Department of Nursing, Shinsung University, Dangjin-Si, South Korea.
Department of Nursing, Chung-Ang University, Seoul, South Korea.
Int J Ment Health Nurs. 2023 Dec;32(6):1598-1615. doi: 10.1111/inm.13198. Epub 2023 Aug 8.
The family is the primary caregiver for most patients with schizophrenia, and their roles are essential in patients' illness trajectories and outcomes. Due to this, various family interventions for schizophrenia have been developed and applied to the relatives who take care of their family members with schizophrenia. This study examined the effectiveness of existing family interventions for schizophrenia in achieving their target outcomes at both the family and patient levels by utilizing a systematic review and meta-analysis. Combinations of terms were used to search for relevant studies from the databases. Thirty-seven randomized controlled trials that met the inclusion criteria were included in the analysis. Based on the pooled result of the included studies, the programmes significantly improved the targeted outcomes with large effect size. The programmes' impacts on family-related outcomes were higher than those on patients. Among the targeted outcomes, patients' treatment satisfaction and adherence and family caregivers' mental health were the most remarkable outcomes that had improved from the included programmes. Conversely, outcomes related to family relationships, caregiving experiences, perceived social support of family caregivers, and patients' medication use did not see significant improvements. The programmes delivered to individual family units and only to the family caregivers were more effective than those delivered to groups of caregivers and caregivers and patients together, respectively. Programme-focused interventions were more effective than emotion-focused ones. Based on these findings, an in-home visiting nurse programme or advanced technology is suggested when applying family interventions for schizophrenia in practice.
家庭是大多数精神分裂症患者的主要照顾者，他们在患者的疾病轨迹和结果中起着至关重要的作用。因此，已经开发并应用了各种针对精神分裂症患者的家庭干预措施，针对照顾精神分裂症患者的家庭成员。本研究通过系统评价和荟萃分析，考察了现有的精神分裂症家庭干预措施在家庭和患者两个层面上实现其目标结果的有效性。使用组合术语从数据库中搜索相关研究。共有 37 项符合纳入标准的随机对照试验被纳入分析。根据纳入研究的汇总结果，这些方案显著改善了目标结果，效果显著。与患者相比，这些方案对家庭相关结果的影响更大。在目标结果中，患者的治疗满意度和依从性以及家庭照顾者的心理健康是改善最显著的结果。相比之下，与家庭关系、照顾经历、家庭照顾者感知的社会支持以及患者的药物使用相关的结果没有明显改善。针对单个家庭单位的方案，以及仅针对照顾者的方案，比分别针对照顾者群体和照顾者和患者一起的方案更有效。以方案为重点的干预措施比以情绪为重点的干预措施更有效。基于这些发现，建议在实践中应用精神分裂症家庭干预措施时，采用家庭访视护士计划或先进技术。
