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A Theoretical Structural Model for Caring Persons with Early Psychosis: A systematic review and qualitative meta-analysis

조기 정신증 돌봄 모형 개발: 질적 메타분석을 통한 이론적 접근

  • Sung, Kyung Mi (College of Nursing & Institute of Health Sciences, Gyeongsang National University)
  • 성경미 (경상대학교 간호대학 & 건강과학연구원)
  • Received : 2016.09.23
  • Accepted : 2017.01.06
  • Published : 2017.01.31

Abstract

This study was aimed to construct a theoretical model for managing persons with early psychosis. We systematically searched SCOPUS, PubMed, RISS, Web of Knowledge, and KoreaMed for related factors to manage persons with early psychosis. Significant terms or phrases for a preliminary structural model were obtained from 19 studies since 2000 regarding the management of persons with early psychosis. Moreover, the content validity for the model was evaluated by 22 professionals. The study results revealed 51 factors for managing persons with early psychosis extracted by meta-analysis, and all factors were divided into 21 medium classification and 8 categories. A theoretical model was constructed with 8 categories, by using the middle range theory of Peplau's Interpersonal Relationships in Nursing. The results suggest that the theoretical model for the management of persons with early psychosis provides a sound theoretical basis for future study.

본 연구는 조기 정신증 환자를 대상으로 포괄적인 간호중재를 제공함으로써 정신증 진행을 늦추고 정신기능의 불구를 줄여 사회적 기능이 최적으로 호전될 수 있도록 돕는 새로운 돌봄의 이론적 모형을 개발하기 위해 시도되었다. 본 연구에서는 조기 정신증 환자의 돌봄에 대한 이론적 모형을 구축하기 위해 1) 연구주제 및 자료 분석방법 결정, 2) 문헌탐색 및 분석대상 선택, 3) 자료 추출, 4) 예비모형 구축 및 타당도 검증의 단계를 적용하였다. 2000년대 이후 '조기 정신증 돌봄'에 대해 실시된 선행문헌중 본 연구대상에 선정된 19개 문헌에 대해 질적 메타분석를 실시하였다. 그 결과 일차 분석틀에서 개별 연구에 나타난 조기 정신증 돌봄 요인 51개를 추출하고 이를 21개의 중분류로 나누었으며 이차 분석틀에서 요인의 속성이 유사한 것끼리 모아 8개의 범주명을 제시하였다. 또한 돌봄 요인에 대한 범주명을 간호사와 환자가 건강과 관련된 어려움을 해결하는 대인관계에 초점을 둔 중범위 이론인 Peplau의 대인관계이론을 기틀로 하여 예비모형을 구축하였다. 본 연구는 지역사회 접근을 통해 조기 정신증 환자의 치료받지 않는 기간을 줄이고 개인의 발달기와 환경에 적합한 간호중재를 제공해 줌으로써 사회적 기능을 증진시킬 수 있는 돌봄 모형의 중요한 토대가 될 수 있다.

Keywords

References

  1. M. J. Cho, S. M. Chang, B. J. Hahm, I. W. Chung, A. Bae, Y. M. Lee, et al. "Prevalence and Correlates of Major Mental Disorders among Korean Adults : A 2006 National Epidemiologic Survey", Journal of Korean Neuropsychiatric Association, vol. 48, no. 3, pp. 143-152, 2009.
  2. S. K. An. "Prevention of early psychosis, and development of a program for psycho-social therapy", Mental Health Policy Forum, vol. 2, no. 1, pp. 206-222, 2008.
  3. H. K. Yoo, K. Kim. "Normal Development and Common Psychiatric Illnesses in Adolescence', Journal of Korean Neuropsychiatric Association, vol. 47, no. 5, pp. 415-429, 2008.
  4. A. Mortimer, T. Brown, "Early intervention in psychosis: Another triumph of hope over experience", Progress in Neurology and Psychiatry, vol. May/June, pp. 10-14, 2015. DOI: http://dx.doi.org/10.1002/pnp.379
  5. H. E. .Peplau, "Future directions in psychiatric nursing from the perspective of history", Journal of Psychosocial Nursing and Mental Health Nursing, vol. 27, no. 2, pp. 18-25, 1989.
  6. H. E. .Peplau, "Interpersonal relations: a theoretical framework for application in nursing practice", Nursing Science Quarterly, vol. 5, no. 1, pp. 13-18, 1992. DOI: https://doi.org/10.1177/089431849200500106
  7. K. Oh. "Theory of interpersonal relations: Hildegard E. Peplau", Journal of Nursing Query, vol. 14, no. 2, pp. 29-48, 2005.
  8. P. Golay, L. Alameda, P. Baumann, J. Elowe, P. Progin, A. Polari, P. Conus, "Duration of untreated psychosis: Impact of the definition of treatment onset on its predictive value over three years of treatment", Journal of Psychiatric Research, vol. 77, pp. 15-21, 2016. DOI: https://doi.org/10.1016/j.jpsychires.2016.02.017
  9. P. S. Baumann, S. Crespi, R. Marion-Veyron, A. Solida, J. Thonney, J. Favrod, et al. "Treatment and early intervention in psychosis program (TIPP-Lausanne): Implementation of an early intervention programme for psychosis in Switzerland', Early Intervention in Psychiatry, vol. 7, no. 3, pp. 322-328, 2013. DOI: http://dx.doi.org/10.1111/eip.12037
  10. P. Conus, S. Cotton, B. G. Schimmelmann, P. D. McGorry, M. Lambert, "The first-episode psychosis outcome study: Premorbid and baseline characteristics of an epidemiological cohort of 661 first-episode psychosis patients', Early Intervention in Psychiatry, vol. 1, no. 2, pp. 191-200, 2007;1(2):191-200. DOI: http://dx.doi.org/10.1111/j.1751-7893.2007.00026.x
  11. A. N. Scholte-Stalenhoef, S. la Bastide-van Gemert, G. van de Willige, R. Dost-Otter, E. Visser, E. J. Liemburg, et al. "Personality and coping in first episode psychosis linked to mental health care use", Psychiatric Research, vol. 238, pp. 218-224, 2016. DOI: http://dx.doi.org/10.1016/j.psychres.2016.02.03
  12. A. R. Yung, "Youth services: the need to integrate mental health, physical health and social care", Social Psychiatry and Psychiatric Epidemiology. vol. 51, no. 3, pp. 327-329, 2016. DOI: http://dx.doi.org/10.​1007/​s00127-015-1195-6 https://doi.org/10.1007/s00127-016-1195-6
  13. N. Bay, J. Bjornestad, J. O. Johannessen, T. K. Larsen, I. Joa, "Obstacles to care in first-episode psychosis patients with a long duration of untreated psychosis", Early Intervention in Psychiatry, vol. 10, no. 1, pp. 71-76, 2016. DOI:http://dx.doi.org/10.1111/eip.12152
  14. W. T. V. Hegelstad, T. K. Larsen, B. Auestad, J. Evensen, U. Haahr, I. Joa, et al. "Long-term follow-up of the TIPS early detection in psychosis study: Effects on 10-year outcome", American Journal of Psychiatry, vol. 169, no. 4, pp. 374-380, 2012. DOI: http://dx.doi.org/10.1176/appi.ajp.2011.11030459
  15. J. O. Johannessen, T. H. McGlashan, T. K. Larsen, M. Horneland, I. Joa, S. Mardal, et al. "Early detection strategies for untreated first-episode psychosis", Schizophrenia Research, vol. 15, no. 1, pp. 39-46, 2001. DOI: http://dx.doi.org/10.1016/S0920-9964(01)00237-7
  16. M. Birchwood, C. Connor, H. Lester, P. Patterson, N. Freemantle, M. Marshall, et al. "Reducing duration of untreated psychosis: Care pathways to early intervention in psychosis services", British Journal of Psychiatry, vol. 203, pp. 58-64, 2013. DOI: http://dx.doi.org/10.1192/bjp.bp.112.125500
  17. M. Birchwood, S. P. Singh, "Mental health services for young people: matching the service to the need", The British Journal of Psychiatry, vol. 202, no. s54, pp. s1-s2, 2013. DOI: http://dx.doi.org/10.1192/bjp.bp.112.119149
  18. S. Singh, H. L. Fisher, "Early intervention services", Psychiatry, vol. 6, no. 8, pp. 333-338, 2007. DOI: http://dx.doi.org/10.1016/j.mppsy.2007.05.003
  19. M. Bak, I. Myin-Germeys, M. Hanssen, R. Bijl, W. Vollebergh, P. Delespaul, et al. "When does experience of psychosis result in a need for care?", Schizophrenia Bulletin, vol. 29, no. 2, pp. 349-358, 2003. https://doi.org/10.1093/oxfordjournals.schbul.a007010
  20. S. W. Kwon, M. S. Shin, S. C. Cho, S. W. Shin, "A survey of the psychosis among school violence victims", Journal of the Korean Academy of Child and Adolescent Psychiatry, vol. 11, no. 1, pp. 124-143, 2000.
  21. P. McGorry, T. Bates, M. Birchwood, "Designing youth mental health services for the 21st century: Examples from Australia, Ireland and the UK", British Journal of Psychiatry, vol. 202, no. s54, pp. s30-s35, 2013. DOI: http://dx.doi.org/10.1192/bjp.bp.112.119214
  22. R. Carney, J. Cotter, T. Bradshaw, J. Firth, A. R. Yung, "Cardiometabolic risk factors in young people at ultra-high risk for psychosis: a systematic review and meta-analysis", Schizophrenia Research. vol. 170, no. 2-3, pp. 290-300, 2015. DOI: http://dx.doi.org/10.1016/j.schres.2016.01.010
  23. D. J. Rickwood, N. R. Telford, A. G. Parker, C. J. Tanti, P. D. McGorry, "Headspace-Australia's innovation in youth mental health: who are the clients and why are they presenting", Medical Journal of Australia, vol. 200, no. 8, pp. 1-4, 2014. D O I : http://dx.doi.org/10.5694/mja14.00276
  24. A. Malla, S. Iyer, P. McGorry, M. Cannon, H. Coughlan, S. Singh, et al. "From early intervention in psychosis to youth mental health reform: a review of the evolution and transformation of mental health services for young people", Social Psychiatry and Psychiatric Epidemiology, vol. 51, no. 3, pp. 319-326, 2015. DOI: http://dx.doi.org/10.1007/s00127-015-1165-4
  25. A. Mortimer, T. Brown, "Early intervention in psychosis: Another triumph of hope over experience", Progress in Neurology and Psychiatry, vol. 19, no. 3, pp. 10-14, 2015. DOI: http://dx.doi.org/10.1002/pnp.379
  26. A. Lavis, H. Lester, L. Everard, N. Freemantle, T. Amos, D. Fowler, et al. "Layers of listening: qualitative analysis of the impact of early intervention services for first-episode psychosis on carers' experiences", The British Journal of Psychiatry, vol. 207, pp. 135-142, 2015. DOI: http://dx.doi.org/10.1192/bjp.bp.114.146415
  27. S. Lal, J. Dell'Elce, N. Tucci, R. Fuhrer, R. Tamblyn, A. Malla, "Preferences of young adults with first-episode psychosis for receiving specialized mental health services using technology: a survey study", JMIR Mental Health, vol. 2, no. 2, pp. e18, 2015. DOI: http://dx.doi.org/10.2196/mental.4400
  28. G. W. Noblit, R. D. Hare, "Meta-Ethnography: Synthesizing qualitative studies", pp. 3-88 Sage Publications: Newbury Park, CA, 1988. DOI: https://doi.org/10.4135/9781412985000
  29. W. L. Wallace, (1992). "Metatheory, conceptual standardization, and the future of sociology", In G. Ritzer (Ed.), Metatheorizing, pp. 53-68, SAGE Publication: Newbury Park, CA, 1992.
  30. C. F. Waltz, B. R. Bausell, "Design, statistics and computer analysis", In Nursing Research. pp. 39-116, F.A. Davis Co.; Philadelphia, PA, 1981.