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应用基于护理的认知解离技术对精神分裂症患者正念觉察、认知融合及妄想可信度的影响:一项随机对照试验

Effect of applying nursing-based cognitive defusion techniques on mindful awareness, cognitive fusion, and believability of delusions among clients with schizophrenia: a randomized control trial.

作者信息

El-Ashry Ayman Mohamed, Abd Elhay Eman Sameh, Taha Samah Mohamed, Khedr Mahmoud Abdelwahab, Attalla Mansour Feby Saad, Alabdullah Amany Anwar Saeed, Farghaly Abdelaliem Sally Mohammed, El-Sayed Mona Metwally

机构信息

Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt.

Faculty of Nursing, Mansoura University, Mansoura, Egypt.

出版信息

Front Psychiatry. 2024 Apr 26;15:1369160. doi: 10.3389/fpsyt.2024.1369160. eCollection 2024.

Abstract

BACKGROUND

Applying cognitive defusion techniques to enduring psychotic symptoms, such as delusions, presents both a challenge and a promising opportunity for psychiatric nurses to manage delusions among schizophrenia clients.

OBJECTIVE

This study aimed to examine the impact of cognitive defusion techniques on psychological flexibility, mindful awareness, cognitive fusion, and the believability of delusions in schizophrenia clients.

METHODOLOGY

This study used a single-blind, parallel-arm Randomized Controlled Trial design. Over five weeks, 70 clients with schizophrenia were randomized to either the cognitive defusion intervention group (n = 35) or the control group (n = 35).

FINDINGS

The participants showed significant reductions in the believability of delusions, cognitive fusion, and psychological inflexibility immediately after the intervention and at follow-up. Notable enhancements were observed in cognitive defusion and mindfulness awareness abilities.

CONCLUSION

Cognitive defusion techniques positively affect schizophrenia clients who struggle with persistent delusional beliefs. This underscores the importance of further investigating this approach to decrease the intensity of delusions as part of a comprehensive therapeutic intervention. Psychiatric nurses must receive training in "cognitive defusion skills" to aid schizophrenia clients in becoming more aware of their emotions and modifying their coping strategies for delusional beliefs. On August 3, 2023, the research was retrospectively registered under the reference number NCT05759091 as a randomized clinical trial.

CLINICAL TRIAL REGISTRATION

https://classic.clinicaltrials.gov/ct2/show/NCT05759091, identifier NCT05759091.

摘要

背景

将认知解离技术应用于持久的精神病性症状,如妄想,对精神科护士管理精神分裂症患者的妄想既是一项挑战,也是一个充满希望的机会。

目的

本研究旨在探讨认知解离技术对精神分裂症患者心理灵活性、正念觉察、认知融合及妄想可信度的影响。

方法

本研究采用单盲、平行组随机对照试验设计。在五周时间里,70名精神分裂症患者被随机分为认知解离干预组(n = 35)和对照组(n = 35)。

结果

干预后及随访时,参与者的妄想可信度、认知融合及心理僵化程度均显著降低。认知解离和正念觉察能力有显著提高。

结论

认知解离技术对与持续妄想信念作斗争的精神分裂症患者有积极影响。这凸显了进一步研究该方法以降低妄想强度作为综合治疗干预一部分的重要性。精神科护士必须接受“认知解离技能”培训,以帮助精神分裂症患者更好地觉察自己的情绪,并改变应对妄想信念的策略。2023年8月3日,该研究作为一项随机临床试验进行了回顾性注册,注册号为NCT05759091。

临床试验注册

https://classic.clinicaltrials.gov/ct2/show/NCT05759091,标识符NCT05759091。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82cd/11082577/815e34f47af7/fpsyt-15-1369160-g001.jpg

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