This five-year nursing study targets adolescents with DSM-IV diagnosed schizophrenia. The purpose is to test the effectiveness of a family centered, community-based, self management intervention for these adolescents between the ages of 15 and 18 years. The primary aim is to test the effectiveness of the intervention in improving the adolescents' level of functioning in role performance, thinking/cognitive processing, behavior towards others, mood, and use of substances.
The second aim i s to assess the impact of the intervention on family functioning.
The third aim i s to describe the relationships among the process variables of the intervention. Nakagawa-Kogan's self-management nursing model, Kanfer's self-regulation theory, and Liberman's theory of stress and vulnerability provide the theoretical basis for the self management intervention developed specifically for a population with deficits in cognitive processing. The intervention involves training in symptom awareness, stress management skills, problem-solving, and social skills. Parents and siblings are included to gain knowledge and skills to support the adolescents. The study is a randomized two-group experimental design with repeated measures. The subjects are 144 adolescents who meet the DSM-IV criteria when screened with the K-SADS and the DISA. The adolescent's level of functioning will be assessed using the Child and Adolescent Functional Assessment Scale, the Birchwood Early Signs & Symptoms Scale for schizophrenia, and the DISA. Family Functioning is assessed by computing a Composite Family Functioning Index using weighted scores from the FACES II, Family Apgar, Family Empowerment, and Family Social Support scales. One parent will be designated by the family to be the family respondent on the scales. The adolescents are referred to the study by mental health professionals. The intervention is administered in small multiple-family groups in 12 sessions over 7-1/2 months. Data are collected at 4 points in time: at baseline, after 6 intensive sessions, after 6 monthly reinforcement sessions, and 6 months post-intervention. ANCOVA will be used to test the study hypotheses. Multivariate relationships will be examined among the process variables of the intervention.
| Lee, Heeyoung; Schepp, Karen G (2011) Multiple informants in assessing stress and symptoms in adolescents with schizophrenia. Arch Psychiatr Nurs 25:120-8 |
