Komóczi Márk, Kósa Karolina
Department of Behavioural Sciences, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
BMC Psychiatry. 2025 Apr 14;25(1):376. doi: 10.1186/s12888-025-06816-1.
Community-based psychiatric rehabilitation (CBPR) helps patients reintegrate into society while enabling them to live autonomously in supportive environments. CBPR uses multi-modal approach to address patients' needs in health, education, livelihood, empowerment and social functioning. In addition to pharmacotherapy, other interventions such as metacognitive training, lifestyle interventions, psychoeducation, arts therapy may be used to improve functioning and quality of life. Storytelling as a new intervention was implemented in a community-based rehabilitation setting with patients with mental health issues to test its feasibility and potential to improve life satisfaction.
Stories presenting difficult lives and complicated relationships were narrated and discussed in eight storytelling sessions for members of a civil organization involved in psychiatric rehabilitation in four months. Acceptability was tested by following participation rate and feedback with scales after each session. Demographic as well as mental health data including sense of coherence, distress, self-efficacy, and life satisfaction were investigated by standard scales before the first and after the last session.
Participation ranged from 31 to 49% compared to all persons present at the setting. Participants (mean age: 53.41 ± 12.23 years, 63% females) found the stories highly interesting (mean: 8.93 ± 1.62) and comprehensible (8.67 ± 1.9) on a 1-10 scale though the means of individual sessions somewhat varied. Significant positive correlation was found between the stories being interesting and comprehensible (Spearman's rho = 0.656) but significant negative correlation was found between story length and comprehension (Spearman's rho=-0.183). Based on the responses from participants who completed the questionnaires before and after the intervention, life satisfaction significantly increased. Psychological variables such as self-efficacy, sense of coherence, pathological distress showed improving tendency without reaching significance. Pre-intervention data showed significant positive correlation between self-efficacy and sense of coherence (Pearson's r = 0.659). Psychological distress was negatively related to both self-efficacy (Pearson's r=-0.728) and sense of coherence (Pearson's r=-0.825).
Storytelling as a means for promoting health proved to be feasible in a group of rehabilitated patients with mental disorders. Their life satisfaction significantly improved in four months. Carefully selected stories narrated and discussed in group settings may result in the gradual shift of participants' perspectives leading to improved life satisfaction.
基于社区的精神康复（CBPR）有助于患者重新融入社会，同时使他们能够在支持性环境中自主生活。CBPR采用多模式方法来满足患者在健康、教育、生计、赋权和社会功能方面的需求。除药物治疗外，还可使用其他干预措施，如元认知训练、生活方式干预、心理教育、艺术治疗等，以改善功能和生活质量。讲故事作为一种新的干预措施，在一个针对有心理健康问题患者的社区康复环境中实施，以测试其可行性以及改善生活满意度的潜力。
在四个月的时间里，为一个参与精神康复的民间组织的成员举办了八次讲故事活动，讲述并讨论了呈现艰难生活和复杂关系的故事。通过每次活动后的参与率和量表反馈来测试可接受性。在第一次活动前和最后一次活动后，使用标准量表调查人口统计学以及心理健康数据，包括连贯感、痛苦、自我效能感和生活满意度。
与该场所的所有在场人员相比，参与率在31%至49%之间。参与者（平均年龄：53.41±12.23岁，63%为女性）认为这些故事非常有趣（平均得分：8.93±1.62）且易于理解（8.67±1.9）（1-10分制），尽管各次活动的平均分略有差异。发现故事的趣味性和可理解性之间存在显著正相关（斯皮尔曼等级相关系数rho = 0.656），但故事长度与理解之间存在显著负相关（斯皮尔曼等级相关系数rho = -0.183）。根据干预前后完成问卷的参与者的回答，生活满意度显著提高。自我效能感、连贯感、病理性痛苦等心理变量呈改善趋势，但未达到显著水平。干预前的数据显示自我效能感和连贯感之间存在显著正相关（皮尔逊相关系数r = 0.659）。心理痛苦与自我效能感（皮尔逊相关系数r = -0.728）和连贯感（皮尔逊相关系数r = -0.825）均呈负相关。
讲故事作为一种促进健康的手段，在一组康复的精神障碍患者中被证明是可行的。他们的生活满意度在四个月内显著提高。在小组环境中讲述并讨论精心挑选的故事可能会导致参与者观点的逐渐转变，从而提高生活满意度。
