to analyze data. To analyze the correlation matrix, we applied the maximum-likelihood method to estimate the parameters. Bootstrapping was used to validate the mediation effects. Findings from the structural equation modeling demonstrated that family function and medication adherence played mediating roles between psychiatric symptoms and disability. This study presents a partial mediation model. Psychiatrists and nurses should assess the level of family function and medication adherence for schizophrenia, as well as provide interventions to improve family function and medication adherence, thereby eventually mediating disability.

摘要

精神分裂症是一种使人衰弱、慢性且高复发的精神疾病。研究人员应将相当多的注意力集中在精神残疾患者身上。本研究旨在探讨家庭功能和药物依从性在精神分裂症恢复期中国患者症状和精神残疾之间的中介作用。本研究使用了横断面样本中 499 名中国精神分裂症患者的数据。参与者使用一般信息表、阳性和阴性症状量表(PANSS)、世界卫生组织残疾评定量表 II(WHO-DAS II)、家庭 APGAR 指数(APGAR)和 Morisky 药物依从性量表(MMAS-8)作为结果进行独立访谈。采用结构方程模型策略进行数据分析。为了分析相关矩阵,我们应用最大似然法估计参数。采用自举法验证中介效应。结构方程模型的结果表明,家庭功能和药物依从性在精神症状和残疾之间发挥了中介作用。本研究提出了一个部分中介模型。精神科医生和护士应评估精神分裂症患者的家庭功能和药物依从性水平,并提供干预措施以改善家庭功能和药物依从性,从而最终缓解残疾。

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