精神疾病日间康复照料机构康复模块效果评价

Efficacy of rehabilitation m el-based interventions on the rehabilitation of chro- nic schizophrenics in community

目的探索精神疾病社区康复机构康复模块及其康复成效。方法对日间康复照料机构的102例慢性精神分裂症患者及其家属，按康复模块内容和流程进行康复干预，观察12个月。于康复干预前及干预12个月末采用阳性与阴性症状量表评估患者的精神症状，自知力与治疗态度问卷评估病情及服药依从性，功能大体评定量表评估当前治疗和照料的需要，社会功能缺陷筛选量表评估社会功能受损程度，家庭负担会谈量表、抑郁自评量表、焦虑自评量表评估家庭负担及家属情绪。结果康复干预后，入组患者阳性与阴性症状量表阴性症状分较干预前显著下降（t=4．78，P〈0．01），自知力与治疗态度问卷评分较干预前显著升高（t=7．57，P〈0．01），社会功能缺陷筛选量表的社会性退缩、家庭外社会活动、个人生活自理、对外界的兴趣和关心因子分均较干预前有显著改变（P〈0．05）；患者家属家庭负担会谈量表、抑郁自评量表、焦虑自评量表评分均较干预前有显著下降（P〈0．01）。结论系统、规范的康复干预对患者的康复有促进作用，可以减轻其家庭负担，改善家属的情绪健康状况。

Objective To investigate the efficacy of interventions based on rehabilitation model on rehabilitation of chronic schizophrenics in community. Methods According to a preliminarily designed rehabilitation model, 102 schizophrenic patients were received intervention and health education in community rehabilitation day services; meanwhile, family members of patients were received health education. Several measuring scales were used to evaluate the health state at pre-therapy and 1 year after intervention, such as Positive and Negative Syndrome Scale （PANSS）, Insight and Treatment Attitudes Questionnaire （ITAQ）, Global Assessment Function （GAF）, Social Disability Screening Schedule （SDSS）, Family Interview Schedule （FIS）, Self-rating Depression Scale SDS）, and Self-Rating Anxiety Scale （SAS）. Results After 1-year intervention, patients had statistically significant improvement on the score of Negative Syndrome in the PANSS （t=4.78, P=0.00）, ITAQ （t=-7.57, P=0.00）, and FIS （t=-5. 039, P=0.00）. The score of SAS and SDS were also significantly reduced （SAS： t=22.45, P=0.00; SDS： t=-4.94, P=0.00）. Conclusion Systemic, standard rehabilitation training can enhance the states of health in both patients and their family members. As a consequence, family burden is alleviated.