精神分裂症恢复期患者及家属家庭干预的对照研究

目的：以康复期出院精神分裂症患者和家属为对象，定期复诊进行家庭干预并对照研究。方法：干预组68例，对照组52例，采用BPRS评定；干预组家属74人，对照组家属65人，采用SCL－90评定。结果：6个月后干预组患者BPRS和入组时对照比较均有显著性差异（P＜0．01），说明干预组患者的精神症状，不良情绪及社会功能明显好转，入组时两组家属SCL－90评定与常模对照比较，均有明显差异（P＜0．05或0．01），经干预后干预组与全国常规比较无显著性差异（P＞0．05），说明患者家属普遍存在心理障碍，经干预后家属心理状况明显改善。结论：对康复期病人及家属进行门诊家庭干预，是有效的康复方法，值得推广应用。     

家庭综合干预对社区精神分裂症患者预后的影响

目的探讨家庭综合干预对社区精神分裂症患者预后的影响。方法将社区精神分裂症患者随机分为家庭综合干预组和对照组。干预组接受药物治疗和家庭综合干预,对照组仅接受药物治疗。采用社会功能缺陷筛选量表（SDSS）进行精神残疾评估。结果3年末干预组病残率、直接医药费用显著低于对照组（P〈0.01）,痊愈率明显高于对照组（P〈0.01）。结论家庭综合干预可以有效降低社区精神分裂症患者病残率,改善患者预后,降低医疗费用。     

家庭综合干预对社区精神分裂症患者的影响

目的探讨家庭综合干预对社区精神分裂症患者的影响。方法将精神分裂症患者随机分为家庭综合干预组和对照组。干预组接受药物治疗和家庭综合干预,对照组仅接受药物治疗。采用简明精神病评定量表（BPRS）、社会功能缺陷筛选量表（SDSS）进行评估。结果3年末干预组BPRS分及SDSS分、复发率、再住院率显著低于对照组（P〈0.01）。结论社区家庭综合干预可以有效减轻精神分裂症患者的症状,预防疾病复发,改善患者社会功能。     

家庭综合干预对社区精神分裂症患者服药依从性的影响

目的探讨家庭综合干预对社区精神分裂症患者自知力和服药依从性的影响。方法将社区精神分裂症患者随机分为家庭综合干预组和对照组。干预组接受药物治疗和家庭综合干预,对照组仅接受药物治疗。采用简明精神病评定量表（BPRS）中自知力因子和自制依从性评分表等进行评估。结果干预组BPRS自知力因子分显著低于对照组（P〈0.01）,而治疗依从性则显著高于对照组（P〈0.01）。结论家庭综合干预可以有效促进精神分裂症患者自知力恢复,改善其服药依从性。     

社区精神分裂症家庭干预效果的对照研究

目的 :探索降低社区精神分裂症复发率、提高康复效果的有效途径。方法 :采用随机抽样法 ,对 86例社区精神分裂症患者和家属主要照料者进行一年的家庭干预 ,并设 10 0例未干预者对照。结果 :干预组患者复发率显著降低 ,社会功能残疾量表和家庭负担量表的减分率具有显著性意义。结论 :家庭干预是社区康复的有效方法之一     

社区精神分裂症患者家庭干预后3年效果评价

目的　探讨精神分裂症患者社区防治康复的有效措施。方法　对宝山区 3个街道 1个镇 2 0 4例精神分裂症患者家属进行 3年的社区家庭干预对照研究 ,采用社会功能量表 ( DAS)进行评估。结果　干预组干预前后的各项社会功能比较有非常显著差异 ( P<0 .0 0 1 ) ,对照组的各项社会功能无显著差异 ( P<0 .0 5) ,干预复发率下降 63.4 %。结论　家庭干预对病人和家属有良好作用 ,有利于精神病人社会功能的康复     

家庭干预对预防精神分裂症复发的效果观察

在我国，９０％以上的精神病人生活在家庭中，接受来自家庭亲属的照顾。然而，较多患者的亲属由于缺少有关知识，难以为病人提供良好的康复环境；另外，家属本人也常有心理健康的损害［１，２，３］。因此，病人的康复质量在很大程度上取决于家庭成员的素质、态度及照顾能...     

精神分裂症患者及其家属的心理社会干预

精神分裂症患者及其家属的心理社会干预华西医科大学心理卫生研究所李洁向孟泽一、问题的由来自本世纪７０年代始，Ｌｅｆ＆Ｗｉｎｇ（１９７１年）［１］、Ｈｏｇａｒｔｙ等（１９８４年）［２］人发现，精神分裂症患者出院后即使维持服用抗精神病药物仍有３０－４０％...     

社区慢性精神分裂症家庭干预随访研究

目的 :探索提高社区慢性精神分裂症康复效果 ,降低成本的有效服务形式。方法 :采用前瞻性研究 ,把 2 2 5例精神分裂症患者随机分入干预组和对照组进行历时二年的随访研究。结果 :干预组患者的复发率、PANSS减分率、DAS减分率和干预组家属的SAS、CES -D总分减分率等均显著优于对照组。成本效益分析干预组家庭平均每户年投入 36 0元 ,干预组康复的直接与间接成本比对照组低 46 0 19元 ,患者或家属复工增加的收入比对照组多 6 33 75元 ,效益成本比值 (BCR)为 3 0 4,净效益 (NB)为 733 94元。结论 :家庭干预能有效降低精神裂症康复的直接、间接成本和隐性成本 ,能有效降低疾病的复发率 ,提高疗效和社会功能 ,是一种高效低耗的服务形式     

家庭干预对精神分裂症患者的效果影响

目的 探讨家庭干预对精神分裂症患者的影响。方法 对60例住开放式病房的精神分裂症患者(A组)在住院期间配合积极家庭干预及出院后继续干预与60例住封闭式病房无家属陪护的精神分裂症患者(B组)进行比较。结果 家庭干预组服药依从性高于对照组(P<0.01),家庭干预组1年内、2年内复发率明显少于对照组(P<0.05)。结论 家庭干预能提高患者治疗依从性,从而减少复发率及预防精神残疾,使患者更好的康复。     

Prevalence of open angle glaucoma in accompanying first degree relatives of patients with glaucoma

OBJECTIVE: The aim of this study was to determine the prevalence of open angle glaucoma in first-degree relatives accompanying POAG patients during routine examination in a reference hospital. METHOD: First-degree relatives of primary open angle glaucoma patients who accompanied their relatives to the glaucoma service of a reference hospital were screened for glaucoma. RESULTS: One-hundred and one first-degree relatives were examined, of which 56.4% had never had their intraocular pressure measured. 10.9% had previously been diagnosed with glaucoma, and 5.9% were newly diagnosed during this study. CONCLUSIONS: The eye examination of first-degree relatives identified a significant percentage of individuals with glaucoma. Despite being first-degree relatives of glaucoma patients, 56.4% of the companions had never had their eye pressure measured, demonstrating a lack of awareness about this disease.     

Psychological crisis intervention for the family members of patients in a vegetative state

OBJECTIVES:

Family members of patients in a vegetative state have relatively high rates of anxiety and distress. It is important to recognize the problems faced by this population and apply psychological interventions to help them. This exploratory study describes the psychological stress experienced by family members of patients in a vegetative state. We discuss the effectiveness of a psychological crisis intervention directed at this population and offer suggestions for future clinical work.

METHODS:

A total of 107 family members of patients in a vegetative state were included in the study. The intervention included four steps: acquisition of facts about each family, sharing their first thoughts concerning the event, assessment of their emotional reactions and developing their coping abilities. The Symptom Check List-90 was used to evaluate the psychological distress of the participants at baseline and one month after the psychological intervention. Differences between the Symptom Check List-90 scores at the baseline and follow-up evaluations were analyzed.

RESULTS:

All participants in the study had significantly higher Symptom Check List-90 factor scores than the national norms at baseline. There were no significant differences between the intervention group and the control group at baseline. Most of the Symptom Check List-90 factor scores at the one-month follow-up evaluation were significantly lower than those at baseline for both groups; however, the intervention group improved significantly more than the control group on most subscales, including somatization, obsessive-compulsive behavior, depression, and anxiety.

CONCLUSION:

The results of this study indicate that the four-step intervention method effectively improves the mental health of the family members who received this treatment and lessens the psychological symptoms of somatization, obsessive-compulsive behavior, depression and anxiety.     

Participation of family members in ward rounds: Attitude of medical staff, patients and relatives

OBJECTIVE: To assess the attitude of medical staff, patients and their relatives to the presence of FMs in WRs. METHODS: This prospective study was performed in an Internal Medicine Department in Israel. WRs were conducted without (phase 1) and with (phase 2) the presence of FMs. Questionnaires were completed by staff members (N = 26, 23), patients (N = 26, 35) and FMs (N = 32, 40) during phases 1 and 2, respectively. RESULTS: 82.6%, 96% and 96.7% of staff, patients and relatives, respectively, expressed a positive attitude towards the participation of FMs in WRs. Staff members became significantly more positive about the concept after having undergone the experience. Patients believed it contributed to a better understanding of their disease and FMs felt it provided them with an opportunity to participate in medical decision-making. CONCLUSION: Hospitalized patients would like their FMs to participate in WRs. Staff members were reluctant at first, but developed a more positive attitude towards the idea after the experience. PRACTICE IMPLICATIONS: Incorporating FMs into WRs is plausible, though adjustment of WRs' routine to the change will be needed. This move might increase patients' satisfaction from WRs.     

心理干预对儿童精神分裂症患者亲属心理健康的影响

目的：探讨心理干预对儿童精神分裂症症患者亲属心理健康的影响。方法：对入组的30例精神分裂症患儿亲属定期进行心理干预，采用症状自评量表（SCL－90）在干预前后进行心理卫生状况调查。结果：心理干预前与国内常模比较SCL－90总分及焦虑，抑郁，强迫症状，恐怖，偏执，精神病性因子分有显著性差异（P＜0．05，P＜0．01），干预后SCL－90总分及各因子分较干预前显著性差异（P＜0．05，P＜0．01）。结论：儿童精神分裂症患者亲属存在较多的心理问题，心理干预能有效提高精神分裂症患者亲属的心理健康水平。     

Satisfaction with communication in ICU patients and relatives: comparisons with medical staffs' expectations and the relationship with psychological distress

Objective

To study intensive care unit (ICU) patients’ and relatives’ satisfaction in regard to communication with medical staff (nurses and physicians), perceived support, environmental strain and their psychological distress. Further, to compare this with expectations of the medical staff.

Methods

Cross-sectional study, 4–6 weeks post-ICU discharge. Respondents to the questionnaire were: 255 (63%) patients, 354 (82%) relatives and 145 (74%) medical staff. Degree of satisfaction and distress were measured on a five-point Likert-scale (0 = low to 4 = high).

Results

The mean score for patient satisfaction with communication was 3.0 (95%CI 2.9–3.1) and for relatives 3.4 (3.3–3.5). This was significantly higher than expected by the staff for patients 2.5 (2.4–2.6) and relatives 2.8 (2.7–2.9), both p < 0.001. Relatives’ degree of psychological distress, 2.5 (2.4–2.6) was significantly higher than for patients’, 1.6 (1.5–1.7), but was significantly lower than expected by the staff, 2.9 (2.8–3.0) and 2.7 (2.6–2.8) respectively, both p < 0.001.

Conclusion

Patients and relatives were more satisfied with the communication than expected by the staff. The staff overestimated the patients’ and relatives’ psychological distress. Relatives report more psychological distress symptoms post-ICU discharge compared to the patients.

Practice implications

Medical staff is aware of psychological distress in ICU patients and relatives and effort to reduce this during ICU stay and afterwards should be implemented.     

The effects of frequency altered feedback on reading comprehension abilities of normal and reading disordered children

The effects of frequency altered feedback (FAF) on the reading comprehension levels and error types of normal children and children with reading disorders were examined. Participants read aloud third, sixth, and ninth grade level material in non-altered auditory feedback (NAF) and FAF conditions. Comprehension improved significantly when the reading disordered children read aloud under the FAF listening condition, regardless of the reading level. Significant differences did not occur in reading comprehension for the normal readers under NAF versus FAF conditions. Reading disordered children produced significantly more reading errors as compared to the normal reading children under the NAF listening condition. No significant difference was found in reading errors between groups when reading under FAF regardless of the reading level, suggesting that the FAF signal produced a facilitory effect on reading errors in the reading disordered children. Theoretically, the FAF signal may have activated those cortical regions responsible for the relationship that has been shown to exist between lexical encoding and decoding of verbal and written material, respectively.     

Frequency distribution of HLA DQ2 and DQ8 in celiac patients and first-degree relatives in Recife, northeastern Brazil

AIMS:

The aim of this study was to evaluate the frequencies of the HLA genotypes DQ2 and DQ8 and the alleles A1*05, A1*0201, B1*0201 and B1*0302 in individuals with celiac disease in Recife, northeastern Brazil.

METHODS:

HLA DQ2 and DQ8 genotyping was performed for 73 individuals with celiac disease and 126 first-degree relatives with negative transglutaminase serology. The alleles DQA1*05, DQA1*0201, DQB1*02 and DQB1*0302 were identified by sequencing using specific primers and the EU-DQ kit from the Eurospital Laboratory, Trieste, Italy and double-checked by the All Set SPP kit (Dynal).

RESULTS:

Among the 73 cases, 50 (68.5%) had the genotype DQ2, 13 (17.8%) had DQ8, 5 (6.8%) had DQ2 and DQ8, and 5 did not have any of these genotypes. Among the 5 negative individuals, four had the B1*02 allele and one did not have any of the alleles studied. B1*02 was the most frequent allele in both groups (94% in the patients and 89% in the control relatives).

CONCLUSIONS:

In this study, celiac disease was associated with the genotypes DQ2 and DQ8. DQ2 predominated, but the distribution of the frequencies was different from what has been found in European populations and was closer to what has been found in the Americas. The high frequencies of the HLA genotypes DQ2 and DQ8 that were found in first-degree relatives would make it difficult to use these HLA genotypes for routine diagnosis of celiac disease in this group.     

Impact of an educational support group on family participants who take care of their schizophrenic relatives

Using a stress-coping framework, we designed a six-session educational support group offering family caretakers information about schizophrenia, training in problem-solving skills for managing patient behavior, and greater access to social support and community resources. Subjects were recruited though local community mental health centers; 24 subjects participated in one of five identically structured caretakers' groups and another 24 subjects served as matched controls. Results of the multivariate analysis of covariance indicated a significant difference between the experimental and control caretakers following the intervention. Caretakers of the educational support group reported significantly reduced anxiety and personal distress and significantly more active coping behaviors (increased use of community resources and better management of home life with their schizophrenic family member). However, no changes were reported in the frequency of their negative feelings toward their mentally ill family member or in their generalized sense of self-efficacy.     

Ethical issues relating to the inclusion of relatives as clients in the post-stroke rehabilitation process as perceived by patients,relatives and health professionals

Objective

To document the ethical issues regarding the systematic inclusion of relatives as clients in the post-stroke rehabilitation process.

Methods

A two-phase qualitative design consisting of in-depth interviews with relatives and stroke-clients (Phase 1) and three focus groups with relatives, stroke-clients and health professionals (Phase 2). Data was audio recorded. Transcribed interviews and focus groups content were rigorously analyzed by two team members.

Results

The interview sample was composed of 25 relatives and of 16 individuals with a first stroke whereas the three focus group sample size varied from 5 to 7 participants. Four main themes emerged: (1) overemphasis of caregiving role with an unclear legitimacy of relative to also be a client; (2) communication as a key issue to foster respect and a family-centered approach; (3) availability and attitudes of health professionals as a facilitator or a barrier to a family-centered approach; and (4) constant presence of relatives as a protective factor or creating a perverse effect.

Conclusion/practice implications

The needs of relatives are well known. The next step is to legitimize their right to receive services and to acknowledge the combined clinical and ethical value of including them post-stroke. Interdisciplinary health care approaches and communication skills should be addressed.