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Schizophrenia is a complex psychiatric disorder characterized by a range of symptoms that significantly impact cognition, behavior, and emotional regulation. Among these, the positive symptoms stand out as they involve the addition or exaggeration of normal mental functions, deviating markedly from typical behavior and perception. Hallucinations and delusions are prominent positive symptoms, each profoundly affecting the individual's experience of reality.
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Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
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Behavioral management of auditory hallucinations.

Martha D Buffum1, Robin Buccheri, Louise Trygstad

  • 1VA Medical Center, San Francisco, CA, USA. Martha.Buffum@va.gov

Journal of Psychosocial Nursing and Mental Health Services
|September 24, 2009
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Summary

A new behavioral course effectively helps schizophrenia patients manage auditory hallucinations. Most participants reported reduced voice intensity and no longer hearing commands to harm themselves or others.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Mental Health Nursing

Background:

  • Auditory hallucinations are a core symptom of schizophrenia, significantly impacting patient well-being and daily functioning.
  • Self-management strategies offer a promising avenue for improving outcomes in schizophrenia care.
  • The integration of evidence-based behavioral interventions into clinical practice requires effective implementation strategies.

Purpose of the Study:

  • To evaluate the implementation and patient benefits of a 10-session behavioral self-management course for auditory hallucinations in schizophrenia patients.
  • To assess the role of advanced practice nurses (APNs) in delivering the course and their perceptions of its utility.
  • To examine the facilitators and barriers encountered during the course's implementation within a healthcare system.

Main Methods:

  • A 10-session behavioral course was delivered to 32 patients with schizophrenia within the U.S. Department of Veterans Affairs.
  • Six advanced practice nurses (APNs) at six sites were trained in course delivery via teleconferencing, electronic media, and conference calls.
  • Patient outcomes, including voice frequency, intensity, and harm ideation, were assessed, alongside APN feedback on implementation and helpfulness.

Main Results:

  • All six APNs reported the course was helpful, improved patient communication regarding hallucinations, and enhanced harm assessment.
  • 96% of participating patients found the course beneficial.
  • 67% of patients no longer experienced auditory hallucinations commanding self-harm or harm to others, and 60% showed improved auditory hallucination intensity scores.

Conclusions:

  • The 10-session behavioral course is an effective intervention for self-management of auditory hallucinations in schizophrenia.
  • Successful implementation was demonstrated through APN adoption and practice integration, aligning with innovation adoption models.
  • The course offers significant benefits to patients, including reduced hallucination severity and decreased harmful ideation, highlighting its clinical utility.