School of Nursing National Yang-Ming University, Taipei, Taiwan.
Cardinal Tien Junior College of Healthcare & Management, New Taipei City, Taiwan.
Int J Ment Health Nurs. 2019 Dec;28(6):1318-1327. doi: 10.1111/inm.12643. Epub 2019 Aug 21.
Past studies have presented evidence that depressive symptoms are affected in different ways by social interaction skills and auditory hallucinatory symptoms in people with schizophrenia. However, few studies have focused on examining the relationship among auditory hallucinatory severity, social interaction skills, and depressive symptoms. This study aimed to explore the mediating effect of auditory hallucinatory severity on social interaction skills and depressive symptoms in people with long-term schizophrenia. We propose that auditory hallucination severity functions as a mechanism through which impaired social interaction skills increase depressive symptoms. In this study, a convenience sample of 186 people with schizophrenia was obtained from hospital-based rehabilitation wards. Four instruments were used: A demographic data questionnaire, the Assessment of Communication and Interaction Skills-Chinese version, the Characteristics of Auditory Hallucinations Questionnaire, and the Beck Depression Inventory II. To investigate the mediating effect of auditory hallucinatory severity after controlling for six covariates, we tested an indirect effect in a simple mediation model using the SPSS macro PROCESS, which is a regression-based approach. The indirect effect and the results of Sobel's test were significant (Z = -2.824, P = 0.005), which confirms that auditory hallucination severity mediates social interaction skills and depressive symptoms. This finding suggests that psychiatric nurses must teach people with schizophrenia to use auditory hallucination management strategies to prevent them from becoming immersed in auditory hallucinations and reducing their social interaction with the real world, so that depressive symptoms can be improved.
过去的研究已经证明，抑郁症状在社交互动技能和精神分裂症患者的听觉幻觉症状方面受到不同的影响。然而，很少有研究关注听觉幻觉严重程度、社交互动技能和抑郁症状之间的关系。本研究旨在探讨长期精神分裂症患者听觉幻觉严重程度对社交互动技能和抑郁症状的中介作用。我们提出，听觉幻觉严重程度是社交互动技能受损导致抑郁症状加重的一种机制。在这项研究中，我们从医院康复病房获得了 186 名精神分裂症患者的便利样本。使用了四种工具：人口统计学数据问卷、中文版交流和互动技能评估、听觉幻觉特征问卷和贝克抑郁量表第二版。为了在控制了六个协变量后研究听觉幻觉严重程度的中介效应，我们使用 SPSS 宏 PROCESS 在简单中介模型中测试了间接效应，这是一种基于回归的方法。间接效应和 Sobel 检验的结果具有统计学意义（Z=-2.824，P=0.005），这证实了听觉幻觉严重程度中介了社交互动技能和抑郁症状。这一发现表明，精神科护士必须教导精神分裂症患者使用听觉幻觉管理策略，以防止他们沉浸在听觉幻觉中，减少与现实世界的社交互动，从而改善抑郁症状。
