Title UTJECAJ SOCIOTERAPIJSKIH POSTUPAKA NA
KVALITETU ŽIVOTA I SURADLJIVOST OBOLJELIH OD SHIZOFRENIJE I DEPRESIJE Title (english) EFFECTS OF PSYCHOSOCIAL INTERVENTIONSON QUALITY OF LIFE AND MEDICATION ADHERENCE IN PATIENTS AFFECTED WITH SCHIZOPHRENIA AND DEPRESSION Author Tanja Grahovac Juretić Mentor Tanja Frančišković (mentor)Committee member Ika Rončević-Gržeta (predsjednik povjerenstva)Committee member Slađana Štrkalj-Ivezić (član povjerenstva)Committee member Zdenka Barićev Novaković (član povjerenstva)Committee member Tanja Frančišković (član povjerenstva)Granter University of Rijeka Defense date and country 2017, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 616 - Pathology. Clinical medicine ThesaurusMESH - Medical Subject Headings )
Depression
Schizophrenia
Mental Disorders
Quality of Life
Abstract Cilj istraživanja: Ispitati utjecaj socioterapijskih postupaka u okviru socioterapijskog dnevno bolničkog programa na kvalitetu života i suradljivost bolesnika oboljelih od shizofrenije i depresije.
Ispitanici i metode: U istraživanje su bili uključeni muškarci i žene oboljeli od shizofrenije i depresije. Ukupno je kontaktirano 232 bolesnika, a njih 200 je završilo istraživanje. Ispitanici su bili raspoređeni u četiri skupine (dvije ispitne i dvije kontrolne), u svakoj skupini bilo je 50 ispitanika. Ispitanici ispitnih skupina osim medikamentne terapije, bili su uključeni i u socioterapijski program dnevne bolnice tijekom četiri mjeseca, dok kod kontrolnih skupina takav oblik tretmana nije bio primijenjen. Svi ispitanici su bili uključeni u istraživanje u okviru mjesec dana po završetku bolničkog liječenja.
Instrumentarij je kod svih ispitanika bio primijenjen u tri navrata: prvo mjerenje bilo je prvog dana intenzivnog socioterapijskog (dnevno-bolničkog) programa za ispitne skupine bolesnika, odnosno tijekom zadnjeg tjedna hospitalizacije za kontrolne skupine. Drugo mjerenje bilo je zadnjeg dana socioterapijskog (dnevno-bolničkog) programa, tj. nakon četiri mjeseca za ispitnu skupinu, odnosno četiri mjeseca nakon hospitalizacije za kontrolnu skupinu, a treće je bilo šest mjeseci nakon drugog mjerenja.
U istraživanju je kod svih ispitanika bio primijenjen slijedeći instrumentarij: upitnik općih podataka, skala za procjenu kvalitete života (MANSA, prema engl. Manchester Short Assessment of Quality of Life), skala za procjenu općeg socijalnog funkcioniranja (GAF, prema engl. Global Assessment of Functional Scale), skala za procjenu suradljivosti u uzimanju medikacije (MARS, prema engl. Medication Adherence Rating Scale), upitnik subjektivne procjene zadovoljstva liječenjem, skala za procjenu općeg kliničkog utiska (CGI-S, prema engl. Clinical Global Impression- Severity of illness scale), skala za procjenu poboljšanja općeg kliničkog utiska (CGI-I, prema engl. Clinical Global Impression- Improvement Scale). U oboljelih od shizofrenije bio je primijenjen upitnik za procjenu simptoma shizofrenije (PANSS, prema engl. Positive and Negative Symptoms Scale), a u oboljelih od depresije upitnik za procjenu depresivnih simptoma (MADRS, prema engl. Montgomery -Ǻsberg Depression Rating Scale).
Rezultati: Socioterapijski postupci kao metoda liječenja provedeni u dnevnoj bolnici u oboljelih od shizofrenije rezultirali su poboljšanjem kvalitete života ali ne i razine općeg socijalnog funkcioniranja, dok je u oboljelih od depresije zabilježeno suprotno. Kod oboljelih od shizofrenije nije registrirana značajna povezanost razine općeg funkcioniranja i kvalitete života dok je kod oboljelih od depresije ta povezanost zabilježena, no ne može se dovesti u vezu sa provedenim socioterapijskim programom. Klinička procjena poboljšanja u oboljelih od shizofrenije i u oboljelih od depresije povezana je s višom kvalitetom života. Ispitanici obje socioterapijske skupine pokazali su bolju suradljivost u uzimanju psihofarmaka što je povezano s višom kvalitetom života. Socioterapijski postupci imaju relativno brz i razmjerno dugotrajan utjecaj na ukupnu razinu simptoma i kod oboljelih od shizofrenije i kod oboljelih od depresije.
Zaključak: Rezultati ovog istraživanja pokazali su da socioterapijski postupci kao metoda liječenja provedeni u dnevnoj bolnici djeluju na smanjenje razine simptoma i na poboljšanje suradljivosti u uzimanju psihofarmaka u oboljelih od shizofrenije i u oboljelih od depresije. Socioterapijski postupci kao metoda liječenja provedeni u dnevnoj bolnici utječu na poboljšanje kvalitete života oboljelih od shizofrenije
Abstract (english) Background: The basic aim of this prospective research was to establish the effects of psychosocial interventions in psychosocial day care programme on the quality of life and adherence to treatment of the patients with schizophrenia and depression.
Subjects and methods: Both male and female patients affected by schizophrenia and depression participated in the research. A total number of 232 patients were recruited of whom 200 completed the study. The participants were subdivided into four groups (two experimental groups and two control groups) of 50 patients. In addition to pharmacotherapy, the experimental groups only were integrated into a day-hospital-based psychosocial day care programme for four months, while such treatment was not applied to the patients of the control groups. All the participants took part in the research within one month after the inpatient treatment.
The instruments were applied in three phases: the first measurement for experimental groups took place on the first day of psychosocial day care programme, while for the control group subjects the same was performed during the last week of their inpatient care. The second measurement for the experimental groups was performed on the last day of psychosocial day care programme which lasted for four months, while for the patients of the control groups it occurred four months after their inpatient treatment. The third measurement was carried out six months after the second one.
The following instruments were administered to all the participants: General Demographic Questionnaire, Manchester Short Assessment of Quality of Life (MANSA), Global Assessment of Functional Scale (GAF), Medication Adherence Rating Scale (MARS), Subjective Treatment Satisfaction Questionnaire, Clinical Global Impression-Severity of Illness Scale (CGI), Clinical Global Impression Improvement Scale (CGI-I).
Positive and Negative Symptoms Scale (PANSS) was used to asses patients affected by schizophrenia, while Montgomery-Asberg Depression Rating Scale (MADRS) was administered to those with depression
Results: The results obtained indicate that as to the patients with schizophrenia, the adjuvant treatment of psychosocial interventions in day care programme has a positive effect on the quality of life, but not on the general social functioning, while the results regarding the patients with depression reveal the opposite. Statistically significant correlation between the general functioning and quality of life was not found in patients affected by schizophrenia, while such correlation was present with regard to the patients with depression although it can’t be related to the psychosocial day care programme. Clinical assessment of improvement in patients affected by schizophrenia and depression is related to higher quality of life. Both patients with schizophrenia and depression who participated in the psychosocial day care programme showed greater medication adherence which is related to the better quality of life. Psychosocial interventions therefore have relatively fast and long-term effects on the overall symptom intensity in patients affected with schizophrenia and depression.
Conclusion: The results of this research have showed that psychosocial day care programme has a positive effect on the reduction of symptom levels and that it contributes to better treatment adherence in patients affected by schizophrenia and depression. Psychosocial day care programme affects the quality of life improvement in patients affected by schizophrenia
Keywords
Depresija
Duševna bolest
Kvaliteta života
Shizofrenija
Socioterapijski postupci
Keywords (english)
Depression
Mental Disease
Psychosocial Interventions
Quality Of Life
Schizophrenia.
Language croatian URN:NBN urn:nbn:hr:184:026506 Promotion 2017 Study programme Title: Biomedicine Postgraduate (doctoral) study programme Type of resource Text File origin Born digital Access conditions Access restricted to students and staff of home institution Terms of use Repository Repository of the University of Rijeka, Faculty of Medicine Created on 2018-01-02 12:33:10
