接纳与承诺疗法对精神分裂症患者病耻感、自我效能及依从性的影响

Effect of acceptance and commitment therapy on stigma,self-efficacy,and medication adherence in patients with schizophrenia

目的 精神分裂症患者具有严重的病耻感及较低的自我效能,影响患者的依从性和疾病的康复。本研究探讨接纳与承诺疗法对精神分裂症患者病耻感、自我效能及依从性的影响,以期为减轻精神分裂症患者的病耻感,提高其自我效能及依从性提供一种有效、安全的方法。方法 选取2022年10月—2023年4月就诊于哈尔滨精神专科白渔泡医院门诊的精神分裂症患者为研究对象,将招募的178例精神分裂症患者使用随机数字列表法分为对照组89例和研究组89例,对照组给予常规药物治疗,研究组在此基础上给予接纳与承诺疗法。于干预前后采用精神疾病内化病耻感量表(ISMI)、一般自我效能量表(GSES)、Morisky服药依从性量表(MMAS-8)进行评估。结果 干预后,研究组ISMI评分为(61.39±9.93)分,低于对照组的(67.34±10.48)分,GSES评分为(21.01±3.63)分,高于对照组的(19.21±3.93)分,MMAS-8评分为(7.66±1.21)分,高于对照组的(6.07±1.48)分,差异均有统计学意义(P<0.05)。干预后,研究组ISMI评分为(61.39±9.93)分,低于干预前的(67.24±10.34)分,GSES评分为(21.01±3.63)分,高于干预前的(19.17±3.89)分,MMAS-8评分为(7.66±1.21)分,高于干预前的(6.01±1.42)分,差异均有统计学意义(P<0.05)。结论 接纳与承诺疗法能有效减轻精神分裂症患者的病耻感,提高其自我效能及依从性。

Objective Patients with schizophrenia have a severe stigma and low self-efficacy,which seriously affects their medication adherence and recovery of the disease.This study explores the effects of acceptance and commitment therapy on the stigma,self-efficacy,and medication adherence of patients with schizophrenia,in order to provide an effective and safe method for reducing the stigma,improving self-efficacy,and medication adherence of patients with schizophrenia.Methods Patients with schizophrenia who visited the Harbin Psychiatry Specialist Baiyupao Hospital from October 2022 to April 2023 were selected as the research subjects.A total of 178 recruited patients with schizophrenia were divided into a control group of 89 cases and a study group of 89 cases using a random number list method.The control group received conventional drug treatment,while the study group received acceptance and commitment therapy.Before and after the intervention,the internalized stigma of mental illness scale(ISMI),general self efficacy scale(GSES),and Morisky medication adherence scale-8(MMAS-8) were used to evaluate the efficacy of mental illness.Results After intervention,the ISMI score of the study group was(61.39±9.93) points,which was lower than that of the control group [(67.34±10.48) points],and the GSES score of the study group was(21.01±3.63) points,which was higher than that of the control group [(19.21±3.93) points],and the MMAS-8 score of the study group was(7.66±1.21) points,which was higher than that of the control group [(6.07±1.48) points],and the differences were statistically significant(P<0.05).After intervention,the ISMI score of the study group was(61.39±9.93) points,which was lower than that before intervention [(67.24±10.34) points],and the GSES score of the study group was(21.01±3.63) points,which was higher than that before intervention [(19.17±3.89) points],and the MMAS-8 score of the study group was(7.66±1.21) points,which was higher than that before intervention [(6.01±1.42) points],and the differences were statistically significant(P<0.05).Conclusion Acceptance and commitment therapy can effectively reduce the stigma in patients with schizophrenia,improve their self-efficacy and medication adherence.