Schizophrenia and Community Integration Service, St. Joseph's Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada.
Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada.
Int J Environ Res Public Health. 2023 Feb 9;20(4):3035. doi: 10.3390/ijerph20043035.
(1) Background: Self-management is advocated as a feasible, effective intervention to support individuals to actively manage the impact of illness and live healthier lives. We sought to evaluate a piloted self-management model, SET for Health, tailored for individuals living with schizophrenia embedded within ambulatory case management. (2) Methods: A mixed-methods design engaged 40 adults living with schizophrenia in the SET for Health protocol. Functional and symptomatic outcomes were measured by self-report and clinician ratings at baseline and completion of self-management plans, on average one year later. Semi-structured qualitative client interviews invited evaluations of personal experiences with the intervention. (3) Results: Significant improvements were found concerning client illness severity, social and occupational functioning, illness management and functional recovery with reductions in emergency visits and days in hospital. Clients endorsed the value of the intervention. Baseline clinical characteristics did not predict who benefited. Participation contributed to motivational gains and quality of life. (4) Conclusions: Results confirmed self-management support embedded within traditional case management improved clients' clinical and functional status, and contributed to quality of life. Clients engaged in their recovery and actively used self-management strategies. Self-management can be successfully adopted by clients with schizophrenia regardless of age, gender, education, illness severity or duration.
(1) 背景:自我管理被倡导为一种可行且有效的干预措施,以支持个体积极应对疾病的影响,过上更健康的生活。我们旨在评估一种针对精神分裂症患者的试点自我管理模式——SET for Health,该模式嵌入在门诊病例管理中。
(2) 方法:采用混合方法设计,有 40 名成年精神分裂症患者参与了 SET for Health 方案。在基线和完成自我管理计划时(平均一年后),通过自我报告和临床医生评分来测量功能和症状结果。半结构化的客户访谈邀请客户对干预措施的个人体验进行评估。
(3) 结果:患者的病情严重程度、社会和职业功能、疾病管理和功能恢复均有显著改善,急诊就诊次数和住院天数减少。客户认可该干预措施的价值。基线临床特征不能预测谁会受益。参与有助于提高动机和生活质量。
(4) 结论:结果证实,嵌入传统病例管理的自我管理支持可改善患者的临床和功能状况,并有助于提高生活质量。客户积极参与他们的康复过程,并主动使用自我管理策略。无论年龄、性别、教育程度、病情严重程度或持续时间如何,精神分裂症患者都可以成功采用自我管理。