社区精神分裂症患者综合干预中联用网络咨询1年随访研究

A one year follow up of comprehensive intervention combined with online consultation in outpatients with schizophrenia

目的探讨社区精神分裂症患者综合干预中联用网络咨询的效果。方法对25例门诊精神分裂症患者进行可变剂量的抗精神病药物治疗12个月,进行综合干预并结合网络咨询和网络健康教育。以阳性和阴性综合征量表(PANSS)、社会功能量表(SFRS)较治疗前差值作为主要疗效指标;以网络咨询相关问题(IT)调查网络咨询的可接受性。结果 (1)治疗后第1、3、6、12个月末PANSS总分及各因子分均较治疗前显著降低(P<0.01);(2)社会功能损害评分治疗后第3、6、12个月末较治疗前显著降低(P<0.05,P<0.01);(3)在治疗前及治疗后第12个月末进行IT调查,对网络咨询可接受性相关问题认可的程度较高,愿意用网络解决医学问题、看好网络咨询前景等均超过(70.0%)。超过半数患者(>50.0%)认为网络咨询收费对其经济状况有影响,建议的网络咨询价格均显著低于面对面心理咨询(P=0.000)。(4)治疗后第12个月末19例患者参加了网络咨询相关问题的深入访谈,大多数患者认为网络咨询有益。结论社区精神分裂症综合干预中联用网络咨询有利于减轻症状和改善社会功能,网络咨询使用方便,患者愿意接受。

Objective To explore the efficacy of comprehensive intervention combined with online consultation on outpatients with schizophrenia.Methods 25 outpatients with schizophrenia were treated with variable-dose antipsychotics for 12 months in a comprehensive intervention program,which was combined with online consultation and network health education.The D-value of Positive and Negative Syndrome Scale （PANSS）,Social Functioning Rating Scale （SFRS） before and after treatment were used to evaluate the efficiency.Questionnaire which concerns the problems of online consultation （IT） was used to investigate the acceptability of online consultation.Results （1） Total score and factor scores of PANSS decreased significantly at the end of the 1st,3rd,6th and 12th month when compare with the baseline （P ＜0.01）.（2） Score of social functioning impairment in SFRS decreased significantly at the end of the 3rd,6th and 12th month when compare with the baseline （P ＜0.05 or 0.01）.（3） IT investigation was performed at the baseline and at the end of the 12-month treatment.It showed that the acceptability of online consultation was satisfying.Over 70.0％ of patients approved online consultation and took optimistic attitude about its application prospect.More than half of the patients believed that the cost for online consultation affected their economic status.The price of online consultation proposed by the patients was significantly lower than price of face-to-face counseling （t =5.152,P =0.000）.（4） 19 patients participated a thorough interview about the online consultation at the end of the 12th month,most of them thought that online consultation was helpful.Conclusion Comprehensive intervention combined with online consultationcan alleviate psychotic symptoms and improve the social function of schizophrenic outpatients.Online consultation is convenient to use and can be easily accepted.