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題名：疾病管理團體於社區精神分裂症病患成效之前驅研究
書刊名：護理暨健康照護研究
作者：藺秀慧／郭鈺屏／林靜蘭／陳柏熹／陳高欽
作者(外文)：Lin, Hsiu-hui／Kuo, Yu-ping／Lin, Esther Ching-lan／Chen, Po-see／Chen, Kao-ching
出版日期：2014
卷期：10:1
頁次：頁15-22
主題關鍵詞：社區；精神分裂症；疾病管理團體；類實驗性研究；Community；Schizophrenia；Illness management group；Quasi-experimental research
原始連結：連回原系統網址new window
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背 景：目前各國精神醫療模式紛紛由機構化轉移為社區導向，實證證據支持疾病管理處置可促進精神分裂症病患因應疾病症狀與管理服藥問題，進而重返與適應社區生活。 目 的：此前驅研究旨在瞭解社區精神分裂症病患接受疾病管理團體的成效。 方 法：運用類實驗單組前後測之研究設計，立意取樣選取某地區醫院日間病房之20位社區精神分裂症病患為對象，比較病患接受疾病管團體於疾病知識、服藥態度及遵囑服藥行為的成效變化。 結 果：社區精神分裂症病患接受疾病管理團體後，其疾病知識顯著提升，服藥態度及遵囑行為亦有進展，但未達顯著差異。團體結束後訪談病患參與團體的主觀收穫，包括獲得知識、同儕支持、認清並接受疾病及服藥、發現原來我不是最嚴重或最奇怪的人。 結論/實務應用：疾病管理團體可有效提升社區精神分裂症病患之疾病知識，但於藥物態度及遵囑服藥行為的實證成效尚待更多研究確認。建議未來可推廣疾病管理團體為社區精神衛生照護的治療模式，以協助病患疾病管理，進而促進其社區適應。
Background: Community care is gradually replacing institutionalized care as the mainstream trend in healthcare worldwide. Community-based mental healthcare care is still developing in Taiwan, and nurses are central to the success and growth of current programs. An evidence-based intervention, the illness management group, may guide nurses to effectively assist people with schizophrenia to manage their psychotic symptoms, take their medication, and reintegrate into the community. Purpose: This pilot study examined the effect of the illness management group of patients with schizophrenia living in the community. Methods: Using a quasi-experimental, single-group pretest-posttest design, a purposive sample of 20 patients with schizophrenia was recruited from a daycare setting at a local hospital. The three outcome indicators were illness knowledge, medication attitude, and adherence. Results: While all outcome indicators showed improvements, only the improvement in illness knowledge was statistically significant. Qualitative feedback from participants included knowledge gains, peer support, recognition and acceptance of the illness and taking medication, and awareness of not being the “most serious”/“most strange”. Conclusions / Implications for Practice: This study partially supported the effect of the illness management group. Future studies should examine the impacts on the medication attitudes and adherent behaviors of this approach. Further, adjustments to the intervention content and the dosage may be incorporated to address specific contextual factors. This pilot study may help enhance the ability of nurses to provide effective community mental health services and benefit mentally ill patients in terms of illness management and community adaptation.
期刊論文
1.Velligan, D. I.、Weiden, P. J.、Sajatovic, M.、Scott, J.、Carpenter, D.、Ross, R.、Docherty, J. P.(2010)。Assessment of adherence problems in patients with serious and persistent mental illness: Recommendations from the expert consensus guidelines。Journal of Psychiatric Practice，16(1)，34-45。  new window
2.Fardig, R.、Lewander, T.、Melin, L.、Folke, F.、Fredriksson, A.(2011)。A randomized controlled trial of the Illness Management and Recovery program for persons with schizophrenia。Psychiatric Service，62(6)，606-612。  new window
3.Fujita, E.、Kato, D.、Kuno, E.、Suzuki, Y.、Uchiyama, S.、Watanabe, A.、Hirayasu, Y.(2010)。Implementing the Illness Management and Recovery program in Japan。Psychiatric Services，61(11)，1157-1161。  new window
4.Salyers, M. P.、Godfrey, J. L.、McGuire, A. B.、Gearhart, T.、Rollins, A. L.、Boyle, C.(2009)。Implementing the Illness Management and Recovery program for consumers with severe mental illness。Psychiatric Services，60(4)，483-490。  new window
5.Whitley, R.、Gingerich, S.、Lutz, W. J.、Mueser, K. T.(2009)。Implementing the Illness Management and Recovery program in community mental health settings: Facilitators and barriers。Psychiatric Services，60(2)，202-209。  new window
6.蕭真真、林維芬、楊馥璟(20100600)。「疾病管理與復元方案」對精神障礙者復元成效之研究。中華團體心理治療，16(2)，11-53。new window  延伸查詢new window
7.Hogan, T. P.、Awad, A. G.、Eastwood, R.(1983)。A selfreports predictive of drug compliance in schizophrenia: Reliability and discriminative ability。Psychological Medicine，13，177-183。  new window
8.Hasson-Ohayon, I.、Roe, D.、Kravetz, S.(2007)。A randomized control trial of the effectiveness of the illness management and recovery program。Psychiatric Services，55(11)，1461-1466。  new window
9.Hogan, T. P.、Awad, A. G.(1992)。Subjective response to neuroleptics and outcome in schizophrenia: A re-examination of two measures。Psychological Medicine，23，347-352。  new window
10.Levit, A.、Mueser, K. T.、DeGenova, J.、Lorenzo, J.、Bradford- Watt, D.、Barbosa, A.、Chernick, M.(2009)。Randomized controlled trial of illness management and recovery in multiple-unit supportive housing。Psychiatric Services，60(12)，1629-1636。  new window
11.Lin, Esther Ching-Lan、Shao, Wen-Chuan、Chan, Chin Hong、Shiau, Shujen、Wang, Hong-Song、Huang, Shi-Chi(2013)。A Pilot Study of an Illness Management and Recovery Program in Discharged Patients With Schizophrenia Being Discharged from the Hospital。The Journal of Nursing Research，21(4)，270-278。  new window
12.Nielsen, R. E.、Lindstrom, E.、Nielsen, J.、Levander, S.(2012)。DAI-10 is as good as DAI-30 in schizophrenia。European Neruopsychopharmacolosy，22，747-750。  new window
13.Roe, D.、Hasson-Ohanon, I.、Salyers, M. P.、Kravetz, S.(2009)。A one year follow-up of illness management and recovery: Participates' accounts of its impact and uniqueness。Psychiatric Rehabilitation Journal，32(4)，285-291。  new window
14.林靜蘭、熊秉荃(20050900)。社區中精神分裂症病患的社會技能訓練。臺灣精神醫學，19(3)，192-203。new window  延伸查詢new window
15.林美伶、熊秉荃、林淑蓉、胡海國(20021200)。精神分裂症患者之烙印處境。慈濟醫學，14:6，381-388。  延伸查詢new window
16.Thompson, K.、Kulkarni, J.、Sergejew, A. A.(2000)。Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses。Schizophrenia Research，42(3)，241-247。  new window
17.Lin, Ching-Lan Esther、Kopelowicz, Alex、Chan, Chin-Hong、Hsiung, Ping-Chuan(2008)。A Qualitative Inquiry into the Taiwanese Mentally Ill Persons' Difficulties Living in the Community。Archives of Psychiatric Nursing，22(5)，266-276。  new window
18.Mueser, K. T.、Corrigan, P. W.、Hilton, D. W.、Tanzman, B.、Schaub, A.、Ginerich, S.(2002)。Illness management and recovery: a review of search。Psychiatric Service，53，1272-1284。  new window
19.Mueser, K. T.、Meyer, P. S.、Penn, D. L.、Clancy, R.、Clancy, D. M.、Salyer, M. P.(2006)。The Illness management and Recovery Program: Rationale, Development, and Preliminary Findings。Schizophrenia Bulletin，32(1)，32-43。  new window
會議論文
1.黃雅琳、張調印、邵文娟、林靜蘭(2010)。精神病患遵囑服藥行為評量工具之發展。第廿六次護理研究論文發表會暨兩岸護理學術交流，台灣護理學會主辦 。台中市：中國醫藥大學。  延伸查詢new window
2.Mueser, K. T.(2012)。IMR program疾病管理與復元(IMR)服務簡介。精神障礙社區服務，台北市心生活協會、中華民國康復之友聯盟、台灣精神醫學會主辦 。台北市：台大醫院國際會議中心。  延伸查詢new window
學位論文
1.陳建泓(2003)。精神分裂症患者疾病適應歷程之敘說研究(碩士論文)。國立臺灣師範大學。  延伸查詢new window
2.蘇玫君(2011)。精神分裂症個案之復原歷程及治療師治療經驗之探討(碩士論文)。國立暨南國際大學。  延伸查詢new window
3.林靜蘭(2007)。疾病管理模式於重返社區之精神分裂症病患的成效性研究(博士論文)。國立臺灣大學。  延伸查詢new window
圖書
1.林信男(1994)。精神科物理及藥物治療。台北：水牛。  延伸查詢new window
2.American Psychiatric Association(2000)。Diagnostic and Statistical manual of mental disorders。Washington, DC：Book Promotion & Service LTD。  new window
其他
1.Substance Abuse and Mental Health Administration(2006)。SAMHSA Issues Consensus Statement on Mental Health Recovery，http://www.samhsa.gov/news/ newsreleases/060215_consumer.htm。  new window
 
 
 
 
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