综合干预管理模式在社区精神分裂症患者康复中的应用效果

Application effect of the comprehensive intervention management mode on the rehabilitation of the community patients with schizophrenia

目的探讨综合干预管理模式对社区精神分裂症患者的康复效果,为开展社区精神分裂症康复管理提供依据。方法将于2010年12月在济宁市精神病防治院系统治疗而痊愈出院的160例符合《ICD-10精神与行为障碍分类》诊断标准的精神分裂症患者随机分为干预组(84例)和对照组(76例)。干预组实施综合干预管理模式,对照组实施自我管理模式,不给予任何形式的社区医疗护理干预。两组观察干预时间为1年,于干预前和干预第3、6、9、12个月末,采用阳性和阴性症状量表(PANSS)、日常生活能力量表(ADL)、社会功能缺陷筛选量表(SDSS)、综合生活质量评定问卷(GQOLI-74)以及恶化率及复发率等指标进行比较,所有数据均采用SPSS 12.0统计学软件进行处理。结果 (1)干预前,干预组与对照组PANSS、ADL、SDSS、GQOLI-74评分比较,差异均无统计学意义(t=0.32、0.88、0.21、0.30,P均>0.05);(2)干预第12个月末,干预组PANSS总分(55.28±6.37)分、ADL总分(16.22±2.91)分、SDSS总分(4.38±0.71)分,恶化率和复发率分别为16.67%和13.10%,均低于对照组[分别为(65.46±9.85)分、(21.53±3.84)分、(5.76±0.58)分、60.53%、44.74%],差异有统计学意义(t=7.83、9.91、13.38,χ2=32.75、19.76,P均<0.01),干预组GQOLI-74评分(13.76±3.42)分,明显高于对照组[(8.83±3.12)分],差异有统计学意义(t=9.49,P<0.01);(3)干预组PANSS、ADL、SDSS和GQOLI-74等各量表干预差值均明显优于对照组,差异均有统计学意义(t=8.23、2.98、5.48、9.83,P均<0.01)。结论对社区精神分裂症患者实施综合干预管理模式能够有助于稳定患者病情,改善社会功能,提高日常生活能力和生活质量,降低复发。

Objective To explore the comprehensive intervention management mode on the community patients with schizophrenia, in order to provides the basis which carried out the rehabilitation management for community schizophrenia. Methods One hundred and sixty patients with schizophrenia who met with the diagnostic criteria of ICD-10 classification of mental and behavior disorders and was given systemic treatment and healing in mental hospital of Jining and left the hospital in December 2010 were randomly divided into intervention groups （ 84 patients ） and control group （ 76 patients）, intervention group was given comprehensive intervention management mode, the control group carried out the self-nursing mode, any form of community health nursing intervention would not be given, the observation intervention time lasted for a year for the two groups, before the intervention and intervention at the end of 3 months, 6 months, 9 months and one year the affection was compared by PANSS, ADL, SDSS, GQOLI-74 and deterioration rate and recurrence rate. The total data was disposed with SPSS 12. 0. Results （ 1 ） Before intervention, the score of PANSS,ADL, SDSS and GQOLI-74 were not statistically different between intervention group and control group （ t = 0. 32,0. 88,0. 21,0. 30, all P 〉 0.05 ） ; （2） At the end of one year of the intervention, the scores of PANSS（55.28 ± 6. 37 ）, ADL （ 16. 22 ±2. 91 ）, SDSS （ 4. 38 ±0. 71 ） and deterioration/recurrence rates （ 16. 67%/13. 10% ） of intervention group were obviously lower than those of PANSS（65. 46 ±9. 85 ）, ADL （21.53 ±3.84）, SDSS （ 5.76 ±0. 58 ） and deterioration/recurrence rate （ 60. 53%/44.74% ） of the control group,it had a statistically significant difference（ t = 7. 83,9. 91,13. 38 ;X2 = 32.75,19.76, all P 〈 0. 01 ）, the score of GQOLI-74 of intervention group（ 13.76 ±3.42） were obviously higher than that of the control group （ 8.83 ＋ 3.12）, it had a statistically significant difference （ t = 9.49, P 〈 0.01 ） ; （ 3 ） The intervention difference score of PANSS, ADL, SDSS and GQOLI-74 of intervention group were obviously better than those of the control group, it had a statistically significant difference （ t = 8. 23,2.98,5.48,9. 83, all P 〈 0. 01 ）. Conclusions Being carried out comprehensive intervention management mode for community patients with schizophrenia could help stable patients state of illness, improve social function, and improve daily living skills, quality of life and reducing relapse, it would had well effect for promoting recovery of patients.