THE EFFECT OF A NURSING INTERVENTION PROGRAM TO ENCOURAGE ACTIVATION OF THE SELF-MONITORING FUNCTION IN ADULT WITH AUTISM SPECTRUM DISORDERS

Abstract

In subjects beyond adolescence, secondary impairments often serve as opportunities to diagnose autism spectrum disorder (ASD), characterized by an underlying lack of self-awareness. Treatment with medication to address the secondary impairment is not sufficient for long-term social adjustment and improvement in quality of life, making psychosocial intervention indispensable. However, apart from a number of case reports, there are no reports on established psychosocial interventions that can be performed by the nurse, indicating need for practical intervention programs that could be delivered by nurses as an alternative approach, taking into account the characteristics of adult with autism spectrum disorders. A nursing intervention program―consisting of a total of ten individual interviews, structured on cognitive and behavioral interventions incorporating reflection support, self-explanation support and externalization support―was created and its effectiveness examined. The evaluation was conducted with the cognitive behavior self-monitoring scale, self-conscious scale, Social Reticence Scale II (SRS-II) (self-report) and SRS-II (others-report). The Wilcoxon signed rank test was used to conduct before-after comparisons, and multiple linear regression analysis was conducted to determine the relationship between scales. Qualitative inductive analysis was conducted to determine changes in self-awareness. Scores of the cognitive behavior self-monitoring scale and the self-conscious scale performed on 16 adult with autism spectrum disorders were higher after implementing the program, whereas the SRS-II (others-report) score was lower after implementation. Also, behavior monitoring had effects on results of the self-conscious scale. In terms of change in self-awareness, the following categories emerged: 1) becoming aware of one's inner self, and 2) becoming aware of interpersonal relationships. The present results demonstrated increase in self-awareness, suggesting effectiveness of this nursing intervention program for the post-adolescent adult with autism spectrum disorders.