Promoting Adherence to Treatment in Schizophrenia

促进精神分裂症治疗的依从性

• 批准号: 7076867
• 负责人: ALEX J KOPELOWICZ
• 金额: $ 30.76万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-25 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7076867
• 关键词: Mexican Americans; behavioral /social science research tag; clinical research; clinical trials; family therapy; human therapy evaluation; longitudinal human study; mental disorder chemotherapy; patient oriented research; schizophrenia; therapy compliance

DESCRIPTION (provided by applicant): This R01 grant proposal is a revised version of a response to PA-00-016 "Research on Adherence to Interventions for Mental Disorders." The project (a) evaluates a culturally adapted, family-based intervention designed to promote treatment adherence among Mexican-Americans with schizophrenia using a randomized, controlled design in a public mental health setting, and (b) tests hypotheses about the applicability of Ajzen's theory of planned behavior (TPB), the conceptual foundation for the intervention's key constructs, to the study of treatment adherence. This conceptual model was selected for study because its emphases on the important roles of subjective norms and perceived behavior control are highly germane to the study population and to the proposed intervention. Mexican-Americans with schizophrenia and their families will be entered into the study during a psychiatric hospitalization and followed after discharge for two years. Subjects will be randomly assigned to either: 1) one year of multiple family groups that emphasize the importance of attitudes towards adherence, subjective norms, and self-perceived and actual adherence skills in maintaining adherence, added to ongoing customary outpatient care; 2) one year of standard multiple family groups added to customary outpatient care; or 3) customary outpatient care only (monthly pharmacotherapy sessions and additional services as clinically needed). Evaluations will be made at baseline and every four months for two years of actual adherence behaviors (using a multi-dimensional approach that integrates behavioral measures with multiple informants), and of the postulated mediating factors based .on the project's theoretical model: intentions to adhere to treatment; decision-making processes used to arrive at this intention; perceived subjective norms (i.e., perceptions regarding their relatives' preferences regarding treatment adherence; real and perceived ability to acquire, maintain, and utilize treatment adherence skills; attitudes towards the illness and its treatment; levels of psychopathology, and other important outcomes (e.g., social functioning, quality of life, relapse and rehospitalization rates). Key relatives will be assessed during those same time frames to determine their understanding of how and why they influence the patient's actions; their attitudes towards their mentally ill relative; their knowledge and views of schizophrenia; their roles as collaborating participants in the treatment process; and their expectations with regard to their relative's treatment and recovery. The results will advance the understanding of the factors that affect adherence to treatment for Mexican, Americans with schizophrenia, and, if the treatment were effective, would add a new tool for improving treatment adherence in this population.

描述（由申请人提供）：本R 01资助提案是对PA-00-016“精神疾病干预依从性研究”的修订版。“该项目（a）评估一种文化适应的、以家庭为基础的干预措施，旨在促进墨西哥裔美国精神分裂症患者的治疗依从性，在公共精神卫生环境中采用随机对照设计，（B）检验关于Ajzen计划行为理论（TPB）适用性的假设，该理论是干预措施关键结构的概念基础，用于治疗依从性研究。选择这个概念模型进行研究，因为它强调主观规范和感知行为控制的重要作用，与研究人群和拟议的干预措施密切相关。患有精神分裂症的墨西哥裔美国人及其家人将在精神病住院期间进入研究，并在出院后随访两年。受试者将被随机分配到：1）一年的多个家庭组，强调对依从性的态度、主观规范以及自我感知和实际依从性技能在维持依从性方面的重要性，并添加到正在进行的常规门诊治疗中; 2）一年的标准多个家庭组，添加到常规门诊治疗中;或3）仅常规门诊护理（每月药物治疗疗程和临床需要的额外服务）。评估将在基线和每四个月进行一次，为期两年，评估实际的依从性行为（使用多维方法，将行为测量与多个知情人相结合），以及基于该项目理论模型的假设中介因素：坚持治疗的意图;用于达到此意图的决策过程;感知的主观规范（即，关于其亲属对治疗依从性的偏好的感知;获得、维持和利用治疗依从性技能的真实的和感知的能力;对疾病及其治疗的态度;精神病理学水平，和其它重要结果（例如，社会功能、生活质量、复发率和再住院率）。关键亲属将在这些相同的时间框架内进行评估，以确定他们对如何以及为什么影响患者的行为的理解;他们对精神病亲属的态度;他们对精神分裂症的知识和看法;他们作为治疗过程中合作参与者的角色;以及他们对亲属治疗和康复的期望。这些结果将促进对墨西哥人和美国精神分裂症患者治疗依从性影响因素的理解，如果治疗有效，将为改善这一人群的治疗依从性增加一个新的工具。

项目成果

Using the theory of planned behavior to improve treatment adherence in Mexican Americans with schizophrenia.

利用计划行为理论提高患有精神分裂症的墨西哥裔美国人的治疗依从性。

• DOI: 10.1037/a0039346
• 发表时间: 2015
• 期刊: Journal of consulting and clinical psychology
• 影响因子: 5.9
• 作者: Kopelowicz,Alex;Zarate,Roberto;Wallace,CharlesJ;Liberman,RobertPaul;Lopez,StevenR;Mintz,Jim
• 通讯作者: Mintz,Jim