精神分裂症患者“药物自我处置程式”训练的研究

Study on medication self-management module for patients with schizophrenia

目的探讨"药物自我处置程式"训练对精神分裂症患者治疗依从性、社会功能和生活质量的影响。方法将66例住院非急性期精神分裂症患者随机分为训练组(n=33)和对照组(n=33)。在抗精神病药物治疗不变的前提下,训练组按照Liberman编写的"药物自我处置程式"进行分组训练8周,8周后两组随访6个月。采用自制的药物依从性评分表、社会功能缺陷量表(SDSS)、生活质量综合评定问卷(GQOLI-74)对两组患者进行评估。结果8周及随访6个月后训练组治疗依从性、SDSS总分、GQOLI-74总分较对照组显著提高(P<0.01、P<0.05)。同组不同时点比较,训练组8周及随访6个月患者治疗依从性、SDSS总分、GQOLI-74总分等较入组时有显著提高(P<0.01或P<0.05);两组随访6个月的治疗依从性下降,且与8周时的差异有统计学意义(P<0.01)。相关分析显示,在8周和随访6个月后,患者GQOLI-74总分与SDSS总分、治疗依从性呈负相关,SDSS总分与治疗依从性呈正相关(P<0.01)。结论"药物自我处置程式"训练能提高患者的治疗依从性,改善其社会功能,提高其生活质量。

Objective To explore the impact of medication self-management module on treatment compliance, social function and quality of life of patients with schizophrenia. Methods Sixty-six inpatients with schizophrenia in non-acute stage were randomly divided into training group（ n = 33 ） and control group（ n = 33 ）. Both groups received the anti-psychotics therapy. Medication self-management module was only given to the training group for 8 weeks. All patients were followed up for 6 months and were evaluated with self-made drug treatment compliance rating scale, social disability screening schedule （SDSS）, generic quality of life inventory-74 （GQOLI-74）. Results Treatment compliance, the total scores of SDSS and the total scores of GQOLI-74 of training group were signifieanfly higher than those of control group after 8 weeks and 6 months（ P 〈 0. 01, P 〈 0. 05 ）. Treatment compliance, the total scores of SDSS and the total scores of GQOLI-74 of training group after 8 weeks and 6 months were significantly higher than those of pretraining（P 〈 0. 05 ）. Treatment compliance of both groups on 6 months follow up were significantly lower than that of 8 weeks （ P 〈 0.01 ）. Correlation analysis confirmed negative relation between the total scores of GQOLI-74 and the total scores of SDSS, treatment compliance, and confirmed positive relation between the total scores of SDSS and treatment compliance on 8 weeks and 6 months （ P 〈 0. 01 ）. Conclusion Medication self-management module could significantly improve treatment compliance, social function and quality of life of patients with schizophrenia.