代币强化行为疗法对精神分裂症患者的康复效果研究

The effects of token therapy on the rehabilitation of Schizophrenic patients

目的探讨代币强化行为疗法对恢复期住院精神分裂症病人的康复效果。方法68例恢复期住院精神分裂症病人随机分为研究组36例和对照组32例，两组病人均给予系统性抗精神病药物治疗，对照组给予普通病房护理管理，研究组在此基础上实施为期8周的代币强化行为疗法，治疗前后，采用精神病人不良言行评定标准，护士用住院病人观察量表（NOSIE）和住院精神病人康复疗效评定量表（IPROS）进行康复效果评价。结果治疗前，不良行为人均发生次数、NOSIE、IPROS评分，两组比较，差异无统计学意义（P〉0．05）；治疗后，研究组不良行为人均发生次数明显少于对照组，研究组NOSIE中总积极因素明显高于对照组，总消极因素明显低于对照组，研究组IPROS评分明显低于对照组，两组比较，差异具有统计学意义（P〈0．01）。结论代币强化行为疗法能够改善精神分裂症病人的适应不良与行为障碍，对恢复其社会功能，降低精神残疾具有积极的作用。

Objective To investigate the effects of token therapy on the rehabilitation of Schizophrenic patients. Methods A total of 68 patients with schizophrenia participated in the current study were randomly divided into the research group and the control group （ n = 32 per group）. Both groups of patients were received systematic antipsychotic treatment. The patients in control group were given routine nursing care and patients in the therapy group were additionally given an 8 - week token therapy. The rehabilitation effects were evaluated by the Criteria of Inappropriate Speech and Behaviors of Psychotic Patients, the Nurses＇Observation Scale for Inpatient Evaluation （NOSIE） and the Inpatient Psychiatric Rehabilitation Outcome Scale （IPROS） before and after the therapy. Results Before the token therapy, there were no significant differences between two groups. After the treatment, compared to the control group, the therapy group showed significantly low- er occurrence of inappropriate behaviors per patient and had lower IPROS scores. The therapy group also exhibited significantly higher scores in positive factors of NOISE and lower scores in the negati,Je factors （ P 〈 0. 01 ） . Concl^lons The token therapy can improve the maladaptation and behavioral disorders of schizophrenic patients and may have a positive effect in restoring their social functions and reducing psychiatric disabilities.