A Randomized Controlled Trial of Reading Therapy as a Narrative Medicine Approach for Bidirectional Interactive Reading Intervention in Patients with Mental Disorders
CHEN Mengxin#1, WANG Huilun#2, JIE Zihan2, CAO Xinyu1, ZHAO Minhan1, WU Xinle1, OUYANG Haijing1, QIN Lulu1,*, ZHOU Ziyang2
1. School of medical, Hunan Normal University, Changsha 410013, China; 2. College of Liberal Arts, Hunan Normal University, Changsha 410081, China
Abstract:Objective Exploring the feasibility and therapeutic effects of combining bidirectional interactive reading therapy under the narrative medicine model with conventional treatment for clinical management of mental disorders in patients. Methods This study was a randomized controlled trial involving 376 patients with mental disorders who were randomly assigned to either the control group or the experimental group. The control group received conventional medication therapy and health education, while the experimental group received conventional medication therapy, health education, and bidirectional interactive reading therapy for a duration of 6 months. Pre-treatment and post-treatment assessments were conducted using a general information questionnaire, the Patient Health Questionnaire-9(PHQ-9) for depressive symptoms, the Generalized Anxiety Disorder-7(GAD-7) Scale for generalized anxiety, the Sleep Rating Scale (SRSS) for sleep quality, the Chinese version of the 8-item Morisky Medication Adherence Scale (MMAS-8) for medication adherence, and a treatment satisfaction scale. Results After intervention, there was a significant improvement (P<0.05) in depression and anxiety symptoms among patients with depression, schizophrenia, bipolar disorder, and anxiety disorders. The experimental group showed significant improvements (P<0.05) in sleep conditions, medication adherence, and treatment satisfaction compared to the control group in all four disease categories, with the experimental group showing more pronounced improvements (P<0.05). Conclusion The narrative medicine approach of bidirectional interactive reading therapy under the narrative medicine model significantly improves patients' depression, anxiety, and sleep conditions, enhances medication adherence, and increases treatment satisfaction.
[1] Huang Y, Wang Y U, Wang H, et al.Prevalence of mental disorders in China: a cross-sectional epidemiological study[J]. Lancet Psychiatry, 2019, 6(3): 211-224. [2] Samiksha S, Amit A, Jyotsna S, et al.Psychiatric disorders and caregiver burden in children with transfusion dependent β-thalassaemia and their caregivers[J]. World J Clin Pediatr, 2023, 12(3): 125-132. [3] 苏永前. 文学治疗的知识谱系[N]. 中国社会科学报, 2022-04-25(006). [4] 郭莉萍, 王一方. 叙事医学在我国的在地化发展[J]. 中国医学伦理学, 2019, 32(02): 147-152. [5] 夏天成. 认识论局限、实践困境与差异性悖论——对叙事医学的批判反思[J]. 自然辩证法通讯, 2023, 45(05): 33-41. [6] 李欣, 张秀, 宋建玮. 阅读疗法研究进展与趋势——基于中英文文献比较分析[J]. 图书馆工作与研究, 2023(07): 77-87+100. [7] 王景文. 突发公共卫生事件下的图书馆阅读疗法应急服务研究——基于后疫情时期大学生心理问题的阅读疗法需求与应用调查[J]. 大学图书馆学报, 2020, 38(06): 28-36. [8] Malibiran R, Tariman J D, Amer K.Bibliotherapy: Appraisal of evidence for patients diagnosed with cancer[J]. Clin J Oncol Nurs, 2018, 22(4): 377-380. [9] Kroenke K, Spitzer R L, Williams J B W, et al. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review[J]. Gen Hosp Psychiatry, 2010, 32(4): 345-359. [10] 孙晓艳, 李怡雪, 余灿清, 等. 中文版抑郁量表信效度研究的系统综述[J]. 中华流行病学杂志, 2017, 38(1): 7. [11] 何筱衍, 李春波, 钱洁, 等. 广泛性焦虑量表在综合性医院的信度和效度研究[J]. 上海精神医学, 2010, 22(04): 200-203. [12] 李建明. 睡眠状况自评量表 (SRSS) 简介[J]. 中国健康心理学杂志, 2012, 20(12): 1851. [13] 司在霞, 郭灵霞, 周敏, 等. 修订版Morisky服药依从性量表用于抗凝治疗患者的信效度检测[J]. 护理学杂志, 2012, 27(22): 23-26. [14] Abdellaoui A, Smit D J A, van den Brink W, et al. Genomic relationships across psychiatric disorders including substance use disorders[J]. Drug Alcohol Depend, 2021, 220: 108535. [15] Lin D, Thompson-Leduc P, Ghelerter I, et al.Real-world evidence of the clinical and economic impact of long-acting injectable versus oral antipsychotics among patients with schizophrenia in the United States: a systematic review and meta-analysis[J]. CNS drugs, 2021, 35(5): 469-481. [16] Brakemeier E L, Guhn A, Stapel S, et al.Stationäre Psychotherapie depressiver Störungen: Möglichkeiten und Herausforderungen[J]. Der Nervenarzt, 2023, 94(3): 213-224. [17] Chien W T, Thompson D R, Lubman D I, et al.A randomized controlled trial of clinician-supported problem-solving bibliotherapy for family caregivers of people with first-episode psychosis[J]. Schizophr Bull, 2016, 42(6): 1457-1466. [18] Volpe U, Torre F, De Santis V, et al.Reading group rehabilitation for patients with psychosis: a randomized controlled study[J]. Clin Psychol Psychother, 2015, 22(1): 15-21. [19] Stuckey H L, Nobel J.The connection between art, healing, and public health: A review of current literature[J]. Am J Public Health, 2010, 100(2): 254-263. [20] 秦丽, 周郁秋, 王伟梁. 精神障碍患者睡眠紊乱与自杀关系的Meta分析[J]. 中国全科医学, 2020, 23(08): 942-948. [21] Wang S, Bressington D T, Leung A Y M, et al. The effects of bibliotherapy on the mental well-being of informal caregivers of people with neurocognitive disorder: A systematic review and meta-analysis[J]. Int J Nurs Stud, 2020, 109: 103643.