参与同侪共同提供职业康复服务的精神分裂症患者的社会支持、心理健康、精神症状和功能：台湾的一项试点研究。
The social support, mental health, psychiatric symptoms, and functioning of persons with schizophrenia participating in peer co-delivered vocational rehabilitation: a pilot study in Taiwan.
机构信息
Department of Psychiatry, Taipei Veterans General Hospital Yuli Branch, Yuli Township, Hualian County, Taiwan, 98142.
Department of Public Health, Tzu-Chi University, Hualian City, Hualian County, Taiwan, 97071.
出版信息
BMC Psychiatry. 2021 May 25;21(1):268. doi: 10.1186/s12888-021-03277-0.
BACKGROUND
Vocational peer support (VPS) services are recovery-oriented interventions in modern psychiatric care for persons with schizophrenia. However, few VPS services are found in Taiwan. Hence, a pilot program of peer co-delivered vocational rehabilitation to support persons with schizophrenia in Taiwan was proposed and evaluated.
METHODS
Six peers were trained and were willing to co-lead and assist workplace problem-solving groups and care skills training in an extended vocational rehabilitation program from August 2017 to December 2018. The social support, mental health, psychiatric symptoms, and functioning of service users were assessed before and after peer co-delivered services, and the assessments were based on the following: Social Support Scale (SSS), Chinese Health Questionnaire-12 (CHQ-12), Brief Psychiatric Rating Scale (BPRS), Global Assessment of Function (GAF), and the Chinese version of the Social Functioning Scale (C-SFS).
RESULTS
The recruited 46 service users were mostly middle-aged (49.1 ± 9.8), with 27 being male (58.7%). After interventions, 42 service users who completed the program had a significantly increased SSS score (149.1 ± 31.8 vs. 161.2 ± 35.0, df = 41, t = 2.70, p = 0.01) and subscale of friend-peer dimension (44.4 ± 12.0 vs. 53.2 ± 13.2, df = 41, t = 4.72, p < 0.001). The objective (GAF: 69.8 ± 9.8 vs. 72.6 ± 8.8, df = 41, t = 3.50, p = 0.001) and subjective social functional scores (C-SFS: 75.2 ± 8.8 vs. 78.1 ± 9.5, df = 41, t = 2.59, p = 0.01) both significantly increased. The weekly wage elevated significantly (37.5 ± 35.5 vs. 43.6 ± 38.0, df = 41, t = 2.57, p = 0.01) and the BPRS-18 score decreased significantly, too (31.2 ± 6.7 vs. 29.3 ± 5.0, df = 41, t = - 2.83, p = 0.007).
CONCLUSIONS
Peer co-delivered vocational rehabilitation services may enhance the social support received by persons with schizophrenia and improve their occupational outcomes. The pilot program proposed can thus be a model for non-Western countries with limited resources allocated by governments to support persons with schizophrenia.
TRIAL REGISTRATION
ClinicalTrials NCT04767204, retrospectively registered on Feb 23, 2021.
背景
职业同伴支持（VPS）服务是现代精神科护理中针对精神分裂症患者的以康复为导向的干预措施。然而，在台湾很少有 VPS 服务。因此，提出并评估了一项由同伴共同提供的职业康复试点计划，以支持台湾的精神分裂症患者。
方法
从 2017 年 8 月至 2018 年 12 月，培训了 6 名同伴，他们愿意共同领导和协助解决工作场所问题的小组和职业康复的护理技能培训。在同伴共同提供服务前后，对服务使用者的社会支持、心理健康、精神病症状和功能进行了评估，评估基于以下内容：社会支持量表（SSS）、中文版健康问卷-12（CHQ-12）、简明精神病评定量表（BPRS）、总体功能评估（GAF）和中文版社会功能量表（C-SFS）。
结果
招募的 46 名服务使用者主要为中年（49.1±9.8），其中 27 名为男性（58.7%）。干预后，完成该项目的 42 名服务使用者的 SSS 评分（149.1±31.8 与 161.2±35.0，df=41，t=2.70，p=0.01）和朋友-同伴维度子量表（44.4±12.0 与 53.2±13.2，df=41，t=4.72，p<0.001）均显著增加。客观（GAF：69.8±9.8 与 72.6±8.8，df=41，t=3.50，p=0.001）和主观社会功能评分（C-SFS：75.2±8.8 与 78.1±9.5，df=41，t=2.59，p=0.01）均显著增加。每周工资显著提高（37.5±35.5 与 43.6±38.0，df=41，t=2.57，p=0.01），BPRS-18 评分也显著降低（31.2±6.7 与 29.3±5.0，df=41，t=-2.83，p=0.007）。
结论
同伴共同提供的职业康复服务可以增强精神分裂症患者所获得的社会支持，并改善他们的职业结果。因此，所提出的试点计划可以成为资源有限的非西方国家的一个模式，为支持精神分裂症患者提供资金。
试验注册
ClinicalTrials NCT04767204，于 2021 年 2 月 23 日回顾性注册。
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