Effects of a Psychosocial Rehabilitation Program in Addition to Medication in Schizophrenic Patients: A Controlled Study

摘要

Objectives: The contemporary approach to psychiatric diseases is to refer the patient to community-based care instead of hospital-based care. In addition to medication, it has been found that day-hospital practices have positive results in schizophrenic patients. In this study, our purpose is to report the results of a psychosocial rehabilitation program at Bak?rk?y Day Hospital for schizophrenic patients receiving medication, and to compare them with the results for schizophrenic patients receiving medication who were not in this program.Methods: The participants were 55 patients who attended Bak?rk?y Day Hospital continuously for a minimum of six months, completed their psycho-education group therapy, a 14-week structured group therapy and had one key person from their family who completed the family psycho-education group program. These patients had not failed to attend personal consultation interviews more than three times, had worked for three months or longer in a workshop or in one of the fields of business defined by the center and had been receiving medication. The study also included 45 control schizophrenic patients who received only medication. All patients were assessed using the Positive and Negative Syndrome Scale, the Quality of Life Scale, the Schedule for Assessing the Three Components of Insight, the Social Functionality Scale and the Disability Assessment Schedule and the groups were compared to each other.Results: No statistically significant difference was found between the two groups in terms of sex, age, marital status, having children, and cohabitant variables (p0.05). The average number of years of education for the “rehabilitation+medication” group was statistically significantly higher compared to the group that received only medication (p0.05). A statistically significant difference was found between the groups for age of onset and number of hospitalizations (p0.05). Statistically lower results were obtained in the “rehabilitation+medication” group when the Positive and Negative Syndrome Scale total score and the Disability Assessment Schedule were compared between the groups (p0.05). The scores of the “rehabilitation+medication” group were significantly higher in terms of the Schedule for Assessing the Three Components of Insight, Social Functionality Scale, and Quality of Life Scale for schizophrenic patients (p0.05).Conclusions: This study is important because it shows that the approach to schizophrenic patients in our country is consistent with treatment progress in the rest of the world. Our study reveals that multidimensional psychosocial rehabilitation influences many fields and highlights the need for other approaches in addition to medication.?ZETAma?: Psikiyatrik hastal?klara ?a?da? yakla??m hastane temelli bak?m yerine toplum temelli bak?ma y?nelmektedir. ?izofreni hastalar?nda ila? tedavisine ek olarak gündüz hastanesi uygulamalar?n?n olumlu sonu?lar? bildirilmektedir.Bu ?al??mada amac?m?z Bak?rk?y Gündüz Hastanesi'nde uygulad???m?z psikososyal rehabilitasyon program?n?n ila? tedavisi alt?ndaki ?izofreni hastalar?ndaki sonu?lar?n? ortaya ??karmak ve bu program uygulanmayan ila? tedavisi alt?ndaki ?izofreni hastalar? ile kar??la?t?rmakt?.Y?ntem: Bak?rk?y Gündüz Hastanesi'ne en azalt? ay boyunca devam etmi? ve 14 haftal?k yap?land?r?lm?? bir grup e?itimi olan psikoe?itim grup tedavisini tamamlam??, ailesinden en az bir anahtar ki?inin aile psikoe?itim grubunu tamamlad???, bireysel dan??manl?k g?rü?melerini ü? kezden daha fazla aksatmam??, en az bir at?lyede ya da merkezde tan?mlanm?? i? alanlar?ndan birinde ü? ay ya da daha uzun surely ?al??an ve ila? tedavisi de almakta olan 55 hasta ve yaln?zca ila? tedavisi g?ren 45 kontrol ?izofreni hastas? al?nm??t?r. Tüm hastalara Pozitif ve Negatif Sendrom ?l?e?i, ?izofreni Hastalar? ??in Ya?am Niteli?i ?l?e?i, ??g?rünün ü? Bile?enini De?erlendirme ?l?e?i, Sosyal ??levsellik ?l?e?i, Yeti Yitimi De?erlendirme ?izelgesi uygulanm?? ve gruplar birbiriyle kar??la?t?r?lm??t?r.Bulgular: Her iki grup aras?nda cinsiyet, ya?, medeni durum, ?ocuk sahibi olma durumu, kiminle birlikte ya?ad??? de?i?kenleri y?nünden istatistiksel olarak anlaml? fark bulunmam??t?r (p0,05). Rehabilitasyon+ila?tedavisi grubunun e?itim süresi sadece ila? tedavisi alan gruptan istatistiksel olarak anlaml? düzeyde yüksekti (p0,05). Gruplar aras?nda hastal?k ba?lama ya??, hastaneye yat?? say?s? aras?nda istatistiksel olarak anlaml? fark bulunmu?tur (p0,05). Pozitif ve Negatif Sendrom ?l?e?i toplam puan?, Yeti Yitimi De?erlendirme ?izelgesi skorlar? gruplar aras?nda kar??la?t?r?ld???nda rehabilitasyon+ila? tedavisi grubunda istatistiksel olarak dü?ük sonu?lar elde edilmi?tir (p0,05). ??g?rü, Sosyal ??levsellik ?l?e?i, ?izofreni Hastalar? ??in Ya?am Niteli?i ?l?e?i a??s?ndan rehabilitasyon+ila? tedavisi grubunun puanlar? anlaml? düzeyde yüksekti (p0,05).Sonu?: Bu ?al??ma ülkemizde ?izofreni hastalar?na dünyadaki gidi?ata uygun