农村社区精神分裂症患者家庭干预的对照研究

A control study of psychoeducational family intervention for relatives of schizophrenics in a Chinese rural community

目的 探讨适合中国农村特色的心理教育性家庭干预的特点、方式及效果。方法 在成都市新津县农村以乡为单位 ,将 32 6例精神分裂症患者随机分为干预组 [心理教育性家庭干预 +药物治疗 (Haloperidol针剂 5 0～ 12 5mg/月 ,或五氟利多 2 0mg/1～ 2周 ) ,12 6例 ]、药物组 (单用相同药物治疗 ,10 3例 )及对照组 (无任何干预 ,97例 )。家庭干预针对患者存在的问题对患者及其家属以家庭访视 (每个月 1次 ,共 9次 )和家属集体座谈会 (每 3个月 1次 ,共 3次 )为主的方式进行教育干预 ,并随访 9个月。采用精神现状检查、社会功能缺陷筛选量表等 ,于干预前后 (共 4次 )进行评定。结果 干预后 ,干预组药物治疗的依从性较药物组及对照组提高 (P <0 0 0 1) ;干预组复发率 (16 3% )低于药物组 (37 8% ) ,药物组低于对照组 (6 1 5 % ;P <0 0 5 )。与药物组及对照组比较 ,干预组家属对疾病的认识水平提高 (P <0 0 5 ,0 0 1) ,对患者的照管态度改善。结论 有针对性的心理教育性家庭干预能提高药物治疗的依从性 ,降低疾病的复发率 ,改善家属对患者照管的态度 ,适合在农村社区开展。

Objective The purpose of this study was to explore the characteristic and effect of psychoeducational family intervention for schizophrenic patients in a Chinese rural community Methods 326 patients with schizophrenia were divided into three groups(drug treatment plus psychoeducational family intervention,drug treatment,and control)to carry out a nine month follow up comparative study Results Compared with drug treatment and control groups, the relatives in the intervention group had more essential knowledge about the disease and improved their caring attitudes to the patients, and the patients were more compliant in treatment ( P <0 001) Moreover, in the intervention group,the clinical outcome of illness was improved and the relapse rate(16 3%)was lower significantly than that in the other two groups( P <0 05) Conclusions Psychoeducational family intervention can improve relative′s recognition of illness and the patient′s outcome of illness This kind of intervention may be suitable for conducting in Chinese rural context