Community-based psychosocial rehabilitation and prospective change in functional, clinical, and subjective experience variables in schizophrenia
Community-based psychosocial rehabilitation and prospective change in functional, clinical, and subjective experience variables in schizophrenia
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DOI：
10.1093/oxfordjournals.schbul.a033485
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发表时间：
2000-01-01
影响因子：
6.6
通讯作者：
Long, JD
中科院分区：
文献类型：
--
作者：
Brekke, JS;Long, JD
在之前的一项研究中，我们发现，对于被诊断为精神分裂症的个体，基于社区的社会心理康复服务的强度、特异性和纵向性与良好的功能结果相关。本研究的目的是评估服务的强度和纵向与主观体验和临床结果改善的相关程度，并检查功能、临床和主观体验变量的预期变化之间的关系。对 172 名被诊断患有精神分裂症谱系障碍的患者进行了为期 36 个月的跟踪调查，采用三种不同的社区护理模式。 3 年期间每 6 个月收集一次功能、临床和主观体验结果数据。使用分层线性模型 (HLM) 和 P 技术因子分析对数据进行分析。结果表明：（1）更大的服务强度和服务的纵向性与客户自尊的提高有关； (2) 有证据表明预期康复改变的三个不同因素对应于临床、功能和主观体验结果的概念领域； (3) 项目对症状水平或内心缺陷没有不同的影响。此外，由功能变化、临床变化和主观体验变化组成的三因素结果模型类似于施特劳斯和卡彭特的精神分裂症“开放链接”结果系统。讨论了这些发现对精神分裂症患者社区康复领域的研究和实践的影响。
In a previous study, we found that the intensity, specificity, and longitudinality of community-based psychosocial rehabilitation services were related to superior functional outcomes For individuals diagnosed with schizophrenia. The purpose of this study was to assess the degree to which the intensity and longitudinality of services were related to improvements in subjective experience and clinical outcomes, and to examine the relationships among prospective changes in functional, clinical, and subjective experience variables. One hundred seventy-two individuals diagnosed with a schizophrenia spectrum disorder were followed for 36 months in three distinct models of community-based care. Functional, clinical, and subjective experience outcome data were gathered every 6 months over a 3-year period. Data were analyzed using hierarchical linear modeling (HLM) and P-technique factor analysis. The results indicated that (1) greater service intensity and the longitudinality of services were associated with improvement in client self-esteem; (2) there was evidence for three distinct factors of prospective rehabilitative change that corresponded to the conceptual domains of clinical, functional, and subjective experience outcomes; and (3) there was no differential program impact on symptom levels or the intrapsychic deficits. In addition, the three-factor model of outcome consisting of functional change, clinical change, and subjective experience change was similar to Strauss and Carpenter's "open-linked" system of outcome in schizophrenia. The implications of these findings for research and practice in the area of community-based rehabilitation for individuals with schizophrenia are discussed.