Qualitative study of daytime rehabilitation experience in patients with high-compliance schizophrenia
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摘要:
目的 探讨高依从性精神分裂症患者参与日间康复的内心感受与体验，为开发针对患者需求的有效干预提供借鉴。 方法 采用目的抽样法选取2018年11月—2019年1月在南京市佑安家园日间康复中心14例高依从性精神分裂症患者进行半结构式访谈，运用质性研究中的现象学研究方法对资料进行整理分析。 结果 14例受访者均能感知日间康复对自身疾病及生活的正性影响，综合受访者的康复体验，分析萃取出4个主题：康复效果的感知表现为日间康复对负性情绪的改善、复发及再住院频率减少；康复促进认知重建表现为肯定自我价值、重建生活乐趣；康复促进行为建立表现为提高生活能力、建立药物自我处置模式、积极应对复发先兆、主动利用医疗资源及社会支持；管理模式与现实问题的冲突表现为注重治疗与管理，忽略患者感受、保护性环境无法模拟现实社会。 结论 高依从性患者对日间康复效果及持续必要性认知充分。高依从性康复锻炼能有效促进病情的稳定，改变患者的认知，改善社会功能，提高生活质量。日间康复中心为患者提供多专业支持的社区康复服务，通过开设多元化的康复活动，满足患者需求，以提高康复依从性，是患者回归社会的有力保障。日间康复模式管理仍处于探索阶段，扩大精神卫生资源的利用需提高全社会的重视和参与。 Abstract:Objective To explore the inner feelings and experiences of patients with high-compliance schizophrenia participating in daytime rehabilitation, and to provide reference for the development of effective interventions tailored to the needs of patients. Methods The purposive sampling method was used to select semi-structured interviews of 14 patients with high-compliance schizophrenia from November 2018 to January 2019 in Nanjing Youan Homeland Day Rehabilitation Center. The phenomenological research method in qualitative research was used to sort out and analyze the data. Results All 14 respondents were able to perceive the positive impact of daytime rehabilitation on their own diseases and life. On the basis of their rehabilitation experience, four themes were extracted from the analysis: the perception of rehabilitation effect showed that daytime rehabilitation improved negative emotions, and the frequency of relapse and rehospitalization decreased. Rehabilitation promoted cognitive reconstruction by affirming self-worth and reconstructing life pleasure. The establishment of rehabilitation promotion behaviour included improving life ability, establishing drug self-management mode, actively coping with the recurrence aura and actively using medical resources and social support. The conflict between management mode and practical problems was that it pays attention to treatment and management and neglects the feelings of patients and protective environment, which could not simulate the real society. Conclusion Patients with high-compliance schizophrenia are fully aware of the effect of daytime rehabilitation and the necessity of continuous rehabilitation. High-compliance rehabilitation exercise can effectively promote the stability of the disease, change the patient's cognition of the disease, improve social function and improve the quality of life. The daytime rehabilitation centre provides community rehabilitation services with multidisciplinary support for patients. It can meet the needs of patients and improve rehabilitation compliance by setting up diversified rehabilitation activities, which is a powerful guarantee for patients to return to society. The management of daytime rehabilitation mode is still in the exploratory stage, and the whole society should pay more attention to and participate in expanding the utilisation of mental health resources. -
Key words:
- Schizophrenia /
- Day rehabilitation /
- Rehabilitation experience /
- Qualitative research
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