| Objective: The purpose of this study is to construct and verify the psychological resilience intervention program of patients with schizophrenia recurrence based on the theory of social support and self-efficacy and the framework model of psychological elasticity,so as to provide a basis for medical staff to conduct the psychological resilience intervention of patients with schizophrenia recurrence.Methods:(1)Objective sampling method was used to conduct semi-structured interviews with patients with schizophrenia recurrence and psychiatric nurses to understand the influencing factors of psychological resilience of patients with schizophrenia recurrence,and further refine the theme of psychological resilience intervention program for patients with schizophrenia recurrence.Secondly,the psychological resilience intervention program was summarized and analyzed through literature analysis.Based on the psychological resilience framework model,the first draft of psychological resilience intervention program for patients with schizophrenia recurrence was formed.(2)Two rounds of expert letter inquiry were conducted by the Delphi method,the content of the program was modified according to the statistical analysis results and expert opinions,and SPSS22.0 software was used to evaluate expert enthusiasm,expert authority coefficient,coordination of expert opinions and variation coefficient of items,so as to form the final draft of the psychological resilience intervention program for patients with schizophrenia recurrence.(3)A randomized controlled trial was conducted to select 60 patients with recurrent schizophrenia who were hospitalized in the psychiatric department of the hospital from January2022 to June 2022 as the study subjects.According to the random number table method,they were divided into experimental group and control group,30 cases in each group.The control group was given routine psychiatric nursing,and the experimental group was given psychological resilience intervention on the basis of the control group for 8 weeks.The total scores of perceived social support scale,general self-efficacy scale,Connor-Davidson resilience scale and Rosenberg self-esteem scale were collected before and after 8 weeks of intervention.The data were statistically analyzed by SPSS22.0 software.The counting data in the general data of the two groups of schizophrenic patients were statistically described by frequency and percentage.Measurement data,using mean,standard deviation or median,quartile descriptive statistics.Independent sample t test or χ2 test was used to compare the differences in baseline data between the two groups of schizophrenia patients before intervention.Non-parametric rank sum test was used to analyze the quantitative data that did not conform to the normal distribution.P < 0.05 was considered statistically significant.Results:(1)A total of 18 interviewees were selected in this study,including 10 patients with relapsed schizophrenia and 8 psychiatric nurses.A total of 6 themes were extracted,namely,low level of perceived social support in patients with relapsed schizophrenia,low self-efficacy in patients with relapsed schizophrenia,low level of self-esteem in patients with relapsed schizophrenia,lack of optimistic attitude towards life in patients with relapsed schizophrenia,lack of positive emotions in patients with relapsed schizophrenia,and negative coping styles in patients with relapsed schizophrenia,which provided a reference for the construction of the program.Secondly,15 literatures were included in this study,and the contents of the literature were summarized and analyzed.Finally,6 first-level items were formed.The first draft of psychological resilience intervention program for recurrent schizophrenia patients with 11second-level items and 23 third-level items.(2)In the two rounds of expert letter inquiry in this study,12 were all valid questionnaires collected,and the recovery rate was 100%.In this study,the first round expert authority coefficient Cr = 0.898(Cs = 0.837,Ca = 0.958),the second round expert authority coefficient Cr= 0.946(Cs = 0.905,Ca = 0.986),2 rounds of expert opinion coordination process.The Kendall’s W coefficients were 0.394 and 0.401(P <0.05),the coefficient of variation was less than 0.2,and the differences were statistically significant.The final draft of 6 primary items,10 secondary items,and 23 tertiary items of the psychological resilience intervention program for patients with recurrent schizophrenia was formed.(3)A total of 60 patients were included in the randomized controlled trial,30 in the intervention group and 30 in the control group.There was no significant difference in general demographic data and disease data between the intervention group and the control group(P>0.05).The levels of psychological resilience(intervention group 78.36 ± 10.35,control group 61.26±14.65),perceived social support(intervention group 71.00±9.2965.42±11.77,control group65.42±11.77),general self-efficacy(intervention group 3.67 ± 0.40,control group 2.78 ± 0.78)and self-esteem(intervention group 28.00 ± 2.94,control group 19.79 ± 3.47)of the two groups of patients with recurrent schizophrenia were improved after intervention,but the intervention group was significantly higher than the control group(P< 0.05).Conclusion:(1)This study is based on the kumpfer psychological resilience framework model,and the psychological resilience intervention program for patients with schizophrenia recurrence constructed based on the understanding of social support theory and self-efficacy theory is scientific and generalized.(2)Through preliminary clinical verification,this program can effectively improve the psychological resilience level of patients with schizophrenia relapse,improve the psychological condition of patients,promote mental health,and can be widely used in the clinical intervention practice of psychological flexibility of patients with schizophrenia relapse. |
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