针对印度精神分裂症患者及其照顾者的社区干预措施的有效性 (COPSI):一个随机对照试验
Sudipto Chatterjee1, Smita Naik1, Sujit John2
1Sangath, Goa, India.
Lancet (London, England)
|March 12, 2014
概括
在印度,以社区为基础的精神分裂症护理与以设施为基础的护理相比,适度改善了症状和残疾. 这种协作方法在服务有限的农村地区尤其有效.
科学领域:
- 精神病学是一种精神病学.
- 全球健康 全球健康
- 公共卫生 公共卫生
背景情况:
- 在低收入和中等收入国家,社区卫生工作者可以在专家监督下有效提供精神分裂症护理.
- 印度精神分裂症患者社区护理 (COPSI) 试验旨在将基于社区的护理与基于标准设施的护理进行比较.
研究的目的:
- 评估基于社区的协作护理干预措施与印度精神分裂症患者的标准设施护理的有效性.
主要方法:
- 一个多中心,并行组,随机对照试验,涉及印度282名成年精神分裂症患者.
- 参与者被随机分配 (2:1) 接受基于社区的协作护理加上基于设施的护理或仅基于设施的护理.
- 症状和残疾变化在12个月内使用阳性和阴性综合征量表 (PANSS) 和印度残疾评估和评估量表 (IDEAS) 进行评估.
主要成果:
- 在12个月后,干预组与对照组相比,出现了较低的PANSS分数 (p=0.08) 和显著较低的IDEAS分数 (p=0.01) 的趋势.
- 在参与者中,总体症状降低>20%的比例没有显著差异 (PANSS:51%与51%;IDEAS:48%与35%).
- 在泰米尔纳德邦农村地区,症状和残疾结果显著减少.
结论:
- 基于社区的协作性护理干预表明了适度的有效性,特别是在减少残疾和精神病症状方面.
- 建议将这种干预作为精神分裂症护理的初始服务模式,用于资源稀缺的环境,如农村地区.
相关概念视频
Community Based Intervention
620
Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
620
Psychological and Sociocultural Causes of Schizophrenia
977
Schizophrenia, a complex psychiatric disorder, has been historically misunderstood. Early psychological theories attributed its origins to childhood trauma and unresponsive parenting. However, contemporary research largely rejects these notions, favoring the vulnerability-stress hypothesis. This model proposes that individuals with a genetic predisposition to schizophrenia may develop the disorder following exposure to significant environmental stressors. Notably, studies on high-risk...
977
Psychosis: Goals of Pharmacotherapy
706
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
706
Drug Therapy
449
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
449
Psychosis and Antipsychotic Drugs: Overview
1.2K
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
1.2K
Acute Coronary Syndrome IV: Interprofessional Care
522
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
522

