家庭防治模式对慢性精神病患者疗效、治疗成本和疾病负担的影响

Effect of family prevention-model on cost-effectiveness and disease burden in patients with chronic mental disorders

目的探讨家庭防治模式对慢性精神病患者的疗效、社会功能、疾病家庭负担、治疗成本及照料者生存质量的影响。方法采用自制一般情况调查表、简明精神病评定量表(BPRS)、社会功能缺陷量表(SDSS)、疾病家庭负担量表(FBS)、世界卫生组织生存质量测定量表简表(WHOQOL-BREF)在干预前、干预后第5、10个月末分别对215例社会精神病患者进行评定。结果 (1)干预前后比较:BPRS各因子得分除焦虑忧郁因子和思维障碍因子无显著变化(P>0.05),其他因子及总分评分差异均有显著性(P<0.01);SDSS、FBS得分成递减状,差异有显著性(P<0.01);照料者生存幸福感(WHOQOL-BREF)明显提高(P<0.01)。(2)疾病直接治疗成本明显减少(P<0.01)。(3)大多数患者和家属更愿意接受家庭防治模式的治疗方式(66.05%)。结论家庭防治模式是一种经济、可行、容易被患者及家属接受、更人性化的防治模式,可以有效提高疗效、改善社会功能、降低疾病家庭负担,提高照料者的生活质量,值得进一步探索推广。

Objective To investigate the influence of family prevention model on the curative effect, social function, family burden of disease, treatment costs and caregivers＇ quality of life in patients with chronic mental disorders. Methods 236 chronic psychiatric patients （215 people completed the investigation） were involved in the family prevention model and were assessed with self-designed general information questionnaire, Brief Psychiatric Rating Scale （ BPRS）, Social Disability Screening Schedule （ SDSS）, Family Burden Scale of Disease （ FBS ）, and World Health Organization＇ s Quality of Life Brief Questionnaire （WHOQOL-BREF） at baseline and at the end of the 5th, 10th month of the prevention. Results （ 1 ） Compared with baseline, total score and all factor scores except the anxiety-depression and thought disturbance of BPRS decreased significantly at the end of the 5th, 10th month （P 〈 0.01 ）. Total scores of SDSS and FBS decreased progressively and significantly when compared with the baseline （ P 〈 0.01 ）. The survival well-being of caregivers increased significantly at the end of 5th, 10th month when compared with the baseline （ P 〈 O. O1 ）. （2） The annual direct treatment cost decreased significantly after the family prevention （ P 〈 0.01 ）. （ 3 ） Most patients and their families prefered to accept family prevention model （ 66.05% ）. Conclusion Family prevention model of chronic mental disorders has obvious advantages such as good economic efficiency, feasibility, accessibility and hommization. It can improve the therapeutic effect and social function, reduce the family burden of disease and improve the quality of life of caregivers. Family prevention model is worthy of further exploration and promotion.