Volovik-Shushan Shani, Krupa Terry, Bloch Yuval, Lipskaya-Velikovsky Lena
Shalvata Mental Health Care Center, Hod-Hasharon, Israel.
School of Health Profession, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Scand J Occup Ther. 2023 Feb;30(2):137-147. doi: 10.1080/11038128.2022.2076734. Epub 2022 May 22.
Recovery-promoting and occupation-oriented interventions for people with schizophrenia who receive in-patient services are scarcely investigated, limiting our understanding of the factors affecting intervention effectiveness and hindering occupational inclusion.
To investigate the impact of contextual factors on the effectiveness of 'Occupational Connections' (OC) - occupational intervention for in-patient psychiatric settings.
Quasi-experimental, single-blind study compared between inpatients with schizophrenia participating in OC ( = 14) and those receiving treatment as usual only ( = 16) on primary outcomes of participation dimensions and recovery-orientation of the service, and on secondary outcomes of cognition, symptom severity, and functional capacity.
Participation in OC in a new context appears to contribute to improvement in cognitive fluency and flexibility, schizophrenia symptoms, and functional capacity (-2.8< < 4.32, < 0.05) with no improvement in the participation dimensions (-1.36< < 1.36, > 0.05) or reduction (-2.25< < 3.74, < 0.05). The pattern of change in primary and secondary outcomes in a new context was distinct from previous reports on OC effectiveness.
These findings suggest the impact of contextual factors on OC effectiveness. Personal participants' factors, institutional features, clinician characteristics, and intervention qualities should be considered in the process of the OC further development, evidence building, and clinical implementation to ensure optimal intervention results.
针对接受住院服务的精神分裂症患者的促进康复和以职业为导向的干预措施鲜有研究，这限制了我们对影响干预效果的因素的理解，并阻碍了职业融入。
研究背景因素对“职业联系”（OC）——一种针对住院精神科患者的职业干预措施效果的影响。
采用准实验、单盲研究，比较了参与OC的精神分裂症住院患者（n = 14）和仅接受常规治疗的患者（n = 16）在参与维度和服务康复导向的主要结局，以及认知、症状严重程度和功能能力的次要结局方面的差异。
在新环境中参与OC似乎有助于改善认知流畅性和灵活性、精神分裂症症状及功能能力（-2.8 < d < 4.32，p < 0.05），但在参与维度方面无改善（-1.36 < d < 1.36，p > 0.05），在康复导向方面也无降低（-2.25 < d < 3.74，p < 0.05）。新环境中主要和次要结局的变化模式与先前关于OC有效性的报告不同。
这些发现表明背景因素对OC有效性有影响。在OC的进一步发展、证据构建和临床实施过程中，应考虑个人参与者因素、机构特征、临床医生特点和干预质量，以确保获得最佳干预效果。
