退院を望まない長期入院統合失調症患者に対する地域生活の自信獲得に向けたコンコーダンス・スキルを活用した看護面接の効果

In the present study, we conducted nursing interviews using concordance skills (CS interviews) aimed at acquisition of self-confidence toward community life for two long-stay patients with schizophrenia who did not wish to be discharged from psychiatric hospital, and evaluated the effectiveness of CS interviews. Case A was a woman in her 70s who was diagnosed with schizophrenia at around age of 17 years and had been institutionalized for approximately 30 years since her ninth admission. Case B was a man in his 30s who was diagnosed with schizophrenia at around age of 22 years and had been admitted 15 times due to auditory hallucination, delusions, suffers a relapse, has been in hospital for two years and six months since his latest admission. As a result of interviews, scores on the Self-Efficacy for Community Life Scale improved from 150 to 160 points for Case A and from 66 to 82 points for Case B. In the Case A, the Global Assessment of Functioning (GAF) score was 35 with no changes before and after intervention. In the case B, GAF score improved from 25 to 35, before and after six months intervention. These findings suggest that CS interviews are effective for promoting self-confidence toward community life among long-stay patients and useful for providing support without exacerbating the severity of psychiatric symptoms or functional level of long-stay patients during the stage in which they nurture the dreams and hopes to be discharged.