治疗师角度下双相障碍强化门诊干预项目的疗效相关因素分析  

Therapeutic factors of intensive outpatient program for bipolar disorder in perspective of therapists

出　　处：《中华精神科杂志》2018年第4期254-259,共6页Chinese Journal of Psychiatry

基　　金：科技部＂十二五＂国家科技支撑项目（2012BAI01B04）;上海市申康发展中心＂适宜技术联合开发推广应用＂项目 （SHDC12016205）;上海市科委医学引导项目（124119a8602）;上海交通大学＂医工交叉研究基金＂面上项目（YG2011MS37）;上海市卫生局公共卫生海外留学人才项目（GWHW201202）;上海市卫生和计划生育委员会科研课题计划（201440327）

摘　　要：目的探讨治疗师角度下双相障碍强化门诊干预项目（intensive outpatient program for bipolar disorder, IOP-BD）的疗效相关因素。 方法2016年6月至2017年4月在上海交通大学医学院附属精神卫生中心招募新近缓解的双相障碍患者进行IOP-BD干预，共有3组团体治疗，每次团体治疗结束后对10名治疗师进行半结构式访谈并录音。采用主题分析方法进行分析，将访谈录音转录为逐字稿并进行编码分析，再将结果反馈给治疗师以确定结果的可靠性。结果团体成员个体因素和治疗过程相关因素会影响双相障碍患者IOP-BD的疗效。治疗师认为那些积极参与并能有所反馈，内心真正接纳自己罹患双相障碍且病程短、家属调节能力强的患者获益更多；治疗过程中治疗师节奏的把握和引导也会影响疗效，而这些与其专业背景有关。结论治疗师需要有足够的经验掌握好治疗节奏，并对参与程度低、病程长、不接纳自己患病等的患者加以引导，增加IOP-BD疗效。ObjectiveTo explore the therapeutic factors of intensive outpatient program for bipolar disorder（IOP-BD） in perspective of therapists.MethodThere were 3 groups of treatment which applied IOP-BD intervention for bipolar disorder patients recently got remission at Shanghai Mental Health Center, Shanghai Jiaotong University, School of Medicine from June 2016 to April 2017. Data collected from semi-structured interviews of 10 therapists by recording after treatment, and applied thematic analysis analyzing data. By transcribing the radio into written form to do the coding process, then feedback the results to therapists to ensure the credibility.ResultsIn perspective of therapists, personal factors and treatment process would impact the outcome of treatment. Therapists thought those actively involved in the therapy, could give back something, and accepted the disease truly, as well short duration of disease, accompanied by caregivers with good adaption would benefit more. Besides, the rhythm of therapy and the guiding role of therapists also impacted outcome, which both of them were connected with therapists＇ background.ConclusionTherapists should have enough experience to balance the rhythm of therapy, and encourage those patients who are low-involvement, long duration of disease and non-accept the disease, to ameliorate the efficacy of IOP-BD.

关 键 词：双相情感障碍 强化门诊干预项目 质性研究 治疗师 疗效相关因素 

分 类 号：R749.4[医药卫生—神经病学与精神病学]