目的: 探索叙事医学模式下双向互动的阅读疗法与常规治疗相结合用于精神障碍患者临床治疗的可行性与治疗效果。方法: 本研究为临床随机对照实验,选取精神障碍患者376例为研究对象,随机分为对照组和实验组。对照组给予常规药物治疗和健康教育;实验组给予常规药物治疗、健康教育和双向互动的阅读疗法,为期6个月。治疗前后使用一般资料调查表、健康问卷抑郁症状群量表（PHQ-9）、广泛性焦虑自评量表（GAD-7）、睡眠状况自评量表（SRSS）、中文修订版Morisky服药依从性测量量表（MMAS-8）和治疗满意度量表进行问卷调查。结果: 抑郁患者、精神分裂症患者、双向情感障碍患者、焦虑患者干预后抑郁和焦虑情况有显著改善。四类疾病患者干预后实验组的睡眠状况、服药依从性、治疗满意度有显著提升,且实验组提升更明显。结论: 叙事医学模式下双向互动的阅读疗法显著改善了患者的抑郁、焦虑和睡眠状况,提升了服药依从性,提高了治疗满意度。
Abstract
Objective Exploring the feasibility and therapeutic effects of combining bidirectional interactive reading therapy under the narrative medicine model with conventional treatment for clinical management of mental disorders in patients. Methods This study was a randomized controlled trial involving 376 patients with mental disorders who were randomly assigned to either the control group or the experimental group. The control group received conventional medication therapy and health education, while the experimental group received conventional medication therapy, health education, and bidirectional interactive reading therapy for a duration of 6 months. Pre-treatment and post-treatment assessments were conducted using a general information questionnaire, the Patient Health Questionnaire-9(PHQ-9) for depressive symptoms, the Generalized Anxiety Disorder-7(GAD-7) Scale for generalized anxiety, the Sleep Rating Scale (SRSS) for sleep quality, the Chinese version of the 8-item Morisky Medication Adherence Scale (MMAS-8) for medication adherence, and a treatment satisfaction scale. Results After intervention, there was a significant improvement (P<0.05) in depression and anxiety symptoms among patients with depression, schizophrenia, bipolar disorder, and anxiety disorders. The experimental group showed significant improvements (P<0.05) in sleep conditions, medication adherence, and treatment satisfaction compared to the control group in all four disease categories, with the experimental group showing more pronounced improvements (P<0.05). Conclusion The narrative medicine approach of bidirectional interactive reading therapy under the narrative medicine model significantly improves patients' depression, anxiety, and sleep conditions, enhances medication adherence, and increases treatment satisfaction.
关键词
叙事医学 /
阅读疗法 /
双向互动 /
医患双方 /
临床随机对照研究
Key words
narrative medicine /
reading therapy /
bidirectional interaction /
healthcare professionals and patients /
randomized controlled trial
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基金
湖南省大学生创新创业项目“以文医心：叙事医学视域下精神障碍患者的文学疗愈临床试验研究”（S202310542021,2023196）
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