Promoting Adherence to Treatment in Schizophrenia

促进精神分裂症治疗的依从性

• 批准号: 7076867
• 负责人: ALEX J KOPELOWICZ
• 金额: $ 30.76万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-25 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7076867
• 关键词: Mexican Americans; behavioral /social science research tag; clinical research; clinical trials; family therapy; human therapy evaluation; longitudinal human study; mental disorder chemotherapy; patient oriented research; schizophrenia; therapy compliance; Mexican Americans; behavioral /social science research tag; clinical research; clinical trials; family therapy; human therapy evaluation; longitudinal human study; mental disorder chemotherapy; patient oriented research; schizophrenia; therapy compliance

DESCRIPTION (provided by applicant): This R01 grant proposal is a revised version of a response to PA-00-016 "Research on Adherence to Interventions for Mental Disorders." The project (a) evaluates a culturally adapted, family-based intervention designed to promote treatment adherence among Mexican-Americans with schizophrenia using a randomized, controlled design in a public mental health setting, and (b) tests hypotheses about the applicability of Ajzen's theory of planned behavior (TPB), the conceptual foundation for the intervention's key constructs, to the study of treatment adherence. This conceptual model was selected for study because its emphases on the important roles of subjective norms and perceived behavior control are highly germane to the study population and to the proposed intervention. Mexican-Americans with schizophrenia and their families will be entered into the study during a psychiatric hospitalization and followed after discharge for two years. Subjects will be randomly assigned to either: 1) one year of multiple family groups that emphasize the importance of attitudes towards adherence, subjective norms, and self-perceived and actual adherence skills in maintaining adherence, added to ongoing customary outpatient care; 2) one year of standard multiple family groups added to customary outpatient care; or 3) customary outpatient care only (monthly pharmacotherapy sessions and additional services as clinically needed). Evaluations will be made at baseline and every four months for two years of actual adherence behaviors (using a multi-dimensional approach that integrates behavioral measures with multiple informants), and of the postulated mediating factors based .on the project's theoretical model: intentions to adhere to treatment; decision-making processes used to arrive at this intention; perceived subjective norms (i.e., perceptions regarding their relatives' preferences regarding treatment adherence; real and perceived ability to acquire, maintain, and utilize treatment adherence skills; attitudes towards the illness and its treatment; levels of psychopathology, and other important outcomes (e.g., social functioning, quality of life, relapse and rehospitalization rates). Key relatives will be assessed during those same time frames to determine their understanding of how and why they influence the patient's actions; their attitudes towards their mentally ill relative; their knowledge and views of schizophrenia; their roles as collaborating participants in the treatment process; and their expectations with regard to their relative's treatment and recovery. The results will advance the understanding of the factors that affect adherence to treatment for Mexican, Americans with schizophrenia, and, if the treatment were effective, would add a new tool for improving treatment adherence in this population.

描述（由申请人提供）：此R01赠款提案是对PA-00-016的回应的修订版，“对遵守精神疾病干预措施的研究”。该项目（a）评估了一种文化适应性的，基于家庭的干预措施，旨在在公共心理健康环境中使用随机，受控的设计来促进墨西哥裔美国人患有精神分裂症的治疗依从性，并且（b）测试假设Ajzen计划的概念基础（TPB）的概念基础，以进行研究，以构建构建，从而构建构建，从而构建次要的研究。之所以选择这种概念模型，是因为它重点是主观规范和感知行为控制的重要作用，对研究人群和拟议的干预措施高度隐藏。具有精神分裂症及其家人的墨西哥裔美国人将在精神病住院期间进入研究，并在出院两年后随后进行。受试者将被随机分配给：1）多个家庭群体的一年，这些家庭强调态度对依从性，主观规范以及维持依从性的自我感知和实际遵守技能的重要性，并增加了持续的习惯门诊医疗； 2）为习惯门诊护理增加了一年的标准多个家庭群体；或3）仅习惯门诊护理（每月药物治疗课程和临床上需要的其他服务）。评估将在基线和每四个月进行两年的实际依从性行为（使用多维方法，将行为度量与多个线人整合在一起），以及基于项目的理论模型的假定中介因素：遵守治疗的意图；决策过程用于实现这一意图；感知的主观规范（即，对他们的亲戚对治疗依从性的偏好的看法；真实和感知的能力获得，维持和利用治疗能力；对疾病及其治疗的态度；心理病理学的水平；他们的行为对他们的态度；他们对精神分裂症的知识和他们在治疗过程中的合作的看法；