精神分裂症患者社区个案管理的效果分析

Analysis on the effect of community case management of schizophrenia patients

目的观察社区个案管理对精神分裂症患者社会功能和生存质量的影响。方法 100例精神分裂症患者随机分为干预组和对照组,干预组实施个案管理,而对照组仅维持原来的社区随访服务。在入组前以及入组后6、9、12个月末分别用阳性与阴性症状量表(PANSS)、个人与社会表现量表(PSP)和生存质量量表(WHO,QOL-100)评定两组患者的精神症状、社会功能和生活质量。结果入组后6、9、12个月末,两组的阳性症状总分及PANSS总分均明显低于同组入组时,且以干预组降低更为显著(P<0.05),干预组一般精神病理量表分低于同期的对照组(P<0.05或0.01)。入组后6、9、12个月末,干预组的PSP评分及QOL-100评分的生存质量和社会关系领域项评分均较入组时高,于入组后12个月末高于同期的对照组(P<0.05或0.01)。结论对精神分裂症患者进行社区个案管理,可以提高患者生活质量及自理能力,减少患者情感和社会功能的减退,提高精神分裂症的疗效。

Objective To observe the effect of community case management on social function and life quality of schizophrenia patients. Methods 100 schizophrenia patients were randomly divided into Intervention Group and Control Group. Case management was implemented for Intervention Group while original community follow-up service was maintained for Control Group. Mental symptoms, social function and life quality of the two groups were evaluated before enrollment and by the end of 6th, 9th and 12 th month after enrollment using Positive And Negative Syndrome Scale（PANSS）, Personal and Social Performance Scale（PSP） and World Health Organization Quality of Life（WHO, QOL-100）, respectively. Results The positive symptom score and PANSS score of the two groups by the end of 6th, 9th and 12 th month after enrollment was obviously lower than that before enrollment, and Intervention Group had a more significant decrease. PSP score and QOL-100 score of Intervention Group by the end of 6th, 9th and 12 th month after enrollment was higher than that before enrollment. Conclusion Community case management contributes to improvement of life quality and self-care ability, the reduction of emotional and social function, and the improvement of curative effect of schizophrenia.