Feasibility of a psychoeducational family intervention for people with bipolar I disorder and their relatives: Results from an Italian real-world multicentre study
Feasibility of a psychoeducational family intervention for people with bipolar I disorder and their relatives: Results from an Italian real-world multicentre study
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DOI：
10.1016/j.jad.2015.10.060
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发表时间：
2016-01-15
影响因子：
6.6
通讯作者：
Maj, M.
中科院分区：
文献类型：
--
作者：
Fiorillo, A.;Del Vecchio, V.;Maj, M.
背景：尽管一些指南建议使用心理教育家庭干预(PFI)作为双相I障碍患者的附加治疗，但其大规模实施仍然有限。本研究的目的是确定在常规护理中使用PFIs的可行性障碍。方法：这是一项多中心、真实世界、对照的门诊试验，在11个随机招募的意大利精神卫生中心进行。来自每个中心的两名精神卫生专业人员参加了关于PFI的模块培训课程，并提供干预。通过6次的家庭干预量表(FIS-R)评估心理卫生专业人员实施干预的困难和益处。结果：在招募的22名专业人员中，有16人完成了培训，并对70名双相I障碍患者及其亲属进行了PFI。接受干预的家庭保留率为93%。心理健康专业人员报告说，他们的组织困难程度很高，他们在日常临床工作中获得了一些好处，而与干预相关的困难水平较低。最重要的组织障碍与需要将干预与其他工作职责结合起来以及缺乏时间进行干预有关。这些困难并没有随着时间的推移而减少。自第一次评估以来，与干预相关的困难被评为问题较少，并随着时间的推移有改善的趋势。限制：招募的专业人员数量较少；使用以前未经验证的评估工具。结论：PFI在双相I障碍患者及其亲属的常规护理中是可行的，主要障碍与心理健康中心的组织/结构有关，而与干预本身的特点无关。(C)2015爱思唯尔B.V.保留所有权利。
Background: Despite several guidelines recommend the use of psychoeducational family interventions (PFIs) as add-on in the treatment of patients with bipolar I disorder, their implementation on a large scale remains limited. The aim of the present study is to identify obstacles for the feasibility of PFIs in routine care.Methods: This was a multicentre, real-world, controlled, outpatient trial, carried out in 11 randomly recruited Italian mental health centres. Two mental health professionals from each center attended a modular training course on PFI and provided the intervention. Difficulties and benefits experienced by mental health professionals in implementing the intervention were assessed through the Family Intervention Schedule (FIS-R), which was administered six times.Results: Sixteen out of the 22 recruited professionals completed the training and administered the PFI to 70 patients with bipolar I disorder and their relatives. The retention rate of families receiving the intervention was 93%. Mental health professionals reported high levels of organizational difficulties, several benefits in their daily clinical work and low levels of intervention-related difficulties. The most important organizational obstacles were related to the need to integrate the intervention with other work responsibilities and to the lack of time to carry out the intervention. These difficulties did not decrease over time. Intervention-related difficulties were rated as less problematic since the first time assessment and tended to improve over time.Limitations: Low number of recruited professionals; use of a not previously validated assessment instrument.Conclusions: PFIs are feasible in routine care for the treatment of patients with bipolar I disorder and their relatives, and main obstacles are related to the organization/structure of mental health centres, and not to the characteristics of the intervention itself. (C) 2015 Elsevier B.V. All rights reserved.