Yosep Iyus, Hikmat Rohman, Suryani Suryani, Widianti Efri, Sriati Aat, Sutini Titin, Rafiyah Imas
Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia.
Nursing Department, Faculty of Health Science, Universitas 'Aisyiyah Bandung, Bandung, Jawa Barat, Indonesia.
BMC Nurs. 2025 May 8;24(1):503. doi: 10.1186/s12912-025-03145-2.
Psychosocial interventions are crucial in managing violent behavior problems in people with schizophrenia, considering the high risk to self and others. Although drug therapy plays an important role, psychotherapy approaches offer holistic solutions in reducing violent behavior that is complex and often resistant to treatment. Therefore, a comprehensive review of the literature on these psychosocial interventions is necessary to evaluate the various approaches that have been developed.
This study aims to map and synthesize existing literature on psychosocial interventions designed to reduce violent behavior in patients with schizophrenia.
A scoping review was carried out by searching for articles from the CINAHL, PubMed, and Scopus databases using the keywords "schizophrenia", "nursing". "psychosocial intervention", and "violence". Inclusion criteria included studies published in English using original research, reporting the results of a nursing intervention, full text, and a publication period of the last five years (2019-2024). Data was extracted using manual tables, and analysis was carried out descriptively qualitatively.
There were 12 articles that met the inclusion criteria and discussed various psychosocial interventions to reduce violent behavior in people with schizophrenia. The results showed that five types of nursing strategies, logotherapy, assertive therapy, forgiveness therapy, cognitive behavioral therapy (CBT) and social skills training (SST), and assertive communication and de-escalation training, consistently resulted in significant reductions in violent behavior.
This scoping review underscores the need for a comprehensive approach to managing violent behavior in schizophrenia by utilizing psychosocial interventions that have been proven to be effective. However, the limited number of studies, heterogeneity in intervention methods, and variability in outcome assessments warrant careful interpretation of the results. Nursing implications include improvements in training and support for nurses to implement these interventions in daily clinical practice. Recommendations for future research include the need for more in-depth studies to explore effective intervention mechanisms as well as improvements in methodologically more robust study designs.
考虑到对自身和他人的高风险，心理社会干预在管理精神分裂症患者的暴力行为问题中至关重要。尽管药物治疗起着重要作用，但心理治疗方法在减少复杂且往往难以治疗的暴力行为方面提供了全面的解决方案。因此，有必要对这些心理社会干预的文献进行全面综述，以评估已开发的各种方法。
本研究旨在梳理和综合关于旨在减少精神分裂症患者暴力行为的心理社会干预的现有文献。
通过在CINAHL、PubMed和Scopus数据库中搜索文章进行范围综述，使用关键词“精神分裂症”“护理”“心理社会干预”和“暴力”。纳入标准包括以英文发表的使用原创研究的文章，报告护理干预的结果、全文以及过去五年（2019 - 2024年）的发表期。数据使用手工表格提取，并进行描述性定性分析。
有12篇文章符合纳入标准，讨论了各种减少精神分裂症患者暴力行为的心理社会干预。结果表明，五种护理策略、意义疗法、自信训练疗法、宽恕疗法、认知行为疗法（CBT）和社交技能训练（SST）以及自信沟通和降级训练，始终能显著减少暴力行为。
本范围综述强调了通过利用已被证明有效的心理社会干预来全面管理精神分裂症暴力行为的必要性。然而，研究数量有限、干预方法的异质性以及结果评估的变异性使得对结果的解释需要谨慎。护理方面的影响包括改善对护士的培训和支持，以便在日常临床实践中实施这些干预。对未来研究的建议包括需要更深入的研究来探索有效的干预机制以及改进方法上更稳健的研究设计。
