开发量表并实施教育项目以减少社区药剂师对精神分裂症的污名化：一项随机对照试验。
Scale development and an educational program to reduce the stigma of schizophrenia among community pharmacists: a randomized controlled trial.
机构信息
Office of Clinical Pharmacy Practice and Health Care Management, Faculty of Pharmacy, Meijo University, Nagoya, Aichi, Japan.
Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Fukuoka, Japan.
出版信息
BMC Psychiatry. 2021 Apr 26;21(1):211. doi: 10.1186/s12888-021-03208-z.
BACKGROUND
Stigma associated with mental disorders is rooted among many pharmacists, and represents a major barrier to patient support in community-based psychiatry. We developed an assessment scale that is specifically designed to assess the level of stigma that pharmacists may have toward schizophrenia, and then examined the effects of reducing stigma with an educational program that focuses on communication with patients diagnosed with schizophrenia (PDS) using the newly developed Stigma Scale towards Schizophrenia for Community Pharmacists (SSCP).
METHODS
SSCP was developed by exploratory factor analysis with promax rotation based on responses from 822 randomly selected community pharmacists. Furthermore, a randomized controlled trial was conducted for 115 community pharmacists to clarify the effects of reducing the stigma of schizophrenia using an educational program for them with a focus on communication with PDS. Participants were individually allocated to two groups: educational lecture group (56; only attending a lecture on schizophrenia) or contact-based intervention group (59; communicating with PDS and attending the lecture). The stigma assessment using SSCP was conducted immediately before and after the educational intervention.
RESULTS
A total of 4 factors and 27 items were extracted from the exploratory factor analysis to comprise the SSCP. Cronbach's α of SSCP, social distance at professional pharmacy service (factor I), attitudes towards PDS (factor II), self-disclosure (factor III), and social distance in personal (factor IV) were 0.89, 0.88, 0.76, 0.62, and 0.62, respectively. Educational program-related changes of the median (interquartile range) total SSCP score from baseline were - 9.0 (- 16.0 - - 5.0) in the contact-based intervention group and - 3.0 (- 7.0-1.0) in the educational lecture group, reflecting a significant reduction of stigma levels in the contact-based intervention group. On examining the SSCP subscales, scores for factor I and factor II significantly improved. The educational program was more effective for pharmacists aged 20-39 years or with negligible experience of communicating with PDS at work and/or in private life.
CONCLUSIONS
SSCP and the educational program for community pharmacists that focuses on communication with PDS were useful for assessing and reducing, respectively, the stigma attached by these pharmacists to schizophrenia.
TRIAL REGISTRATION
UMIN Clinical Trials Registry ( UMIN000043189 , registered on January 30, 2021), Retrospectively registered.
背景
精神障碍相关污名在许多药剂师中根深蒂固，这是社区精神病学中患者支持的主要障碍。我们开发了一种评估量表，专门用于评估药剂师对精神分裂症可能存在的污名程度，然后通过使用新开发的社区药剂师对精神分裂症的污名量表（SSCP）评估与精神分裂症患者（PDS）沟通为重点的教育计划来检验减少污名的效果。
方法
SSCP 通过探索性因子分析和 promax 旋转基于 822 名随机选择的社区药剂师的反应得出。此外，对 115 名社区药剂师进行了一项随机对照试验，以通过针对与 PDS 沟通的教育计划来阐明减少精神分裂症污名的效果。参与者被单独分配到两组：教育讲座组（56 名；仅参加精神分裂症讲座）或基于接触的干预组（59 名；与 PDS 沟通并参加讲座）。使用 SSCP 在教育干预前后立即进行污名评估。
结果
从探索性因子分析中提取了 4 个因子和 27 个项目，构成了 SSCP。SSCP 的 Cronbach's α 为 0.89、0.88、0.76、0.62 和 0.62，分别为专业药房服务的社会距离（因子 I）、对 PDS 的态度（因子 II）、自我披露（因子 III）和个人的社会距离（因子 IV）。基于接触的干预组的 SSCP 总分中位数（四分位距）从基线的-9.0（-16.0- -5.0）变化，而教育讲座组的-3.0（-7.0-1.0），反映出接触组的污名水平显著降低基于干预的。在检查 SSCP 子量表时，因子 I 和因子 II 的分数显着提高。该教育计划对年龄在 20-39 岁之间的药剂师或在工作和/或私人生活中与 PDS 沟通经验极少的药剂师更有效。
结论
SSCP 和专注于与 PDS 沟通的社区药剂师教育计划可分别用于评估和减少药剂师对精神分裂症的污名。
试验注册
UMIN 临床试验注册（UMIN000043189，注册于 2021 年 1 月 30 日），回顾性注册。
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