A Pilot Study of an Illness Management and Recovery Program in Discharged Patients with Schizophrenia

疾病管理及復元方案於出院精神分裂症病患之先驅研究

10.1097/JNR.0000000000000004

林靜蘭(Esther Ching-Lan Lin)；邵文娟(Wen-Chuan Shao)；陳展航(Chin-Hong Chan)；蕭淑貞(Shu-Jen Shiau)；王鴻松(Hong-Song Wang)；黃仕奇(Shi-Chi Huang)

出院 ； 疾病管理及復元方案 ； 精神分裂症 ； discharge ； Illness Management and Recovery model ； schizophrenia

The Journal of Nursing Research

21卷4期（2013 / 12 / 01）

270 - 278

英文

Background: Accumulated evidence supports the effectiveness of equipping chronically ill patients with illness management knowledge and skills. The Illness Management and Recovery (IMR) program developed by the United States government has been widely adopted for persons with mental illness. However, few studies support its effectiveness in patients with schizophrenia.Purpose: This pilot study developed a culturally adapted and abbreviated version of the IMR for Taiwanese patients with schizophrenia who were ready for discharge from the hospital. Furthermore, we investigated the impact of the program in terms of illness knowledge, drug attitude, insight, and psychopathology.Methods: The original IMR was condensed and modified for implementation during participants' preparation for hospital discharge. Using a preexperimental design, pretest and posttest assessments for a single group of 26 participants received the new IMR twice a week for 3 weeks on the four outcome indicators of illness knowledge, drug attitude, insight, and psychopathology.Results: Participants improved in terms of treatment-related illness knowledge, insight, and affective-domain psychopathology (p G .01) after intervention completion. Average participant attendance was 5.45 sessions out of 6 total sessions.Conclusions/Implications for Practice: The intensive symptom and medication-focused IMR model for soon-to-be-discharged patients with schizophrenia had positive impacts on illness management. In the future, studies using a two-group randomized controlled design and extended follow-up should be conducted to determine the long-term effects of IMR.

Background: Accumulated evidence supports the effectiveness of equipping chronically ill patients with illness management knowledge and skills. The Illness Management and Recovery (IMR) program developed by the United States government has been widely adopted for persons with mental illness. However, few studies support its effectiveness in patients with schizophrenia.Purpose: This pilot study developed a culturally adapted and abbreviated version of the IMR for Taiwanese patients with schizophrenia who were ready for discharge from the hospital. Furthermore, we investigated the impact of the program in terms of illness knowledge, drug attitude, insight, and psychopathology.Methods: The original IMR was condensed and modified for implementation during participants' preparation for hospital discharge. Using a preexperimental design, pretest and posttest assessments for a single group of 26 participants received the new IMR twice a week for 3 weeks on the four outcome indicators of illness knowledge, drug attitude, insight, and psychopathology.Results: Participants improved in terms of treatment-related illness knowledge, insight, and affective-domain psychopathology (p G .01) after intervention completion. Average participant attendance was 5.45 sessions out of 6 total sessions.Conclusions/Implications for Practice: The intensive symptom and medication-focused IMR model for soon-to-be-discharged patients with schizophrenia had positive impacts on illness management. In the future, studies using a two-group randomized controlled design and extended follow-up should be conducted to determine the long-term effects of IMR.

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