以家庭为中心的护理干预对精神分裂症患者康复影响的研究

A study about the effect of family nursing intervention on schizophrenia＇s rehabilitation

目的探讨以家庭为中心的护理干预对精神分裂症患者康复的作用。方法将首次发病且住院的精神分裂症患者289例随机分为研究组（145例）和对照组（144例），入院后两组患者均给予常规抗精神药物治疗和一般的心理教育，研究组在此基础上，实施“以家庭为中心”的护理干预。出院后每3个月深入家庭进行家访或给予针对性具体指导，随访时间为2年。采用自制家庭用经神分裂症健康知识调查表，简明精神病评定量表（the Brief Psychialric Rating Scale，BPRS）、社会功能缺陷筛查量表（the Social Disability Screening Schedule，SDSS）、生活质量综合评定问卷（the Generic Quality of Life Inventory，GQOLI）、家庭关怀度指数问卷（Family APGAR index，APGAR）、坎伯威家庭问卷中文版（CFI—CV），服药依从性量表分别于入院时、半年、1年、2年进行评定。统计分析通过“以家庭为中心”的护理干预2年后，精神分裂症患者对健康知识的了解，复发率、服药依从性，生活质量、社会功能，家庭功能等指标。结果入组时，精神分裂症的健康知识、BPR8、SDSS，GQOOL评分以及家庭功能障碍，高情感表达的构成比等两组比较，差异无显著意义（P〉0．05）；2年后，研究组健康知识评分，GQOOL评分均高于对照组（P〈0．05），BPRS、SDSS评分低于对照组（P〈0．05），严重家庭功能障碍，情撼表达的构成比低于对照组（P〈0．01），复发率也低于对照组（P〈0．01）。结论以家庭为中心的护理干预对预防精神分裂症的复发，提高病人的生活质量，促进家庭功能的改善等具有重要意义。

Objective To explore the effect of fanily nursing intervention on sehizophrenia＇s rehabilitation. Methods 289 first episode and hoaitalized schizophrenia were derided into sutdy group （ 145 cases） and controI group （ 144 cases） randomly. Both of the two groups were administered antipsychotics and common psychological education, furthermore study group received nursing intervention. All patients received home visit or directed and detailed guidance every 3 months post - discharged, and the total folIowing- up course was 2 years. AII subjects were symptoms with a self - developed schizophrenia health knowledge questionnaire, the Brief Psychiatric Rating Scale （BPRS） , the Social Disability Screening Schedule （ SDSS）, the Generic Quality of Life Inventory （ CQOLI）, Family APGAR index （ APGAR）, Chinese version of Camber well FamiIy Interview （ CFI - CV） and compliance scble of taking medicine before treatment, after half year, I year and 2 years. The knowledge about health, recurrence rate, compliance of taking medicine, quaIity of life, social and famiIy function were analyzed after family nursing intervention for 2 years. Results There was no significant difference between two group in health knowledge, scores of BPRS, SOSS, CQOOL, constituent ratio of sever family functional impairment and high affect express, et al. After 2 years, compared with congtroIs, study group showed significant higher GQOOL score, lower BPRS and SDSS scores, lower constituent ratio of sever family functional impairment and high affect express, and lower recurrence rate （P 〈0.05 or P 〈0.01 ） . Conclusion The family nursing interventlon played an important role in preventing schizophrenia from recurrence, improving quality of life and family function, et al.