基于Kolb理论的教育模式对复发精神分裂症照顾者照顾负担与心理一致感的影响

徐玥; 茅丽利; 张芬

doi:10.16766/j.cnki.issn.1674-4152.003557

基于Kolb理论的教育模式对复发精神分裂症照顾者照顾负担与心理一致感的影响

doi: 10.16766/j.cnki.issn.1674-4152.003557

湖州市第三人民医院精神科，浙江湖州 313000

基金项目:

浙江省医药卫生科技计划项目 2023KY1182

湖州市第三人民医院院级科研项目 2022SYB018

详细信息

通讯作者:
徐玥，E-mail：15957246347@163.com

中图分类号: R749.3R473.2
计量
- 文章访问数: 143
- HTML全文浏览量: 102
- PDF下载量: 17
- 被引次数: 0
出版历程
- 收稿日期: 2024-04-07
- 网络出版日期: 2024-07-22

The impact of Kolb theory-based education model on care burden and psychological consistency among caregivers with recurrent schizophrenia

Department of Psychiatry, Huzhou Third Municipal Hospital, Huzhou, Zhejiang 313000, China

摘要

摘要: 目的分析基于Kolb理论的教育模式在复发精神分裂症照顾者中的应用效果，探讨其对照顾者照顾负担与心理一致感的影响。方法采用便利抽样法，选取2021年6月—2023年6月湖州市第三人民医院收治的110例复发精神分裂症患者及其照顾者作为研究对象，根据随机数字表法将其分为对照组(55例)和观察组(55例)。对照组应用传统教育指导方法，观察组在对照组基础上应用基于Kolb理论的教育模式。分析2组患者照顾者干预前后照顾负担、心理一致感及焦虑、抑郁情绪水平。结果干预后，2组照顾者照顾负担(CBI)量表各维度得分及总分均下降，且观察组总分低于对照组[(37.81±3.92)分vs. (39.73±5.32)分, P < 0.05]。干预后，观察组心理一致感量表(SOC-13)得分为(83.22±2.17)分，高于对照组[(78.73±4.52)分，P < 0.05]，观察组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分分别为(42.75±4.82)分、(40.26±4.81)分，明显低于对照组[(48.99±5.13)分、(46.78±5.30)分，P < 0.05]。结论基于Kolb理论的教育模式能减轻复发精神分裂症患者照顾者照顾负担及焦虑、抑郁不良情绪，提高其心理一致感，在复发精神分裂症患者疾病康复中起到积极作用。
- 复发精神分裂症 /
- 照顾者 /
- Kolb理论 /
- 健康教育 /
- 照顾负担 /
- 心理一致感
Abstract: Objective This study aims to analyze the application effect of the Kolb theory-based education model on caregivers of individuals with recurrent schizophrenia, specifically examining its impacts on caregiver care burden and psychological consistency. Methods A Convenience sampling was used to select a total of 110 caregivers and individuals with recurrent schizophrenia admitted to the Huzhou Third Municipal Hospital from June 2021 to June 2023. They were divided into a control group and an observation group using a random number table method, with 55 cases in each group. The control group received traditional educational guidance methods, while the observation group received an educational model based on the Kolb theory in addition to the traditional methods used in the control group. The study aimed to analyze the levels of caregiver burden, psychological consistency, anxiety, and depression in both groups of patients before and after intervention. Results Following the intervention, the scores and total scores of all dimensions of the caregiver burden inventory (CBI) scale decreased in both groups. However, the total score of the observation group was (37.81±3.92) points, much lower than the control group with (39.73±5.32) points, P < 0.05. Moreover, the sense of coherence-13 (SOC-13) in the observation group was (83.22±2.17) points, which was higher than that of the control group with (78.73±4.52) points, P < 0.05. Additionally, the self-rating anxiety and depression scale (SAS, SDS) in the observation group were (42.75±4.82) points and (40.26±4.81) points, respectively, which were significantly lower than those of the control group with (48.99±5.13) points and (46.78 ±5.30) points, P < 0.05. Conclusion The educational model based on Kolb theory can alleviate the care burden, anxiety, and depression of caregivers with recurrent schizophrenia. Additionally, it improves their psychological consistency, and play a positive role in the rehabilitation of recurrent schizophrenia patients.
- Recurrent schizophrenia /
- Caregivers /
- Kolb theory /
- Health education /
- Taking care of the burden /
- Psychological consistency

HTML全文

表 1 2组患者及其照顾者一般资料比较

Table 1. Comparison of general information between two groups of patients and their caregivers

项目	对照组(n=55)	观察组(n=55)	统计量	P值
患者
性别(例)
男性	27	28	0.036^a	0.849
女性	28	27
年龄(x ± s，岁)	35.33±9.41	34.36±8.54	0.566^b	0.572
病程[M(P₂₅, P₇₅)，年]	6(4，15)	5(3，13)	0.683^c	0.401
照顾者
性别(例)
男性	20	26	1.345^a	0.246
女性	35	29
年龄(x ± s，岁)	54.53±11.73	57.84±10.97	1.528^b	0.129
文化程度(例)
初中及以下	44	38	1.725^a	0.189
中专及以上	11	17
与患者关系(例)
配偶	13	8	3.754^a	0.153
父母	40	47
其他	2	0
照顾年限[M(P₂₅, P₇₅)，年]	3(2, 9)	2(1，8)	0.729^c	0.338
注：^a为χ²值，^b为t值，^c为Z值。

下载: 导出CSV

表 2 2组照顾者干预前后照顾负担水平比较(x ± s，分)

Table 2. Comparison of caregiver burden levels before and after intervention between two groups of caregivers(x ± s, points)

组别	例数	生理负担		情感性负担		社交性负担
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	55	6.43±1.12	5.85±0.98^b	7.89±1.43	6.73±1.38^b	5.46±0.94	4.77±0.82^b
观察组	55	6.41±1.10	5.01±0.86^b	7.84±1.47	5.65±1.31^b	5.39±0.92	4.01±0.70^b
统计量		0.094^a	4.256^c	0.181^a	3.819^c	0.395^a	4.773^c
P值		0.925	< 0.001	0.857	< 0.001	0.694	< 0.001

组别	例数	时间依赖性负担		发展受限负担		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	55	12.85±1.57	11.73±1.48^b	11.48±1.53	10.35±1.42^b	48.77±5.76	39.73±5.32^b
观察组	55	12.83±1.52	10.33±1.36^b	11.49±1.57	9.23±1.24^b	48.34±5.85	37.81±3.92^b
统计量		0.068^a	4.180^c	0.034^a	3.925^c	0.388^a	2.243^c
P值		0.946	< 0.001	0.973	< 0.001	0.698	0.031
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

下载: 导出CSV

表 3 2组照顾者干预前后心理一致感及负性情绪水平比较(x ± s，分)

Table 3. Comparison of psychological consistency and negative emotions levels between two groups of caregivers before and after intervention(x ± s, points)

组别	例数	SOC-13		SAS		SDS
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	55	71.29±6.30	78.73±4.52^b	58.81±7.29	48.99±5.13^b	56.52±5.89	46.78±5.30^b
观察组	55	70.86±5.72	83.22±2.17^b	60.10±7.47	42.75±4.82^b	58.03±6.00	40.26±4.81^b
统计量		0.375^a	6.069^c	0.917^a	6.377^c	1.332^a	5.981^c
P值		0.709	< 0.001	0.361	< 0.001	0.186	< 0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

下载: 导出CSV

参考文献(18)

[1]	余林花, 王铁虎. 复发性精神分裂症患者生活质量状况调查及影响因素分析[J]. 中华全科医学, 2022, 20(5): 821-823, 858. doi: 10.16766/j.cnki.issn.1674-4152.002463 YU L H, WANG T H. Investigation of Quality of Life and Analysis of Influencing Factors in Patients with Recurrent Schizophrenia[J]. Chinese Journal of General Practice, 2022, 20(5): 821-823, 858. doi: 10.16766/j.cnki.issn.1674-4152.002463
[2]	段登艾, 王维, 张志雄, 等. 昆明市寻甸县重性精神病患者主要照料者照料负担的影响因素[J]. 昆明医科大学学报, 2023, 44(11): 120-125. doi: 10.12259/j.issn.2095-610X.S20231118 DUAN D A, WANG W, ZHANG Z X, et al. Factors influencing the care burden of primary caregivers for patients with severe mental illness in Xundian County, Kunming City[J]. Journal of Kunming Medical University, 2023, 44(11): 120-125. doi: 10.12259/j.issn.2095-610X.S20231118
[3]	王双, 王蓓, 朱琰琰. 胃癌化疗病人主要照顾者心理一致感在照顾压力与积极感受间的效应分析[J]. 护理研究, 2022, 36(18): 3245-3251. doi: 10.12102/j.issn.1009-6493.2022.18.009 WANG S, WANG B, ZHU Y Y. Analysis of the effect of psychological consistency among the main caregivers of gastric cancer chemotherapy patients on the relationship between care pressure and positive feelings[J]. Chinese Nursing Research, 2022, 36(18): 3245-3251. doi: 10.12102/j.issn.1009-6493.2022.18.009
[4]	KUMAR S, DIXIT V, ALI R, et al. Gender differences in burden of care and coping strategies among caregivers of schizophrenia patients[J]. Ind Psychiatry J, 2023, 32(1): 78-85. doi: 10.4103/ipj.ipj_44_22
[5]	黄志宇, 高润英. 基于Kolb经验学习理论的内科护理学教学模式研究[J]. 卫生职业教育, 2021, 39(16): 120-122. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYX202116059.htm HUANG Z Y, GAO R Y. Research on the Teaching Model of Internal Medicine Nursing Based on Kolb Empirical Learning Theory[J]. Health Vocational Education, 2021, 39(16): 120-122. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYX202116059.htm
[6]	中华医学会精神病学分会. 中国精神障碍分类与诊断标准第三版(精神障碍分类)[J]. 中华精神科杂志, 2001, 34(3): 184-188. doi: 10.3760/j:issn:1006-7884.2001.03.028 Chinese Medical Association Psychiatry Branch. Chinese Classification and Diagnostic Standards for Mental Disorders Third Edition (Classification of Mental Disorders)[J]. Chinese Journal of Psychiatry, 2001, 34(3): 184-188. doi: 10.3760/j:issn:1006-7884.2001.03.028
[7]	岳鹏, 付艺, 尚少梅, 等. 照顾者负担问卷的信度和效度检验[J]. 中国心理卫生杂志, 2006, 20(8): 562-564. doi: 10.3321/j.issn:1000-6729.2006.08.026 YUE P, FU Y, SHANG S M, et al. Reliability and validity testing of caregiver burden questionnaire[J]. Chinese Journal of Mental Health, 2006, 20(8): 562-564. doi: 10.3321/j.issn:1000-6729.2006.08.026
[8]	包蕾萍, 刘俊升. 心理一致感量表(SOC-13)中文版的修订[J]. 中国临床心理学杂志, 2005, 13(4): 399-401. doi: 10.3969/j.issn.1005-3611.2005.04.007 BAO L P, LIU J S. Revision of the Chinese version of the Psychological Consistency Scale (SOC-13)[J]. Chinese Journal of Clinical Psychology, 2005, 13(4): 399-401. doi: 10.3969/j.issn.1005-3611.2005.04.007
[9]	段泉泉, 胜利. 焦虑及抑郁自评量表的临床效度[J]. 中国心理卫生杂志, 2012, 26(9): 676-679. doi: 10.3969/j.issn.1000-6729.2012.09.007 DUAN Q Q, SHENG L. The clinical validity of the Self Rating Anxiety and Depression Scale[J]. Chinese Journal of Mental Health, 2012, 26(9): 676-679. doi: 10.3969/j.issn.1000-6729.2012.09.007
[10]	SOLMI M, CROATTO G, PIVA G, et al. Efficacy and acceptability of psychosocial interventions in schizophrenia: systematic overview and quality appraisal of the meta-analytic evidence[J]. Mol Psychiatry, 2023, 28(1): 354-368. doi: 10.1038/s41380-022-01727-z
[11]	蔡颖, 樊理诗, 何锐, 等. "安全屋"家庭教育对社区精神分裂症患者症状的影响[J]. 中国心理卫生杂志, 2023, 37(10): 825-832. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202310001.htm CAI Y, FAN L S, HE Y, et al. The impact of "safe house" family education on symptoms of community schizophrenia patients[J]. Chinese Journal of Mental Health, 2023, 37(10): 825-832. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202310001.htm
[12]	KOÇ M, TEL H, KARAKVLAH K. Determining care burden and psychiatric symptom level in caregiver of schizophrenia patient[J]. Perspect Psychiatr Care, 2021, 57(2): 642-647. doi: 10.1111/ppc.12588
[13]	SAME K, SHOBEIRI P, RASHIDI M M, et al. A global, regional, and national burden and quality of care index for schizophrenia: global burden of disease systematic analysis 1990-2019[J]. Schizophr Bull, 2023: sbad120. DOI: 10.1093/schbul/sbad120.
[14]	GUAN Z, WILEY J A, TANG S, et al. Internalised stigma, social support, coping and care-giving burden among Chinese family caregivers of adults diagnosed with schizophrenia: a parallel mediation analysis[J]. Health Soc Care Community, 2022, 30(6): 2300-2310. doi: 10.1111/hsc.13780
[15]	杨洁, 彭涛, 李晔, 等. 支持性护理干预对军队保健人群阿尔茨海默病照顾者负担的影响[J]. 中国临床保健杂志, 2022, 25(5): 700-702. doi: 10.3969/J.issn.1672-6790.2022.05.028 YANG J, PENG T, LI Y, et al. The impact of supportive nursing interventions on the burden of Alzheimer' s disease caregivers in military healthcare populations[J]. Chinese Journal of Clinical Health, 2022, 25(5): 700-702. doi: 10.3969/J.issn.1672-6790.2022.05.028
[16]	王志羽, 鲁显玉, 邢凤梅. 疾病接受度和家庭关怀度对老年共病患者心理一致感的影响[J]. 解放军护理杂志, 2022, 39(2): 25-28. doi: 10.3969/ji.ssn.1008-9993.2022.02.007 WANG Z Y, LU X Y, XING F M. The impact of disease acceptance and family care on the psychological consistency of elderly comorbidities patients[J]. Journal of Nursing of the People' s Liberation Army, 2022, 39(2): 25-28. doi: 10.3969/ji.ssn.1008-9993.2022.02.007
[17]	陆钰, 廖碧, 莫小源, 等. 整合照护模式对多发伤重症患者ICU转出后照顾者的迁移应激及心理一致感的影响分析[J]. 中国实用护理杂志, 2022, 38(5): 341-346. doi: 10.3760/cma.j.cn211501-20210406-01020 LU Y, LIAO B, MO X Y, et al. An analysis of the impact of integrated care mode on the migration stress and psychological consistency of caregivers after ICU transfer in critically ill patients with multiple injuries[J]. Chinese Journal of Practical Nursing, 2022, 38(5): 341-346. doi: 10.3760/cma.j.cn211501-20210406-01020
[18]	喻晓芬, 袁琳琳, 张赛飞. Kolb经验学习理论联合加速康复外科理念的培训模式在机器人手术护理培训中的应用[J]. 中华现代护理杂志, 2022, 28(7): 915-920. doi: 10.3760/cma.j.cn115682-20210607-02489 YU X F, YUAN L L, ZHANG S F. The application of Kolb' s experiential learning theory combined with the concept of accelerated rehabilitation surgery in robot surgical nursing training[J]. Chinese Journal of Modern Nursing, 2022, 28(7): 915-920. doi: 10.3760/cma.j.cn115682-20210607-02489