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題名 | 自然體驗活動介入對慢性精神分裂症病患精神病症狀之成效探討=The Efficacy of Nature Experience Activities on Psychotic Symptoms in Sufferers of Chronic Schizophrenia |
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作者 | 張碧凰; 戎瑾如; 林寬佳; 郭千哲; Chang, Beh-huan; Rong, Jiin-ru; Lin, Kuan-chia; Kuo, Chian-jue; |
期刊 | 護理暨健康照護研究 |
出版日期 | 20111200 |
卷期 | 7:4 2011.12[民100.12] |
頁次 | 頁305-316 |
分類號 | 418.993 |
語文 | chi |
關鍵詞 | 自然體驗活動; 慢性精神分裂症; 精神病症狀; Nature experience activities; Chronic schizophrenia; Psychotic symptoms; |
中文摘要 | 背景 : 自然體驗活動為新興的輔助療法之一,非侵入性措施,目前國內外尚無以慢性精神分裂症病患為對象之實證研究。 目的 : 探討八週自然體驗活動對慢性精神分裂症患者精神病症狀改善之成效。 方法 : 採用類實驗設計,以方便取樣台北一精神醫院的日間留院精神分裂病患共 48位(實驗組 25位,對照組 23位)。兩組均進行常規性精神復健治療活動,實驗組另接受為期八週,每週一次 90分鐘的自然體驗活動。以正性與負性症狀量表評估病患症狀。評估時間點為介入前、八週介入活動結束時、介入結束後四週,資料分析則應用概似化估計方程式 (generalized estimating equations, GEE) 及獨立樣本 t檢驗。 結果 : 經 GEE model分析,發現實驗組介入活動結束時 (T2;B = -2.850, p < .001) 與介入結束後四週 (T3; B = -2.637, p < .001),病患之整體精神病症狀較前測之進步幅度顯著大於對照組;尤其,病患之正性症狀及一般精神病理症狀較接受自然體驗活動前測仍呈現進步與對照組有顯著差異。自然體驗活動的介入可以顯著減輕慢性精神分裂症患者的正性症狀總分 (t = 3.30, p = .002) 及一般精神病理 (general psychopathology) 總分 (t = 4.81, p < .001),特別是幻覺行為 (t = 2.59, p = .02)、焦慮 (t = 2.89, p = .01)、愧疚感 (t = 2.30, p = .03)、身體緊張 (t = 2.45, p = .02)、衝動控制障礙 (t = 1.99, p = .05) 等項目,且有持續緩和幻覺行為、焦慮、愧疚感及衝動控制障礙之效益。 結論/實務應用 : 建議將自然體驗活動納入慢性精神病患例行的復健活動。 |
英文摘要 | Background: Nature experience activity is an evolving, non-invasive, adjunctive therapy for patients with schizophrenia. The current literature lacks empirical evidence on its effectiveness in treating chronic schizophrenic patients. Purpose: This study examines the efficacy of nature experience activities on positive and negative symptoms in individuals with chronic schizophrenia. Methods: Researchers used a quasi-experiment design and subjects comprised a convenience sample of forty-eight patients diagnosed with schizophrenia recruited from a Taipei City psychiatric hospital daycare center. The experimental group (n = 25) received the usual psychiatric rehabilitation program as well as an additional 90-minute nature experience activity once each week for eight weeks. The control group (n = 23) received the usual psychiatric rehabilitation program only. Researchers administered positive and negative syndrome scale (PANSS) surveys three times as follows: pre-treatment (baseline), immediate post-treatment (week 8), and follow-up (week 12). Data were analyzed using generalized estimating equation analysis and an independent samples t test. Results: Generalized estimating equations (GEE) analysis showed nature experience activity indeed improved psychotic symptoms at T2 (B = -2.850, p < .001) and at T3 (B = -2.637, p < .001) in the experiment group. In addition, the effects of the nature experience activity continued to improve both positive and general psychopathology syndromes. The experimental group further showed significantly more relief than the control group in terms of positive psychotic syndromes (t = 3.30, p = .002) and general psychopathology syndromes (t = 4.81, p < .001). Nature experience activities demonstrated lasting benefits in terms of hallucinatory behavior (t = 2.59, p = .02), anxiety (t = 2.89, p = .01), guilt (t = 2.30, p = .03), tension (t = 2.45, p = .02), poor impulse control (t = 1.99, p = .05), and active social avoidance (t = 1.99, p = .05) in the experimental group. Conclusions / Practical application: Findings recommend that nature experience activities be incorporated into psychiatric rehabilitation programs for sufferers of chronic schizophrenia. |
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