Authors (including presenting author) :
Lee TK(1), Lam YL(1), Chew SW(1), Ng KK(1), Yau HWV(1), Leung CL(1)
Affiliation :
(1)Department of Psychiatry, Tai Po Hospital
Introduction :
Patients with severe mental illness, diagnosed with schizophrenia, major depression and bipolar affective disorder, often struggle with psychotic symptoms including delusions or hallucinations that interfere with daily functioning and life in community. Maladaptive coping of symptoms is associated with high risk of relapse, leading up to 80% relapse rate within first year after discharge. Subsequent readmissions and relapses are associated with poorer prognosis, quality of life and will bring huge burden to healthcare organization. A client-centered group intervention program (3 sessions within 1 week, 1.5 hours each) with adoption of Solution focused brief therapy strategies had been implemented to empower and enhance adult psychiatric inpatients’ symptoms self-regulation. Nurses work collaboratively with participants in groups sessions, to elicit and utilize past successful coping strategies. Participants also adopt new coping strategies from psychoeducation provided, and experience from other patients. Upon completion, patients would develop an individualized self-management plan which include identification of symptoms’ early warning signs, personal symptoms regulating strategies, and advance planning for worsened symptoms.
Objectives :
To minimize symptoms distress; to enhance self-efficacy for: (1) symptoms regulation, (2) prevention of symptoms deterioration.
Methodology :
A “Pre-test” vs. “Post-test’ design was employed. Subjects were both male and female inpatients in acute wards having history or active psychotic symptoms. Outcome measurements were Brief Psychiatric Rating Scale (BPRS) (higher scores indicates more severe psychiatric symptoms and distress); Self-efficacy for Managing Chronic Disease 6-item Scale (SES6) (higher scores indicates better perceived ability on illness self-management); and participant satisfaction survey. Data was analyzed using SPSS with Descriptive statistics, Mann-Whitney U test, and t-test for normally distributed data.
Result & Outcome :
From 17/11/21 to 09/1/22, 5 intervention groups were conducted with 22 participants (Male=16, Female=6, Age=25-63) completed the program. BPRS median score was reduced significantly from 8.5 to 3 (U=145, Z=-2.284, p=0.022). SES6 mean scores increased significantly from 37.23 (SD=9.087) to 46.55 (SD=8.545); t(21)=-5.284, p=0.000. Satisfaction survey showed most of the participants (n=20, 91%) agreed that they were satisfied with the program, and vast majority (n=21, 95%) agreed the program had enhanced their ability in preventing symptoms deterioration. The program is effective and time-efficient for adult psychiatric inpatients to reduce symptoms distress, and could enhance self-efficacy for symptoms self-regulation and prevention of symptoms deterioration.
