| Summary: | 博士 === 國立臺北護理健康大學 === 護理研究所 === 106 === Background and Purpose:
Maladaptive styles of coping are believed to be a barrier to problem solving from schizophrenia. Patient appears to have a limited range of possible ways to respond when under stress. The inability to manage and respond to stress is believed to be among the primary causes of relapse and reduced quality of life in schizophrenia。Our Aims were to develop and evaluate the effects of problem-solving skills training (PSST) on self-control behaviors, health state, self efficacy and psychiatric symptoms of schizophrenia in community-dwelling patients.
Method:
There are two phases during our study。In phase 1，the aim was to systematically review the problem solving intervention and their efficacy in schizophrenia patient care. In phase 2，the aim were to construct, implement and evaluate the PSST。
This experimental study was conducted in 63 adult community-dwelling outpatients with schizophrenia in Taiwan. The control group (n=28) received routine life skills training alone, while the experimental group (n=35) received both routine life-skills and problem-solving training. This study measured outcome variables including problem-solving skills (Self-control Schedule, SCS), heath state(Chinese Health Questionnaire, CHQ-12)，self efficacy(self efficacy in schizophrenic spectrum disorders, SESS) and psychiatric syndromes ( Positive and Negative Syndrome Scale, PANSS)，they were administered at baseline, week 6, week12 and 4 weeks after training ended。
Results:
Generalized Estimating Equation (GEE) model showed a significant improvement in the self-control behavior score in the experimental group at week 12 and 4 weeks after training ended, compared with the control group. In addition, the Negative symptoms score was significantly improved at week 12 and 4 weeks after training ended, compared with baseline. However, there was no significant difference between the experimental and control groups in terms of self-efficacy and physical and mental health of life issues.
Conclusion:
In the experimental group, the self-control behavior of the problem solving was significantly improved, and the effect was maintained until 4 weeks after the end of the intervention. According the study results, the PSST was recommended for patients with cognitive disorder and schizophrenia in promoting problem-solving skills and self-control behaviors, in reducing psychiatric symptoms and maintaining physical and mental health functioning to deal with the life stressful events.
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