目标:职能管理和康复是一种标准化的心理教育干预措施,派生自“积分”,对康复过程中的人们进行有效的salutogenic心理教育干预,旨在改善精神病住宅设施(PRF)中精神病患者的康复和功能。这项研究的目的是评估该干预措施的主要和次要结果,该干预措施专门针对基于证据的结构化干预措施似乎很少且可取的PRF。
方法:在北部9个PRF中招募了66名精神病患者,Center和南意大利和63进行了多中心随访研究,并进行了两个时间点评估(t0,治疗前和t1,6个月;)。在每个时间点,通过个人和社会绩效量表(PSP)将社会功能评估为主要结果;此外,精神病理学状况通过简明精神病学评定量表(BPRS)进行评估,恢复评估量表(RAS)通过可重复电池评估神经心理学状态(RBANS)的认知功能,通过压力量表进行压力管理,通过改良五点测验(M-FPT)的认知灵活性,情绪智力指数(EI-I),PRF气氛和用户对PFR的意见,通过特设问卷。能力知识,会话的效用和愉快性是通过临时项目列表来衡量的。
结果:根据DSM-5-TR,66例52例(82,5%)受精神分裂症影响,11例(17,5%)由躁郁症I型障碍伴精神病症状。在研究结束时,43(68,3%)为男性,57人(90.5%)为单身,5人(7.9%)参与,1人(1.6%)已婚;45人(71.4%)失业。PSP的总分,RAS,BPRS,班斯,压力管理,能力知识,会话的实用性和愉悦性在t1与t1时显示出统计学上的显着改善。t0.5个M-FPT中的两个子量表显示出统计学上的显着改善。情商,单位气氛和用户对PFR的意见没有统计学意义。随访研究结束六个月后,样本中的22个人被解雇,营业额很高。
结论:经过六个月的随访(短时间),这些结果表明功能有所改善,主要结果,以及以下次要结果变量:RAS,BPRS,班斯,压力管理,能力知识,M-FPT的5分中有两个分尺,会话的实用性和愉快性。总的来说,观察到心理教育结构化干预对关键恢复变量的显着影响。需要进一步的研究来解决这些改进的程度和持续时间。
OBJECTIVE: Functional Management and Recovery is a standardized Psychoeducational Intervention, derived from \"Integro\", an effective salutogenic-psychoeducational intervention for people in recovery journey, designed to improve recovery and
functioning of individuals with psychotic disorders in Psychiatric Residential Facilities (PRFs). The aim of this study is to evaluate the primary and secondary outcomes of this intervention elaborated specifically for PRFs where evidence based structured interventions seem rare and desirable.
METHODS: 66 individuals with psychotic disorders were recruited in 9 PRFs dislocated in the North, Center and South Italy and 63 underwent a multicenter follow-up study with a two time-point evaluation (t0, pre-treatment and t1, 6 months; ). At each time point, social
functioning was assessed as primary outcome by the Personal and Social Performance scale (PSP); furthermore, psychopathological status was assessed by Brief Psychiatric Rating Scale (BPRS), Recovery by Recovery Assessment Scale (RAS), Cognitive
Functioning by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Stress management by Stress-Scale, Cognitive Flexibility by Modified Five-Point Test (M-FPT), Emotional Intelligence by Emotional Intelligence Index (EI-I), the PRF Atmosphere and the Opinion of users about the PFR by an ad hoc questionnaire. The Abilities Knowledge, the Utility and Pleasantness of sessions were measured by an ad hoc list of items.
RESULTS: 63 individuals out of 66, 52 (82,5%) affected by schizophrenia and 11 (17,5%) by bipolar I disorder with psychotic symptoms according to DSM-5-TR completed the study. At the end of the study, 43 (68,3%) were male, 57 (90.5%) were single, 5 (7.9%) engaged, 1 (1.6%) married; 45 (71.4%) unemployed. The total scores of PSP, RAS, BPRS, BANS, Stress management, Abilities Knowledge, Utility and Pleasantness of sessions showed a statistically significant improvement at t1 vs. t0. Two sub-scales out of 5 of M-FPT showed a statistically significant improvement. The Emotional Intelligence, the Unit Atmosphere and the Opinion of Users about PFR improved without statistical significance. Six months after the end of the follow-up study 22 individuals of the sample were dismissed with a very high turnover.
CONCLUSIONS: After a six-month follow-up (a short period of time), these results showed improvement in
functioning, the primary outcome, as well as in the following secondary outcome variables: RAS, BPRS, BANS, Stress management, Abilities Knowledge, two sub-scales out of 5 of M-FPT, Utility and Pleasantness of sessions. Overall, a remarkable impact of psychoeducational structured intervention on the key Recovery variables is observed. Further studies are needed to address extent and duration of these improvements.