Høier Nanna Yosser Ben, Mølstrøm Ida-Marie, Urfer-Parnas Annick, Henriksen Mads Gram, Nordgaard Julie
Mental Health Center Amager, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.
Front Psychiatry. 2024 Jun 5;15:1399935. doi: 10.3389/fpsyt.2024.1399935. eCollection 2024.
A structure of everyday life creates routines and a sense of familiarity, which provides a recognizable basis for being and acting in the world. A structure of everyday life reduces stress, and daily stress has consistently been associated with higher levels of psychiatric symptoms. Little is known about how patients with schizophrenia and severe social impairment structure their lives. Thus, we aimed to explore the everyday lives of this group of patients, looking for structuring elements.
In this qualitative study, we included patients diagnosed with schizophrenia who were either homeless or had difficulties reporting for treatment and, thus, needed treatment from an outreach team.
17 participants were included in the study. We found only few structuring elements across all participants in the qualitative analyses. We identified five themes in our sample that serve as structuring elements in the everyday life: social interactions, volunteering to assist with basic tasks, self-initiated routines such as going for a walk daily, exoskeleton (structure provided by others), and having pets. None of the participants reported much activity during the day, and for most of them, social interactions were minimal.
All the participants had very little structure and routines in their everyday life. The shelters provided the homeless participants with some structuring elements, whereas the domiciled participants had no external structuring elements. The findings have important implications for psychosocial treatment of severe social impairment in schizophrenia. The lack of structure in these patients' everyday lives highlights the need for targeted interventions that could facilitate such structures and guide social involvement and personal recovery.
日常生活结构会形成惯例和熟悉感，为在世界上的生存与行动提供可识别的基础。日常生活结构能减轻压力，而日常压力一直与较高水平的精神症状相关。对于精神分裂症患者及严重社会功能障碍患者如何构建其生活，知之甚少。因此，我们旨在探索这组患者的日常生活，寻找结构化元素。
在这项定性研究中，我们纳入了被诊断为精神分裂症的患者，他们要么无家可归，要么难以前往接受治疗，因此需要外展团队的治疗。
17名参与者纳入了该研究。在定性分析中，我们在所有参与者中仅发现了很少的结构化元素。我们在样本中确定了五个主题，它们在日常生活中作为结构化元素：社交互动、自愿协助完成基本任务、自我发起的日常活动（如每天散步）、外部结构（由他人提供的结构）以及养宠物。没有参与者报告白天有很多活动，而且对大多数人来说，社交互动很少。
所有参与者在日常生活中的结构和惯例都很少。收容所为无家可归的参与者提供了一些结构化元素，而有家的参与者则没有外部结构化元素。这些发现对精神分裂症严重社会功能障碍的心理社会治疗具有重要意义。这些患者日常生活中缺乏结构凸显了针对性干预的必要性，这种干预可以促进此类结构的形成，并指导社会参与和个人康复。
