2004-2005 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Arthur, DG

Lau, YL

Li, Z

Wong, CY

丁伟华

张海霞

李金红

王君英

郝占军

2004-2005 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishedVoR allowe

PolyU Institutional Repository

·?　?·????????????????????李峥　David Arthur　王志英　刘玉莲　丁伟华　郝占军　张海霞　李金红　王君英【??】　??　?????????????????????????/????/???? ,?????????????。??　101??? CCMD-II-R??????????????????? , ??? 46? , ??? 55 ?。??/?????????? ,???? 、?? 3????? 9 ???????????????????????。??　????/?? ,??????? 9 ????????? ,???????? ,??????? , ???????????????????。???????????????? ,?????? 。???????????????????????。??　????????/????/??????????????。【???】　?????;　??;　??;　????The effect of nurse initiated patient/ family education strategy on people with schizophrenia in Beijing// LI Zheng , David Arthur,WANG Zhiying , et al// Chinese Journal of Nursing ,-2004 , 39(7):481.【Abstract】　Objective　 In the light of the prevalence of schizophrenia in China , this study aimed to develop an innovative patient/ familyeducation package and test its effectiveness within a group of people with schizophrenia and their families.Methods　One hundred and onepatients and their families participated in the study and were assigned to the experimental group (46 patients and families)and control group(55 patients and families).The patients and families in the experimental group received individual education from nurses in the hospital and af-ter discharge.Results　Patient' s symptoms were alleviated significantly , social function improved significantly and relapse rates were reducedsignificantly during the follow-up of nine months.The families' knowledge about schizophrenia and their relatives' treatment were improvedsignificantly.Although the patients in the experimental group had better medication compliance , compared with the control group , no signifi-cant difference was found.Expressed emotion(EE)was measured by means of a brief interview.High EE was not confirmed as a predictor ofrelapse of patients in this study.Conclusion　It was found that patient/ family education had a positive impact.【Key words】　Schizophrenia;　Education;　Intervention;　Expressed emotion【Author' s address】　School of Nursing , Peking Union Medical College , Beijing , 100041????:100041　???　????????????(??);??????????(David Arthur);??????????????(??? ,??? ,??? ,??? ,??? ,??? ,???)??:? , 1967???,?? ,???2003-08-13??　　??????????????????????? , 20?? 80 ??????????????????????????????????????/???????? ,?????????????????????? ,??????????? , ??????? , ??????? ,?????? , ????????????????? ,?????????? , ????????[ 1-3] 。???????????????????[ 4-6] , ??????????????(Expressed Emotion , EE)????。 ???????????????? , ???????????/????????? 、?????????????????。?????????????????/????/???? ,???????????? , ?????????????。1　?????1.1　????2000? 1 ?? 2002 ? 6 ?????????????101????????????。???? CCMD-II-R???????????? ,?? 16 ～ 65 ? ,????????????? 3????。1.2　??1.2.1　?????:????????? ,??????????????? ,??????????????? 。??????????????????? ,??????????????????。 ??????????????????????? ,?????????????????? ,???????????????/??。1.2.2　??/????/??:??/?????/??????? 2????? , ????? 36h ,?????????·481·?????? 2004? 7?? 39?? 7??????????? 8h , ?????????????3h ? 3 ??。??/??????? 7 ???:?????????? 、????? 、????? 、????? 、??????? 、??????? 、???????。??/????????????? ,????/?????????????? ,?????????????????????? , ??????????????????????????? 、?? 、?? ,?????????????? , ??????。????/????????????????????? ,????????????????。1.2.3　???????:??/???????????①??????????(?? 、?? 、???? 、???? 、???)????????(?? 、?????? 、?????);②????? 、?????? 、?????? 、????? 、???;③????????????? 、???????。????? 、?????? 、??????????????????????(BPRS)、??????(GAS)、??????????(NOISE-30)??[ 7] 。?? BPRS 、GAS 、NOSIE-30 ???????????????????[ 7] 。???????????? Hornung ?????[ 8] , ?????????? , ??? 、??? 、???。??????????????????????? ,? BPRS ??? 、???? 、???????????????? 5 ????。?????????(KASI)???????????????????? ,?????????? 0.66～ 1.00。?????? 、?? 、?? 、???? 、?????????? 6??? , ????????? , 1 ?(????)、2(??)、3 ?(????)、4 ?(???????????)。 ??????????? 5min ??(FMI),?????????????? ,?????????[ 9] 。1.2.4　?????:??????? 、?? 、???? 、???????? ,??????? 、???????????????????????? 1 ??????。??????? 1 ???????? 、???? 、????????????????? ,??????? 3 ?? 、9 ????????? 、???? 、????? 、????????? 、????。2　?　?2.1　??????????101?????? , 10?(??? 2? , ??? 8 ?)???? 3???? , 2?(??? 、???? 1 ?)????9 ????。????????? ,???????????????????? 101 ?????? , ??? 3 ??? 9 ????? ,????????????????。????????? 32.89 ?(16 ～ 61 ?), 41.9%??? , 20 ??? , 3 ??? , ???? , ?????????1.78 ?(1～ 5?),?????6 ?(0.6～ 26 ?);????????? 32.16 ?(15 ～ 49 ?), 58.1%??? , 28 ??? ,3 ??? ,???? ,??????? 1.73?(1～ 6?),????? 5.3 ?(0～ 21 ?)。????? t???χ2 ?????????????(t=0.393 , P=0.696;χ2=0.410 , df=1 ,P=0.522;χ2=0.408 , df=1 , P =0.523;χ2=0.974 , df=2 , P =0.614;t=0.999 , P=0.320)。????? 1 ????????????/???? ,??????????????? , ???????? , ?????????。???????????? 37%??????? , 63%?????? , ???? 45.5%???? ,50.9%??? , 3.6%?????。 ?χ2 ????????????(χ2=3.232 , df=3 , P=0.357)。??????? 、???? 、?????? , ?????????? ,?? BPRS 、GAS 、NOSIE 、FAS 、EE ????????????????????????。2.2　????????? ,?????? , ?????????????(? 1)? 1　?????????????(Adm)、???(Disch)、?? 3??(3mth)、?? 9 ??(9mth)??????????? ,?????? , ????????????????( x±s)???(n =36)Adm　　　Disch　　　　3mth　　　9mth　　　F or t? 　???(n=33)Adm　　　Disch　　　　3mth　　　9mth　　　F or t ?BPRS 45.57 23.63 23.57 22.691) 102.43) 47.89 24.24 25.75 26.531) 71.713)(11.94) (5.56) (4.14) (3.73) (12.08) (7.02) (10.38) (7.36)GAS 32.91 72.96 74.57 78.002) 184.803) 29.51 77.06 73.64 70.182) 139.483)(9.30) (9.63) (12.59) (10.33) (11.35) (11.74) (16.71) (15.91)NOSIE 168.83 208.13 7.473) 161.67 206.15 10.683)(32.62) (14.47) (26.69) (14.96)1)t=2.66, P <0.01;2)t=2.40 , P <0.05;3)P <0.00　　?? 9 ??? , ???? BPRS ???? t ?????????。?????????????????? ,??????? 、?????? 3 ?? 、?????? 9 ???????????。? t?? , ?? 9?????? GAS ?????????。???????????????????????????? , ?????? 3 ?? 、?????? 9 ???????????。·482· ?????? 2004? 7?? 39?? 7??????? NOSIE?????? ,? t ?????????????????。???????? 、??????????????。2.3　??????????????12 ????????? , ??89 ????? , ??? 4?(??? 2? , ???2 ?)???3 ???????;16 ?(??? 5 ? , ??? 11 ?)??? 9 ????????? , 4?(???????)???9 ???? BPRS ??????。?χ2 ?? ,??????????????(χ2=4.83 , P <0.05),???? 16.28%, ????36.96%。??3 ????? 10?????? ,???? 91 ????? ,?χ2?? , ?????????????? , ??????????????????(χ2=1.12 , P=0.29)。2.4　??????????????(? 2)? 2　????????????? 、??? 、?? 3 ?? 、?? 9????????????????????( x±s)?? ??? ??? ?? 3?? ?? 9?? F???? 11.63±2.06 15.00±2.581) 15.19±3.002) 15.86±3.113) 21.744)??? 11.96±2.35 13.04±2.121) 12.80±2.142) 13.03±2.323) 2.681)t=4.10, P <0.01;2)t=4.25 , P<0.01;3)t=4.31, P<0.01;　4)P <0.01　　? t ?? ,??? 、?? 3?? 、??9 ??? , ???????? KASI ??????????。??????? ,?????????????? 、?? 3 ?? 、?? 9 ?????????????? ,????? 、?? 3 ?? 、??9 ???????????。????????????????????????。2.5　???????[ 10](? 3～ 5)　　???????????????????????? 3　???????????????? ?? ????????Freq　　　?(%)??????????Freq　　　?(%)?????Freq　　　?(%) χ2 P???? 46 13 28.3 3 6.5 30 67.4??? 55 10 18.2 9 16.4 36 65.5 2.76 0.25? 4　???? 3 ?????????????? 　　?? 　　????????Freq　　　?(%) 　　??????????Freq　　　?(%) 　　?????Freq　　　?(%) χ2 P???? 42 8 19.0 1 2.4 33 71.7??? 45 9 20.0 0 0.0 36 80.0 1.09　　 0.58　　? 5　???? 9 ?????????????? ?? ????????Freq　　　?(%)??????????Freq　　　?(%)?????Freq　　　?(%) χ2 P???? 36 2 5.6　 0 0.0 34 94.4　??? 33 2 6.1　 0 0.0 31 93.9　 0.01 0.93?? 、?? 3 ?? 、?? 9 ?????????????。????13???????????????? 8 ???????? , ??? 10 ???????????????? 5???????? , ?????????????????(χ2=1.68 , P<0.25)。????? 2 ? , ????? 8? , ????????????????????????? ,???????????????????。3　?　?3.1　??/????/????????????BPRS ??????????????????????????????? , ?????????????? ,???? 9???????????????? , ???????????????????????????????。???????????????????????? ,??/??????????????????? , ?????????。????????????????????? ,???????/??????????。3.2　??/????/????????????????GAS ?????????????????????????????? 3?????????? , ????????????? , ???? 9 ??? ,????????????????。????????????????·483·?????? 2004? 7?? 39?? 7???????????????????????????? ,????????????????。????????????????[ 4-6 , 11] 。??NOSIE ????????????????????????????????? , ??????????????。?????????????????? ,??????。3.3　??/????/??????????????????????? ,???????????????。??????????/??????????? ,???/????????? , ????????? , ??????????????????????????50%,????????????????????????[ 12] 。?????????????????(68.18%)????(57.45%)???????。?????????? 、????????????????? , ????????????????????? , ??????????????????[ 13] 。3.4　??/????/???????????Falloon????????????? 9 ???????? 44%??? 6%, ???????? 83%???17%[ 14] 。??????? 9 ??? , ???????(16.28%)???????(36.96%)。???? 、?? 、?????????/????/?????? 、1 ? 、2 ? 、3??????????????????[ 4-6] 。?????????[ 14] ,??/?????/?????????? 0.2 , ???????? , ???????/??????????20%,?????????????。??????????????????????? ,?????????????????????????。Phillips ?????????????? 18 ????????????????????????????????????? ,???????????????[ 15] 。3.5　??/????/?????????????????????????????????????;???????????????;??????????????。???????????????????????? , ?????????????????。 ???????????????????????? , ???????????? , ????????????????????[ 16] 。?????????????????????????????? ,????????????? , ?????????????????。3.6　??/????/??????????????????????????????????????????????????。?????? , ???????????????????????????????? 。Brown???? , 30%???????????????? , [ 17]?????????????????????? ,???????? , ??????????。 ????????????????????? ,????????????????????????????。???????/?????????? , ??????????;??????/????/??????? , ?????? ,????????????????[ 18] 。4　?　?????????????????/????/??????????????。????/?? , ??????? 9 ????????? , ???????? , ??????? ,???????????????????。???????????????? , ??????。???????????????????????。??????????????????????????????????????????? , ???????????????????/???。??????????/????/?????????????? , ???/??????? 、?????????? 、?????????? 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? ? ? ? ? ?———“中华护理人的骄傲·传承与创新”护理学术交流会演讲???????????　林菊英　　???????????????????? , ????????????? 、?? 、?????????????? ,????????????????。???????? ,?????????????????????????。 1884 ? , ????????(Mck-echnie)????????????????。1888? ,??????(Johnson)?????????????。 1900 ??? , ??????????????????? , ??????????。 1907 ? , ???????(Simpson)?? ,???????????????。 1909 ???????? , 1914 ?????????????? ,? Nurse ??“?”? ,??????????? , ???????? , ??????????? ,????“?????”?? , ? Nurse ????? ,????? , ????。1922???????? , ???? 11?????? , 1936?????????。??????? ,??????????:????(1949 ???)????? , ?????? 80????????????????????:?????40 ?(1909～ 1949 ?), ??????? 、?? 、????? ,?????? ,????????????????? , ????????? ,??????? ,??? 180 ??? , ??? 3 ????? , ?????????????? , ???????? , ???????????????????。????(1949～ 1979 ?)????? , ??????????????????? ,?????????。???? ,? 、? 、???????? , ?????????????? ,????????????????? , ?????????????。?????????????????? ,??? 80 ??????????????????。????(?????? 20 ?), ??????????????????? 、???????? , ?????? 、??? 、????????? , ????????? , ??????????? 、????? 、????????? ,??? 20?????????? , ?? 21 ???????????????。???? ,???? , ???? 、??????????? ,????? 21 ??????????????!·485·?????? 2004? 7?? 39?? 7?

The effect of nurse initiated patient/family education strategy on people with schizophrenia in Beijing

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