The effects of compliance therapy programme on Chinese patients with schizophrenia

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The effects of compliance therapy programme on Chinese patients with schizophrenia

 

Author: Tsang, Ho-wing
Title: The effects of compliance therapy programme on Chinese patients with schizophrenia
Degree: M.Sc.
Year: 2002
Subject: Hong Kong Polytechnic University -- Dissertations
Schizophrenia -- Treatment
Schizophrenics -- China -- Hong Kong -- Rehabilitation
Department: Multi-disciplinary Studies
School of Nursing
Pages: iv, 217 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1686677
URI: http://theses.lib.polyu.edu.hk/handle/200/875
Abstract: Background: Prevention of relapse, sympton control and recovery associated with compliance of treatment regime. Studies found that psychoeducation using motivational interviewing skills were effective to promote compliance for as long as two years. Previous studies suffered from certain methodological weakness such as not being randomized clinical trials, non-blinded evaluation and small sample size. Therefore scientific randomized clinical trial with single blind design was precious, especially implemented at local setting where no published study investigating the appplication of motivational interviewing skills in promotion of compliance. Objective: This study was to investigate the effects of a compliance-enchancing strategy called "compliance therapy programme" (CTP) on Chinese patients with schizophrenia. The CTP comprised five semi-structured psychoeducational sessions, each lasted for an hour and conducted in way of motivational interview by investigator. Design: It was a prospective experimental study with randomized single blind design. Seventy eight schizophrenic inpatients with CMMSE score reaching 24 or above were recuited at a psychiatric ward and 47 subjects completed the study. They were allocated to control group and experimental group according to table of random number. All subjects received same standard treatment (ST) in control group. The experimental group received ST plus compliance therapy programme (CTP). Main outcome measurement: Battery of assessment included Chinese Mini Mental State Examination (CMMSE), Brief Psychiatric Rating Scale (BPRS), Drug Attitude Inventory - Chinese version (DAI-C), self-report drug compliance (SRDC) and outpatients follow-ups record. Schedule of evaluations: They were tested with the battery of assessment before interventions. Right before discharge they were reassessed with BPRS. Post-tests with identical battery of assessment repeated by independent assessor at the third and sixth month of post-discharge. Follow-ups records (FU) were traced with assistance of medical record department. Results: At the end of study, there were 47 male subjects with schizophrenia completed the study: control group n = 19 and experimental group n = 28. No significant difference in patients' profile was identified. Both groups showed improvement of psychopathology with similar magnitude within period of in-patient care (total BPRS score changed more than 10, sd = 5). Significant advantages were found for experimental group on the measures of follow-ups (P<.05) and attitudes to medication (P>.08). The sustainability of improved attitudes to medication was double in experimental group (P>.08). Experimental group was more able to keep follow-ups than control group: 90% versus 75%(P<.001). Subjects who were able to keep outpatients follow-ups for three months would be more likely to keep compliance. Conclusion: Compliance therapy programme is a pragmatic programme for improving attitudes to medication and compliance with outpatients follow-ups in patients with schizophrenia. The health gains persist for at least six months. All subjects were able to complete the self-administered questionnaire independently.

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