الفهرس | Only 14 pages are availabe for public view |
Abstract Relapse in schizophrenia remains common and cannot be entirely eliminated even by the best combination of biological and psychosocial interventions Relapse in schizophrenia is a major clinical event and commonly affects the personal and social functioning of the person. Moreover, relapses are associated with a high economic burden. Psychiatric services and mental health service staff are particularly challenged to recognize and deal with reality of relapse behavior and to examine their attitude and perceptions of this problem. They also need to increase their knowledge and develop most effective skills in working with releasers’, their family members and those significant people immediately affected by the relapsing person’s behavior. This study aimed to develop psycho educational program for prevention of relapse among the schizophrenic patients and evaluate the effectiveness of the psycho educational program on the prevention of relapse among the schizophrenic patients. The research hypothesizes that the program will improve patient’s knowledge about schizophrenia the importance of drug compliance for relapse prevention. The study was conducted at the Psychiatric Mental Health Hospital at Benha City which is affiliated to Secretariat The subject included 60 schizophrenic patients (45 male and15 female). The target population of this study consists of convenient patients who will be included according to the following inclusion criteria:- 1. Diagnosed as schizophrenic 2. The last patient’s admission not less than 6 months. 3. Able to communicate 4. Willingness to participate in the study.Exclusion criteria:-Patients will be excluded if: 1- They have organic brain disorder or mental retardation. 2- Alcohol or drug abuse accompanied by serious communication or behavioral problems. To collect data of this study, the following tools were used:- Tool One: Structured interview questionnaire which consists of three parts: Part one includes: Socio-demographic and clinical data questionnaire: A-Socio-demographic data: to elicit data about the patients characteristics such as age, sex, marital status, level of education, occupation, type of occupation and residence. B- Clinical data: which included; date of last admission, mode of last admission, number of previous admissions, age at the beginning of disease and relationship between patient and affected family member. Part Two: Knowledge about schizophrenia :- It will be developed by the researcher based on literature review, the questionnaire include close ended questions and the patients will be asked to respond to these questions, it include: definition of schizophrenia, causes, signs and symptoms, and methods treatment , types of drugs, side effects of these drugs, methods of coping with these side effects. Part three: - Knowledge about relapse: which included definition of relapse, causes, early warning signs of relapse, methods of prevention and ways of coping with stress, delusion, and hallucinations. Tool two: Drug Attitude Inventory; (DAI-30) (Hogan et al, 1983): The DAI consists of a questionnaire that is completed by the patient. It included a series of questions, each with true/false answers, pertaining to various aspects of the patient’s perceptions and experiences of treatment.Tool Three: The Psychoeducational intervention program to prevent relapse among the schizophrenic patients Psycho education about schizophrenia, early warning signs and symptoms of relapse and relapse prevention which will be carried out in the form of sessions. The findings of the study can be summarized in the following o According to socio- demographic characteristic of the studied patients, the findings pointed out that two thirds of them were male and more than half of them were single not married( 75.0% , 58.3% respectively). o According to clinical data of the studied patients, the finding revealed that more than half of them were hospitalized more than one time 58.3%, and regarding to relationship with affected patient in the family, nearly two thirds of them had no relationship 70.0%. o Concerning the studied patients ability to recognize the symptoms leading to of their hospitalization, the findings demonstrated that auditory, visual hallucination, delusions, lack of insight and drug non-compliance were the most common symptoms of hospitalization. o Regarding patient`s insight, the finding revealed that more than three quarters (78.33%) of the studied schizophrenic patients had no insight about their illness o In relation to the knowledge of the schizophrenic patients about schizophrenia, the results illustrated that there is a highly significant differences between their knowledge ino Considering the knowledge of the schizophrenic patients about relapse, the results revealed that there is severe lack of knowledge of the schizophrenic patients about relapse and that there is a highly significant differences between their knowledge in pre, post and follow up program implementation as at p value <0.001. o Regarding attitude of the studied schizophrenic patients toward drug compliance , the results revealed that there is a highly statistical significant difference between patients’ attitude toward compliance before, immediately and 3 months after program implementation as P-value<0.05. o As regards to relation between socio-demographic characteristics and patient’s knowledge about schizophrenia and relapse, the results illustrated that, there is significant relationship between educational level and patient’s knowledge about schizophrenia and relapse as p value <0.05. o Concerning to relation between socio-demographic characteristics and patient’s attitude toward DAI, the results illustrated that, there is no significant relationship as p value >0.05. o A highly positive significant correlation coefficients between patient’s knowledge about schizophrenia and relapse and their patient’s attitude toward DAI. Recommendations Based on the findings and conclusion of this study, the following recommendations are suggested:- Recommendations aiming at patients: · Psychoeducational sessions need to be continuously and regularly conducted dailyminutes per day and must be provided to all psychiatric patients voluntary and involuntary admitted, in psychiatric and in general hospitals. · Providing patients with relapse`s warning signs checklist on discharge for early detection and monitoring of relapse indicators to prevent it. · Discharged patients should be followed by the hospital staff throughout patient appointments, home visits or telephone calls to reduce potential relapses. · Recommendations aiming at family: · Participate patients` families and relatives in the treatment planning and enlisted as a source of encouragement and support. · Family education about the patient`s illness, medication and methods of dealing with warning signs of relapse will be more effective. · Recommendations aiming at hospital staff: · In-service training programs and workshops need to be implemented for hospital staff to provide them with enough information, training, and skills necessary for communicating effectively, and for providing new ways of coping with relapsed patients. |