Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Effects of a Relapse Prevention Program on Insight, Empowerment and Treatment Adherence in Patients with Schizophrenia

조현병 재발예방 프로그램이 퇴원전 환자의 병식, 임파워먼트 및 치료준수에 미치는 효과

  • Joung, Jaewon (College of Nursing, Seoul National University) ;
  • Kim, Sungjae (College of Nursing.The Research Institute of Nursing Science, Seoul National University)
  • 정재원 (서울대학교 간호대학) ;
  • 김성재 (서울대학교 간호대학.간호과학연구소)
  • Received : 2016.02.27
  • Accepted : 2016.11.04
  • Published : 2017.04.30
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Abstract

Purpose: The purpose of this study was to develop a relapse prevention program (RPP) and examine the effects of the RPP on insight, empowerment, and treatment adherence in patients with schizophrenia. Methods: A non-equivalent control group pretest-posttest design was used. Participants were 54 inpatients who had a diagnosis of schizophrenia (experimental group: 26, control group: 28). The study was carried out from February 7, 2012 to February 6, 2013. Over a 10-day period prior to discharge each participant in the experimental group received three one-hour sessions of RPP a one-to-one patient-nurse interaction. Data were collected using Assess Unawareness of Mental Disorder (SUMD), Empowerment Scale, and Insight and Treatment Attitude Questionnaire (ITAQ) and analyzed using PASW 18.0 with chi-square test, independent t-test, Mann-Whitney U test, and ANCOVA. Results: The experimental group had a significant increase in insight and treatment adherence compared to the control group. However, there was no significant difference in empowerment between the two groups. Conclusion: Findings indicate that the RPP for patients with schizophrenia was effective in improving insight and treatment adherence. A longitudinal study is needed to confirm the persistence of these effects of RPP in patients with schizophrenia.

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References

  1. van Meijel B, Kruitwagen C, van der Gaag M, Kahn RS, Grypdonck MH. An intervention study to prevent relapse in patients with schizophrenia. Journal of Nursing Scholarship. 2006;38(1):42-49. http://dx.doi.org/10.1111/j.1547-5069.2006.00076.x
  2. Kim SH, Byeon YC, Son CK, Lee YH, Lee MK, Lee SH, et al. 2011 disabled survey report. Seoul: Ministry of Health & Welfare, Korea Institute for Health and Social Affairs, 2011. Report No.: Policy Report 2011-82.
  3. Lieberman JA, Murray RM. Comprehensive care of schizophrenia: A textbook of clinical management. Kwon JS, translator. London, UK: Martin Dunitz; 2001. p. 37-58.
  4. Almond S, Knapp M, Francois C, Toumi M, Brugha T. Relapse in schizophrenia: Costs, clinical outcomes and quality of life. The British Journal of Psychiatry. 2004;184(4):346-351. http://dx.doi.org/10.1192/bjp.184.4.346
  5. van Meijel B, van der Gaag M, Kahn RS, Grypdonck MHF. Recognition of early warning signs in patients with schizophrenia: A review of the literature. International Journal of Mental Health Nursing. 2004;13(2):107-116. http://dx.doi.org/10.1111/j.1440-0979.2004.00314.x
  6. Abdel-Baki A, Ouellet-Plamondon C, Malla A. Pharmacotherapy challenges in patients with first-episode psychosis. Journal of Affective Disorders. 2012;138(Suppl):S3-S14. http://dx.doi.org/10.1016/j.jad.2012.02.029
  7. Lee YH, Kim E. Factors on treatment compliance-illness behavior of schizophrenics under the long-term treatment. Journal of Korean Neuropsychiatric Association. 1989;28(2):292-305.
  8. Kim BY, Lee CW, Park CW. The relationship among insight, psychopathology and drug compliance in the schizophrenic patient. Journal of Korean Neuropsychiatric Association. 1993;32(3):373-380.
  9. Day JC, Bentall RP, Roberts C, Randall F, Rogers A, Cattell D, et al. Attitudes toward antipsychotic medication: The impact of clinical variables and relationships with health professionals. Archives of General Psychiatry. 2005;62(7):717-724. http://dx.doi.org/10.1001/archpsyc.62.7.717
  10. Goff DC, Hill M, Freudenreich O. Strategies for improving treatment adherence in schizophrenia and schizoaffective disorder. The Journal of Clinical Psychiatry. 2010;71(Suppl 2):20-26. http://dx.doi.org/10.4088/JCP.9096su1cc.04
  11. Birchwood M, Spencer E, McGovern D. Schizophrenia: Early warning signs. Advances in Psychiatric Treatment. 2000;6(2):93-101. http://dx.doi.org/10.1192/apt.6.2.93
  12. Agius M, Oakham H, Biocina SM, Murphy S. The use of card sort exercises in the prevention of relapse in serious mental illness. Psychiatria Danubina. 2006;18(1-2):61-73.
  13. Sutton DL. Relapse signatures and insight: Implications for CPNs. Journal of Psychiatric and Mental Health Nursing. 2004;11(5):569-574. http://dx.doi.org/10.1111/j.1365-2850.2004.00762.x
  14. Smith J. Early warning signs: A self management training manual for individuals with psychosis. Worcester, UK: Worcester Community and Mental Health Trust; 2003. p. 1-24.
  15. Lee EO, Lim NY, Park HA, Lee IS, Kim JI, Bae J, et al. Nursing research and statistics. Paju: Soomoonsa; 2009. p. 768
  16. Lincoln TM, Wilhelm K, Nestoriuc Y. Effectiveness of psychoeducation for relapse, symptoms, knowledge, adherence and functioning in psychotic disorders: A meta-analysis. Schizophrenia Research. 2007;96(1-3):232-245. http://dx.doi.org/10.1016/j.schres.2007.07.022
  17. Amador XF, Flaum M, Andreasen NC, Strauss DH, Yale SA, Clark SC, et al. Awareness of illness in schizophrenia and schizoaffective and mood disorders. Archives of General Psychiatry. 1994;51(10):826-836. http://dx.doi.org/10.1001/archpsyc.1994.03950100074007
  18. Song JY, Kim KT, Lee SK, Kim YH, Noh JH, Kim JW, et al. Reliability and validity of the Korean version of the scale to assessment unawareness of mental disorder (SUMD-K). Journal of Korean Neuropsychiatric Association. 2006;45(4):307-315.
  19. Rogers ES, Chamberlin J, Ellison ML, Crean T. A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatric Services. 1997; 48(8):1042-1047. http://dx.doi.org/10.1176/ps.48.8.1042
  20. Lim JG. A study on the effect of social support on mental health disorder's empowerment: Compared with residential type [master's thesis]. Seoul: Ewha Womans University; 1999. p. 1-76.
  21. McEvoy JP, Apperson LJ, Appelbaum PS, Ortlip P, Brecosky J, Hammill K, et al. Insight in schizophrenia. Its relationship to acute psychopathology. The Journal of Nervous and Mental Disease. 1989;177(1):43-47. http://dx.doi.org/10.1097/00005053-198901000-00007
  22. van Meijel B, van der Gaag M, Kahn RS, Grypdonck MHF. The practice of early recognition and early intervention to prevent psychotic relapse in patients with schizophrenia: An exploratory study. Part 1. Journal of Psychiatric and Mental Health Nursing. 2002;9(3):347-355. http://dx.doi.org/10.1046/j.1365-2850.2002.00500.x
  23. Fallon P. The role of intrusive and other recent life events on symptomatology in relapses of schizophrenia: A community nursing investigation. Journal of Psychiatric and Mental Health Nursing. 2009;16(8):685-693. http://dx.doi.org/10.1111/j.1365-2850.2009.01451.x
  24. Choi CS, Chae JH, Woo DW, Choi YH, Hahm W, Lee KH, et al. Effects of brief symptom management module on inpatients with chronic schizophrenia: A preliminary study. Journal of Korean Neuropsychiatric Association. 2001;40(1):72-80.
  25. Kim JE, Moon JJ, Kim MH, Kim WJ, Park MK, Song TH, et al. Effects of psychoeducation program on insight and treatment attitudes in patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder. Korean Journal of Psychopharmacology. 2010;21(2):87-94.
  26. Ko KH, Yang SH, Kim YA, Kwon MS, Bang SH, Lee JM, et al. The effects of an empowerment program for chronic schizophrenic patients on their empowerment and internalized stigma. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2008;17(4):491-499.
  27. Fishbein M, Ajzen I. Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley; 1975. p. 12-13.
  28. Seo YM. Meta-analysis of psycho-social rehabilitation programs about schizophrenia patients [master's thesis]. Busan: Kyungsung University; 2002. p. 1-90.
  29. Chae JH. History and problems of concept of positive and negative symptoms in schizophrenia. Schizophrenia Clinics. 2000;2(1):53-63.

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