Thomas Matt, Rusten Kim
Bloomfield Hospital, Orange, NSW, Australia.
School of Psychology, Charles Sturt University, Bathurst, NSW, Australia.
Aust J Rural Health. 2019 Oct;27(5):463-468. doi: 10.1111/ajr.12578.
Many people with schizophrenia experience cognitive impairments and current practice guidelines recommend cognitive remediation therapy. This implementation trial examined aspects of feasibility, acceptability and outcomes of the computerised interactive remediation of cognition-interactive training for schizophrenia cognitive remediation therapy program in our local context.
A longitudinal design was utilised with participants providing outcome data at commencement of the computerised interactive remediation of cognition-interactive training for schizophrenia program, completion and at follow-up 3 months later.
Our trial was conducted in the inpatient and community mental health contexts within the New South Wales regional city of Orange, between January 2017 and December 2018.
Fifty-three adult volunteers commenced the computerised interactive remediation of cognition-interactive training for schizophrenia program and participated in this trial. Forty-five participants were currently admitted to psychiatric rehabilitation inpatient units at Bloomfield hospital, and eight were referred by Orange Community Mental Health Service.
MAIN OUTCOME MEASURE(S): Participants completed measures of cognitive functioning (repeatable battery for the assessment of neuropsychological status), functional independence (Adaptive Behaviour Assessment Scales 3) and Goal attainment scaling.
Most participants reported they liked computerised interactive remediation of cognition-interactive training for schizophrenia therapy and made excellent progress towards their goals. Those who completed the program made significant gains in the domains of attention, memory and independence in key aspects of daily living. Gains in functional independence were sustained for a small sample following program completion.
This implementation trial showed the computerised interactive remediation of cognition-interactive training for schizophrenia cognitive remediation therapy program was feasible, acceptable and contributed to strong outcomes in both the inpatient and community contexts. Efforts are in progress to translate the computerised interactive remediation of cognition-interactive training for schizophrenia program, and future research will focus on longer term outcomes, cost-benefit analyses and the experiences of participants and therapists.
许多精神分裂症患者存在认知障碍，当前的实践指南推荐认知康复治疗。本实施性试验在我们当地环境中，考察了精神分裂症认知康复治疗项目——计算机化交互式认知康复训练的可行性、可接受性及效果等方面。
采用纵向设计，参与者在精神分裂症计算机化交互式认知康复训练开始时、完成时及3个月后的随访时提供结果数据。
我们的试验于2017年1月至2018年12月在新南威尔士州奥兰治地区城市的住院和社区心理健康环境中进行。
53名成年志愿者开始参与精神分裂症计算机化交互式认知康复训练项目并参与了本试验。45名参与者当时被收治在布卢姆菲尔德医院的精神康复住院部，8名由奥兰治社区心理健康服务机构转诊而来。
参与者完成了认知功能测量（可重复神经心理状态评估量表）、功能独立性测量（适应性行为评估量表第3版）和目标达成量表。
大多数参与者表示他们喜欢精神分裂症计算机化交互式认知康复训练治疗，并在实现目标方面取得了显著进展。完成该项目的参与者在注意力、记忆力以及日常生活关键方面的独立性等领域取得了显著进步。项目完成后，一小部分样本在功能独立性方面的进步得以维持。
本实施性试验表明，精神分裂症认知康复治疗项目——计算机化交互式认知康复训练是可行的、可接受的，并且在住院和社区环境中均取得了良好效果。目前正在努力将精神分裂症计算机化交互式认知康复训练项目进行转化，未来的研究将聚焦于长期效果、成本效益分析以及参与者和治疗师的体验。
