Long-term outcomes of a randomized trial of integrated skills training and preventive healthcare for older adults with serious mental illness.
Long-term outcomes of a randomized trial of integrated skills training and preventive healthcare for older adults with serious mental illness.
复制标题
DOI：
10.1016/j.jagp.2013.04.013
复制
发表时间：
2014-11
影响因子：
7.2
通讯作者：
Feldman, James
中科院分区：
文献类型：
--
作者：
Bartels, Stephen J.;Pratt, Sarah I.;Mueser, Kim T.;Forester, Brent P.;Wolfe, Rosemarie;Cather, Corinne;Xie, Haiyi;McHugo, Gregory J.;Bird, Bruce;Aschbrenner, Kelly A.;Naslund, John A.;Feldman, James
关键词：
本报告描述了对患有严重精神疾病的老年人进行社会心理技能培训和预防性保健干预（帮助老年人获得成功——希望）的一、两年和三年的结果。一项随机对照试验比较了n=183名患有严重精神疾病的老年人（年龄≥50岁）（平均年龄=60.2岁，28%为精神分裂症，28%为分裂情感障碍，20%为双相情感障碍，24%为重度抑郁症）的hope与常规治疗（TAU）。马萨诸塞州波士顿的两个社区精神健康中心和新罕布什尔州纳舒厄的一个。为期12个月的每周技能培训课程，每月两次的社区实践旅行，每月的护士预防性保健访问，然后是为期1年的每月会议维护阶段。在基线、1年（强化阶段结束）、2年（维持阶段结束）和3年（干预后12个月）随访期间对功能、症状和服务使用情况进行盲法评估。与TAU相比，希望与改善的社区生活技能和功能，更高的自我效能感，更低的总体精神和阴性症状，更多的预防性保健（更频繁的眼科检查，视力，听力测试，乳房x光检查和PAP涂片检查）以及完成预先指示的比率接近两倍相关。在3年随访中，在医疗严重程度、医疗状况数量、主观健康状况或急性服务使用方面没有发现差异。技能培训和护士促进了对患有严重精神疾病的老年人的预防性保健，与功能、症状、自我效能、预防性保健筛查和预先护理计划的持续长期改善有关。
This report describes one, two, and three-year outcomes of a combined psychosocial skills training and preventive health care intervention (Helping Older People Experience Success – HOPES) for older persons with serious mental illness. A randomized controlled trial compared HOPES to treatment as usual (TAU) for n=183 older adults (age≥50) with serious mental illness (mean age=60.2; 28% schizophrenia, 28% schizoaffective disorder, 20% bipolar disorder, 24% major depression). Two community mental health centers in Boston, MA and one in Nashua, NH. Twelve months of weekly skills training classes, twice-monthly community practice trips, and monthly nurse preventive health care visits, followed by a 1-year maintenance phase of monthly sessions. Blinded evaluations of functioning, symptoms, and service use were conducted at baseline, one-year (end of the intensive phase), two-year (end of the maintenance phase), and three-year (12 months after the intervention) follow-up. HOPES compared to TAU was associated with improved community living skills and functioning, greater self-efficacy, lower overall psychiatric and negative symptoms, greater acquisition of preventive health care (more frequent eye exams, visual acuity, hearing tests, mammograms, and PAP smears) and nearly twice the rate of completed advance directives. No differences were found for medical severity, number of medical conditions, subjective health status, or acute service use at 3-year follow-up. Skills training and nurse facilitated preventive health care for older adults with serious mental illness was associated with sustained long-term improvement in functioning, symptoms, self-efficacy, preventive health care screening, and advance care planning.
登录
查看更多内容
影响因子：
7.2
作者：
Hendrie, Hugh C.;Lindgren, Donald;Callahan, Christopher M.
通讯作者：
Callahan, Christopher M.
影响因子：
3
作者：
KAZIS, LE;ANDERSON, JJ;MEENAN, RF
通讯作者：
MEENAN, RF
影响因子：
1.8
作者：
Berry, Katherine;Purandare, Nitin;Barrowclough, Christine
通讯作者：
Barrowclough, Christine
影响因子：
4.8
作者：
FOLSTEIN, MF;FOLSTEIN, SE;MCHUGH, PR
通讯作者：
MCHUGH, PR
影响因子：
7.2
作者：
Bartels, SJ;Clark, RE;Pratt, SI
通讯作者：
Pratt, SI