个别系统家庭干预对精神分裂症患者家庭功能和社会功能的作用:随机对照研究

Effect of individual system family intervention on the family and social functions in patients with schizophrenia:a randomized control study

目的:探讨个别系统家庭干预,对精神分裂症患者家庭功能和社会功能的作用。方法:将济宁市精神病防治院221例精神分裂症患者及家属按入院顺序分层随机法,分为研究组和对照组,待患者病情缓解出院后随访3年。前半年进行10次系统精神医学知识指导,研究组进行个别系统家庭干预,对照组进行集体系统家庭干预,于出院时和出院后1,2和3年末评定两组家庭功能量表、社会功能缺陷量表(SDSS)。结果:出院3年后研究组家庭功能的问题解决能力(1.35±0.78),沟通能力(1.39±0.45),角色定位和转换(1.22±0.46),情感的协调性(1.48±0.78),情感介入(1.62±0.95),行为控制(1.22±0.58),总分(1.27±0.66)较对照组降低明显,差异有显著性(t=2.10～2.79,P<0.05～0.01);研究组社会功能评定量表的职业和工作(0.69±0.11),婚姻职能(1.13±0.23),父母职能(0.66±0.16),社会交往(0.94±0.21),家庭外的社会功能(1.00±0.21),家庭内的社会功能(1.00±0.28),家庭职能(1.00±0.26),个人卫生自理能力(0.78±0.22),对外界的兴趣和关心(0.93±0.26),责任心和计划性(1.05±0.23)和总分(9.15±0.54)较对照组降低明显,差异具有显著性意义(t=1.97～2.63,P<0.05～0.01)。结论:个别系统家庭干预能显著改善精神分裂症患者的家庭功能和社会功能。

AIM:To study the influence of individual system family intervention on the family and social functions in patients with schizophrenia. METHODS:Totally 221 patients with schizophrenia in the Jining Hospital of Prevention and Treatment for Mental Disease were divided into study group and control group according to their order of hospitalization randomly.All the patients were followed up for three years after discharge,and they received 10 systematic instructions on mental medical knowledge in the first half year.Individual and collective system family interventions were performed in the study and control group respectively.All the patients were evaluated by family function scale and social disability screening schedule(SDSS) when discharge and at the end of 1st,2nd and 3rd years after discharge. RESULTS:Three years after discharge,the score of ability of solving problem(1.35±0.78), communicating ability (1.39±0.45),location and exchange of role(1.22±0.46),affective concordance(1.48±0.78),affective intervention(1.62±0.95),master of action(1.22±0.58) and total score(1.27±0.66) of family function scale in the study group were significantly lower than those in the control group(t=2.10 to 2.79,P< 0.05 to 0.01). The scores of profession and employment(0.69±0.11),marriage function (1.13±0.23),parents function(0.66±0.16),social communication (0.94±0.21), social function outside family(1.00±0.21),social function inside family(1.00±0.28),family function(1.00±0.26),self care ability in personal hygiene(0.78±0.22),interest and care for external environment(0.93±0.26),responsibility and plan(1.05±0.23) and total score(9.15±0.54) of SDSS in the study group were significantly lower than those in the control group (t= 1.97 to 2.63,P< 0.05 to 0.01). CONCLUSION:Individual system family intervention can significantly improve the family and social functions in the patients with schizophrenia.