Dong Die, Mu Ting-Yu, Xu Jia-Yi, Dai Jia-Ning, Zhou Zhi-Nan, Zhang Qiong-Zhi, Shen Cui-Zhen
College of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
Hangzhou Wenhui School, Hangzhou, China.
Front Psychol. 2022 Aug 30;13:931802. doi: 10.3389/fpsyg.2022.931802. eCollection 2022.
At present, adherence to antipsychotic treatment is often poor, leading to the recurrence of symptoms. This increases the likelihood of the patient experiencing disability and thus increases the disease burden for the patient, their family, and society as a whole. However, to date, there is no clear evidence regarding the effect of medication adherence interventions on outcomes for patients with schizophrenia. Moreover, the traditional intervention methods are limited by manpower and resources in low- and middle-income countries. Recent studies have demonstrated that increasing a patient's level of self-compassion may improve their treatment adherence. Online mental health care interventions have advantages in terms of feasibility and acceptability for patients with schizophrenia. In this regard, a WeChat-based self-compassion training protocol to improve patient treatment adherence was designed in this study and will be evaluated in the future to determine its impact on patients with schizophrenia.
The protocol for the randomized controlled trial (RCT) is based on the SPIRIT 2013 statement. This parallel RCT will aim to recruit 392 patients with schizophrenia who will be randomized at a 1:1 ratio into a 3-week intervention or control group. Both groups will receive routine care. The intervention group will also receive WeChat-based self-compassion training, which requires participants to complete three tasks every day, including a reading task, a meditation task, and a self-compassion journal task. The control group will receive WeChat-based psychological health education, which will only require participants to read positive articles about psychological health every day. Medication adherence, self-compassion, stigma, and social support will be measured at baseline (T), immediately after the intervention (T), and 3 weeks after the intervention (T). Program feasibility will be evaluated throughout the course of the study, and acceptability will be measured immediately after the intervention (T).
The intervention described here will address the barriers to accessing mental health care for people with schizophrenia, including patients' desire for independent management, difficulty accessing providers, and concerns about privacy and stigma. The current study provides guidance for clinical nurses to carry out psychological intervention, with the ultimate aim of addressing the problems associated with a shortage of psychological professionals in low- and middle-income countries.
目前，抗精神病药物治疗的依从性往往较差，导致症状复发。这增加了患者出现残疾的可能性，从而加重了患者及其家庭乃至整个社会的疾病负担。然而，迄今为止，尚无明确证据表明药物依从性干预对精神分裂症患者的治疗结果有何影响。此外，在低收入和中等收入国家，传统干预方法受到人力和资源的限制。最近的研究表明，提高患者的自我同情水平可能会改善他们的治疗依从性。在线心理健康护理干预对于精神分裂症患者在可行性和可接受性方面具有优势。在这方面，本研究设计了一种基于微信的自我同情训练方案，以提高患者的治疗依从性，并将在未来进行评估，以确定其对精神分裂症患者的影响。
随机对照试验（RCT）方案基于2013年SPIRIT声明。这项平行RCT旨在招募392名精神分裂症患者，他们将以1:1的比例随机分为为期3周的干预组或对照组。两组都将接受常规护理。干预组还将接受基于微信的自我同情训练，要求参与者每天完成三项任务，包括阅读任务、冥想任务和自我同情日记任务。对照组将接受基于微信的心理健康教育，只要求参与者每天阅读有关心理健康的积极文章。将在基线（T0）、干预结束后立即（T1）和干预后3周（T2）测量药物依从性、自我同情、耻辱感和社会支持。将在整个研究过程中评估方案的可行性，并在干预结束后立即（T1）测量可接受性。
这里描述的干预措施将解决精神分裂症患者获得心理健康护理的障碍，包括患者对自主管理的渴望、难以获得医疗服务提供者的帮助以及对隐私和耻辱感的担忧。当前的研究为临床护士开展心理干预提供了指导，最终目的是解决低收入和中等收入国家心理专业人员短缺的相关问题。
