Intervención para lograr la independencia física en los adultos mayores con esquizofrenia residual / Health intervention to achieve physical independence in older adults with residual schizophrenia

RESUMEN Fundamento: la esquizofrenia residual es un trastorno frecuente en los adultos mayores diagnosticados con esquizofrenia, enfermedad crónica, caracterizada por abulia, aplanamiento afectivo y aislamiento social. Objetivo: diseñar una intervención para lograr la independencia física en los adultos mayores con esquizofrenia residual. Métodos: se realizó un estudio de intervención y desarrollo que muestra la intervención de salud para lograr la independencia física en los adultos mayores con esquizofrenia residual del Hospital Psiquiátrico Docente de la provincia Sancti Spíritus, en el período comprendido entre septiembre 2016 a enero 2018. Variables de estudio independencia física se midió como independiente, mínimo dependiente y dependiente. Se aplicaron diferentes modalidades de rehabilitación. Se utilizó entrevista estructurada y la observación directa a los adultos mayores. Con análisis porcentual de la variable utilizada. La población estuvo constituida por 27 adultos mayores con diagnóstico de esquizofrenia residual. Se consultaron 18 expertos a los que se les aplicó el método Delphi. Resultados: la proporción de los adultos mayores que logro independencia física fue de 52,17 %, lo que obedeció a cambios de conductas generadoras de salud. Conclusiones: la intervención de salud para lograr la independencia física en los adultos mayores con esquizofrenia residual articula acciones y actividades educativas que favorecen la relación personal de salud-paciente-contexto sociocultural, para llevar la independencia física hasta una concepción sistémica que favorece el seguimiento y control de la enfermedad.

ABSTRACT Background: residual schizophrenia is a frequent disorder in older adults diagnoseds with schizophrenia, a chronic disease, characterized by apathy, affective flattening and social isolation. Objective: to design an intervention to achieve physical independence in older adults with residual schizophrenia. Methods: intervention and development study that shows the health intervention to achieve physical independence in older adults with residual schizophrenia at the Sancti Spíritus Provincial Teaching Psychiatric Hospital, in the period from September 2016 to January 2018. The physical independence Study variable was measured as independent, minimally dependent and dependent. Different rehabilitation modalities were applied. A structured interview and direct observation of the elderly were used. With percentage analysis of the variable used. The population consisted of 27 older adults with a diagnosis of residual schizophrenia. Eighteen experts to whom the Delphi method was applied were consulted. Results: the proportion of older adults who achieved physical independence was 52.17%, which was due to changes in health-generating behaviors. Conclusions: the health intervention to achieve physical independence in older adults with residual schizophrenia articulates actions and educational activities that favor the personal health-patient-sociocultural context relationship, to bring physical independence to a systemic conception that favors monitoring and disease control.

A Two-year Follow-up Study on Efficacy of Skills Training on Schizophrenia / 中国康复理论与实践

@# Objective To study the efficacy of medication management, symptom management and community reentry skills-training modules to prevent rural patients with schizophrenia from relapse and increase their social function.Methods 89 subjects were randomly assigned to the skills training group (45 cases) and the control group (44 cases). Both groups received the same treatments, but the skills training courses were given to the skills training group for twelve weeks when the subjects were addmitted into the trial and at their one-year follow-up timepoint respectively. And a two-year follow-up was carried out. All subjects were evaluated with PANSS, SDSS, relapse and employeement.Results 89 subjects had completed the study. The skills training group demonstrated clinical Results significantly superior to those of the control group on overall improvement according to PANSS and SDSS. Substantially, statistically significant advantages of the skills training group were related to 1) the rate of relapse (11.1% vs 31.8%), 2) the rate of employment (37.8% vs 15.9%).Conclusion Medication management, symptom management and community-re-entry skills-training modules are effective in reducing patients' psychiatric symptoms, preventing them from relapse and increasing their social function.

Family Intervention for Chronic Schizophrenic Outpatients in Countryside / 中国康复理论与实践

@#Objective To observe the effects of family intervenes on the social function of chronic schizophrenic outpatients in countryside.Methods 150 chronic schizophrenic patient were divided into the intervention group(75 cases)and the control group(75 cases).The intervention group accepted comprehensive family intervention education by the professional,while the control group only accepted the medical intervention.They were assessed with Social Disability Screening Schedule(SDSS),Scale for Assessment of Positive Symptoms(SAPS),Scale for Assessment of Negative Symptoms(SANS),Morningside Rehabilitation Stats Scale(MRSS)before,1 year,2 years and 3 years after intervention.Results The scores of SANS and MRSS improved in the intervention group compared with that of the control group(P<0.001),as well as the ability of self-care,family,responsibility,vocation of SDSS(P<0.05).Conclusion The family intervenes may improve the negative symptom and some social ability of chronic schizophrenic outpatients in countryside.

Effect of Psych-Social Intervention on the Rehabilitation of Schizophrenia / 中国康复理论与实践

@#ObjectiveTo investigate the effect of psych-social intervention on the recovery from schizophrenia.Methods160 cases schizophrenia patients leaved hospital were divided into intervention group (80 cases) and control group (80 cases). Meanwhile maintenance drug therapy, intervention group accept systemic psych-social and family intervention. The control group accept maintenance drug therapy only. At the end of initiation 3 month, 1 and 2 years, the patients were evaluated with Disability Assessment Schedule (DAS) and Positive and Negative Syndrome Scale (PNASS). The number of cases relapsed were counted in both groups. ResultsThe difference of the score of DAS and PANSS between two groups was not significant in 3 month, and became significant at the end of 1 year (P<0.05), very significant at the end of 2 years (P<0.01). The relapsed cases within two years were 12 cases in intervention group and 34 cases in control group (P<0.01).ConclusionPsych-social and family intervention is significantly effective on the improvement of psychiatric symptom, recovery of society function and degrade of relapse rate of patients with schizophrenia.

Efficacy of rehabilitation in open wards on chronic schizophrenics / 中国康复理论与实践

@#ObjectiveTo explore the effect of rehabilitation in open wards on chronic schizophrenic patients.Methods48 chronic schizophrenic patients were shifted to open wards with comprehensive rehabilitational therapy.They were evaluated with Positive And Negative Symptoms Scale(PANSS),Nurse's Observation Scale for Inpatient Evaluation(NOSIE),Social Disability Screening Schedule (SDSS) before and 6 months after the shifting.ResultsThere was significant difference in the total scores, negative symptoms scales score, general psychopathological scales score and response deficient factor score of PANSS, all the factors scores except psychiatric manifestations and depression of NOSIE, and scores of SDSS pre- and post-shifting(P<0.01).ConclusionRehabilitation in open wards can improve the negative symptoms and social function of chronic schizophrenics.

Effect of whole-period psychiatric rehabilitation on outpatients with schizophrenia / 中国康复理论与实践

@#ObjectiveTo investigate the effect of whole-period psychiatric rehabilitation on outpatients with schizophrenia.Methods90 outpatients with schizophrenia were randomly divided into the study group and control group with 45 cases in each group. All cases in two groups received pharmacotherapy, but cases of study group were added with whole-period psychiatric rehabilitation. Assessments were performed before and after study. All subjects were evaluated with the Brief Psychiatric Rating Scale (BPRS) and Social Disability Screening Schedule (SDSS).ResultsThe outcome of the study group was significantly superior to the control group on overall improvement according to the reductions of BPRS score, Anergia factor score, thought disturbance factor score, suspiciousness factor score and SDSS score(P<0.05-0.01).ConclusionThe whole-period psychiatric rehabilitation may play an important role in controlling symptoms and improving social function to outpatients with schizophrenia.

Literature-art-therapy on the inpatients with schizophrenia at the phrase of rehabilitation / 中国康复理论与实践

@#ObjectiveTo research the efficiency of literature-art-therapy (LAT) using in the phrase of rehabilitation in the inpatients with schizophrenia.Methods120 inpatients were randomly divided into two groups, the trial and the control, 60 patients respectively. The trial group was treated by LAT for 3 to 18 months, while both groups were routinely treated by neuroleptic. IPROS was used in assessment at the start and the end. ResultsThe degree of functional deficiency in trial group had significant decreased. The length of time used with rehabilitation therapy had correlated directly with improvement of social function. Conclusions LAT as an efficient way of rehabilitation therapy, had played a huge role in recovery of inpatients with schizophrenia.