Effectiveness of continuity of care in schizophrenia through virtual modality at the National Institute of Mental Health, Lima, Peru
DOI:
https://doi.org/10.20453/rnp.v89i1.6599Keywords:
continuity of patient care, telemedicine, psychosocial functioning, paranoid schizophrenia, patient care groupAbstract
Objective: To determine the effectiveness of a virtual comprehensive care continuity program for individuals with paranoid schizophrenia. Methodology: A quasi-experimental design with pretest-posttest measurements was used with a sample of fifteen adults. The interdisciplinary intervention lasted six months and focused on the remote monitoring of participants. Results: Significant improvements were evidenced in treatment adherence (p = 0.018) and community skills within activities of daily living (p = 0.023). A significant decrease in positive (p = 0.016) and negative (p = 0.005) psychotic symptoms was observed, with an overall result of high relevance (p = 0.001). Regarding functionality, progress was found in cognition (p = 0.004), interpersonal relationships (p = 0.014), and social participation (p = 0.001). Although areas such as mobility, self-care, and work did not show statistically significant differences, the overall functionality score was significant (p = 0.001). Regarding family dynamics, an improvement in cohesion was recorded (p = 0.028), while adaptability did not reach statistical significance (p = 0.067). Conclusions: The program demonstrated effectiveness in key dimensions of treatment and psychosocial functioning, with positive implications for clinical management and the participants' quality of life.
Downloads
References
Gonzáles A. Programas de continuidad de cuidados: éxitos, fracasos y retos futuros. Estud Psicol. 2011;16(3):305-12. doi:10.1590/S1413-294X2011000300014
Diez-Canseco F, Rojas-Vargas J, Toyama M, et al. Estudio cualitativo sobre la implementación del Programa de continuidad de cuidados y rehabilitación para personas con trastornos mentales graves en el Perú. Rev Panam Salud Publica. 2020;44:e134. doi:10.26633/RPSP.2020.134
Gallinat C, Moessner M, Apondo S, et al. Feasibility of an intervention delivered via mobile phone and internet to improve the continuity of care in schizophrenia: a randomized controlled pilot study. Int J Environ Res Public Health. 2021;18(23):12391. doi:10.3390/ijerph182312391
Gonzáles-Villalobos I, Menéndez-García A, García-Cid S, et al. Tratamiento Ambulatorio Intensivo Multidisciplinar (TAIM) para adolescentes con trastorno mental grave. Rev Área 3. 2022;26:1-14. doi:https://area3.org.es/descargas/a3-26-TAIMadolescentesconTMG-EquipoCSM-Majadahonda.pdf
Nicaise P, Giacco D, Soltmann B, et al. Healthcare system performance in continuity of care for patients with severe mental illness: A comparison of five European countries. Health Policy. 2020;124(1):25-36. doi:10.1016/j.healthpol.2019.11.004
Campbell DT, Stanley JC. Experimental and quasi-experimental designs for research [Internet]. Florida: Houghton Mifflin Company; 1963. Disponible en: https://www.sfu.ca/~palys/Campbell&Stanley-1959-Exptl&QuasiExptlDesignsForResearch.pdf
Ministerio de Salud (PE). Norma técnica de salud: centros de salud mental comunitarios [Internet]. Plataforma del Estado Peruano; 2017, 1 de setiembre. Disponible en: https://www.gob.pe/institucion/minsa/informes-publicaciones/279706-norma-tecnica-de-salud-centros-de-salud-mental-comunitarios
De las Cuevas C, Peñate W. Psychometric properties of the eight-item Morisky Medication Adherence Scale (MMAS-8) in a psychiatric outpatient setting. Int J Clin Health Psychol. 2015;15(2):121-9. doi:10.1016/j.ijchp.2014.11.003
Rodríguez-Chamorro MA, García-Jiménez E, Rodríguez-Pérez A, et al. Revisión de test validados para la valoración de la adherencia al tratamiento farmacológico utilizados en la práctica clínica habitual. Pharm Care Esp [Internet]. 2020;22(3):148-72. Disponible en: https://www.pharmcareesp.com/index.php/PharmaCARE/article/view/572
Grupo Andaluz de Investigación en Salud Mental. Habilidades básicas de la vida diaria (BELS). Grupo Andaluz de Investigación en Salud Mental. [Internet]. 2010; 162(supl.19):18-24. Disponible en: https://www.sspa.juntadeandalucia.es/servicioandaluzdesalud/sites/default/files/sincfiles/wsas-media-pdf_publicacion/2020/Anexo_3-2_BELS.pdf
Martínez O. Escala breve de evaluación psiquiátrica Brief Psychiatric Rating Scale (BPRS). Psychol Rep [Internet]. 2010;10:799-812. Disponible en: http://medsol.co/informacion/medolan/escala_breve_de_evaluacion_psiquiatrica_bprs.pdf
Vásquez GA, Vega-Dienstmaier J, Mazzotti G, et al. Validación de la Brief Psychiatric Rating Scale (BPRS) en el Perú. Rev Neuropsiquiatr. 200;64(3):185-98. Disponible en: 10.20453/rnp.v64i3.1486
Vásquez-Barquero JL, Herrera S, Vásquez E, et al. Cuestionario para la Evaluación de Discapacidad de la Organización Mundial de la Salud (OMS), Who-Das II. Madrid: Ministerio de Trabajo y Asuntos Sociales; 2006.
Ponce ER, Gómez FJ, Terán M, et al. Validez de constructo del cuestionario FACES III en español (México). Aten Primaria [Internet]. 2002;30(10):624-30. Disponible en: https://www.elsevier.es/es-revista-atencion-primaria-27-articulo-validez-constructodel-cuestionario-faces-13041205
Bandura A. Self-efficacy: the exercise of control. New York: W.H. Freeman and Company; 1997.
Beck JS. Cognitive behavior therapy: basics and beyond [Internet]. 2.a ed. New York: The Guilford Press; 2011. Disponible en: https://psycnet.apa.org/record/2011-22098-000
Velligan D, Weiden P, Sajatovic M, et al. The expert consensus guideline series: adherence problems in patients with serious and persistent mental illness. J Clin Psychiatry [Internet]. 2009;70(supl.4):1-46. Disponible en: https://europepmc.org/article/MED/19686636
Kane J, Kishimoto T, Correll C. Non-adherence to medication in patients with psychotic disorders: epidemiology, contributing factors and management strategies. World Psychiatry. 2013;12(3):216-26. doi:10.1002/wps.20060
Higashi K, Medic G, Littlewood K, et al. Medication adherence in schizophrenia: factors influencing adherence and consequences of nonadherence, a systematic literature review. Ther Adv Psychopharmacol. 2013;3(4):200-18. doi:10.1177/2045125312474019
Mayorga R. Nivel de adherencia terapéutica en pacientes con esquizofrenia paranoide en un centro especializado de salud mental comunitaria de Chiclayo, 2024 [tesis de título profesional en Internet]. Chiclayo: Universidad Señor de Sipán; 2024. Disponible en: https://hdl.handle.net/20.500.12802/13379
Arnautovska U, Trott M, Vitangcol KJ, et al. Efficacy of user self-led and human-supported digital health interventions for people with schizophrenia: a systematic review and meta-analysis. Schizophr Bull. 2025;51(5):1402-16. doi:10.1093/schbul/sbae143
Orem DE. Nursing: concepts of practice. 6.a ed. San Luis: Mosby; 2001.
Roy C, Whetsell M, Fredeickson K. The Roy adaptation model and research. Nurs Sci Q. 2009;22(3):209-11. doi:10.1177/0894318409338692
Herrera-López VE, Molina-Quiñones H, Valdivieso J, et al. Apoyo social, calidad de vida, habilidades de vida diaria y restrictividad en personas con trastornos mentales residentes de hogares protegidos en el Perú. Rev Neuropsiquiatr. 2024;87(4):354-67. doi:10.20453/rnp.v87i4.5690
Jiménez JF, Torres F, Laviana M, et al. Evaluación del funcionamiento de la vida diaria en personas con trastorno mental de larga evolución. Adaptación y fiabilidad de la versión española del «Basic Everyday Living Skills» (BELS). Actas Esp Psiquiatr [Internet]. 2000;28(5):284-288. Disponible en: https://actaspsiquiatria.es/index.php/actas/article/view/1301/2098
Kahn R, Sommer I, Murray R, et al. Schizophrenia. Nat Rev Dis Primers. 2015;1:15067. doi:10.1038/nrdp.2015.67
Beck AT, Rector N. Cognitive approaches to schizophrenia: theory and therapy. Annu Rev Clin Psychol. 2005;1:577-606. doi:10.1146/annurev.clinpsy.1.102803.144205
Katsushima M, Nakamura H, Shiko Y, et al. Effectiveness of a videoconference-based cognitive behavioral therapy program for patients with schizophrenia: pilot randomized controlled trial. JMIR Form Res. 2025;9:e59540. doi:10.2196/59540
Rotondi AJ, Anderson CM, Haas GL, et al. Web-based psychoeducational intervention for persons with schizophrenia and their supporters: one-year outcomes. Psychiatr Serv. 2010;61(11):1099-105. doi:10.1176/ps.2010.61.11.1099
Slade M. Personal recovery and mental illness: a guide for mental health professionals. Cambridge: Cambridge University Press; 2009. doi:10.1192/bjp.bp.109.069997
Beck AT, Rector NA. Cognitive therapy of schizophrenia: a new therapy for the new millennium. Am J Psychother. 2000;54(3):291-300. doi:10.1176/appi.psychotherapy.2000.54.3.291
Cella M, Price T, Corboy H, et al. Cognitive remediation for inpatients with psychosis: a systematic review and meta-analysis. Psychol Med. 2020;50(7):1062-76. doi:10.1017/s0033291720000872
Fisher M, Etter K, Murray A, et al. The Effects of remote cognitive training combined with a mobile app intervention on psychosis: double-blind randomized controlled trial. J Med Internet Res. 2023;25:e48634. doi:10.2196/48634
Brown CA, Weisman de Mamani A. The mediating effect of family cohesion in reducing patient symptoms and family distress in a culturally informed family therapy for schizophrenia: a parallel-process latent-growth model. J Consult Clin Psychol. 2018;86(1):1-14. doi:10.1037/ccp0000257
Teyes R, García CD, Costa VE. Resiliencia familiar. Cod Cientf Rev Inves [Internet]. 2021;2(1):137-51. Disponible en: https://revistacodigocientifico.itslosandes.net/index.php/1/article/view/30
McFarlane WR, Dixon L, Lukens E, et al. Family psychoeducation and schizophrenia: a review of the literature. J Marital Fam Ther. 2003;29(2):223-45. doi:10.1111/j.1752-0606.2003.tb01202.x
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 GLADYS LOURDES ROSALES-GABINO
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
RNP is distributed under a 