医院社区一体化管理模式对精神分裂症患者的管理效果研究

Effect of Integrated Management Model of Hospital and Community on Patients with Schizophrenia

目的探讨医院社区一体化管理模式对精神分裂症患者的管理效果，以期为精神分裂症患者的管理提供科学的依据。方法选取于2010年3月—2011年6月在我院住院治疗的精神分裂症患者280例，采用随机数字表法分为研究组140例和对照组140例。对照组给予常规的抗精神病药物治疗和健康教育；研究组在对照组基础上采用医院社区一体化管理模式进行管理。采用Morningside康复状态量表（MRSS）、社会功能缺陷筛选量表（SDSS）、服药依从性、复发率、肇事肇祸率进行管理效果评价。结果干预前，研究组与对照组MRSS得分间差异无统计学意义（P=0．271）；干预后，研究组的得分间较对照组明显下降，差异有统计学意义（P=0．002）。干预前，研究组与对照组SDSS得分差异无统计学意义（P=0．887）；干预后，研究组的得分较对照组明显下降，差异有统计学意义（P=0．003）。干预后，两组患者服药依从性间差异有统计学意义（P=0．003），研究组的服药依从性明显优于对照组。研究组复发6人（4．3％），对照组复发19人（13．6％），两组间差异有统计学意义（P=0．006）。研究组无1例发生肇事肇祸，对照组发生肇事肇祸4人（2．9％），两组间差异有统计学意义（P=0．047）。结论医院社区一体化管理模式对精神分裂症患者的管理效果较好，医院社区协同服务提高了患者的服药依从性，降低了患者的复发率和肇事肇祸率，应大力推广。

Objective To investigate the management effect of integrated management model of hospital and community to patients with schizophrenia so as to provide a scientific basis for management of patients with schizophrenia. Methods A total of 280 schizophrenia inpatients in our hospital from March 2010 to June 2011 were according to random number table divided as trial group of 140 cases and control group of 140 cases. The patients in the control group received conventional antipsychotic ther- apy and health education, while those in the trial group were additionally given integrated management model of hospital and community. Morningside Rehabilitation Status Scale （ MRSS）, Social Disability Screening Schedule （ SDSS）, medication compliance, relapse rate, accident rate were applied to evaluate the effect of management. Results Before the intervention, MRSS scores showed no statistically significant difference between the two groups （P = 0. 271 ） ; but after the intervention, the MRSS scores were statistically significant lower in the trial group than that in the control group （P = 0. 002）. Before the intervention, SDSS scores showed no statistically significant difference between the two groups （P = 0. 887） ; but after the intervention, the SDSS scores were statistically significant lower in the trial group than that in the control group （P = 0. 003 ）. After the interven- tion, the patients＇ medication compliance in the trial group was statistically better than that in the control group （P = 0. 003）. The relapse occurred in 6 cases （4. 3% ） of the trim group, but in 19 （ 13.6% ） of the control group, with a statistically significant difference （P =0. 006）. No one of the trial group had accident, but 4 （2. 9% ） of the control group had, the difference was statistically significant （P = 0. 047 ） . Conclusion The integrated management model of hospital and community is of good effect to patients with schizophrenia, and it increases the patients＇ medication compliance and decreases the relapse rate and accident rate, so it is worth of popularization.