中国上海的一项精神分裂症患者社区康复效果的对照试验（英文）

Controlled trial of the effectiveness of community rehabilitation for patients with schizophrenia in Shanghai,China

背景:"阳光心园"是社会福利机构网络,为精神疾病患者提供以社区为基础的康复服务。目的:评估"阳光心园"针对精神分裂症患者的精神病性症状和社会功能提供的康复服务的有效性,并根据这些发现得出基于社区的康复服务的理论模型。方法:上海市黄浦区的60名精神分裂症患者自愿在六个"阳光心园"社区参加了由其社区中心提供的康复训练计划,涉及日间治疗、用药监测、每两周一次的康复训练、以及其它休闲、社交和智力活动。从黄浦区"重性精神疾病预防与康复系统"中登记注册的精神分裂症患者中招募相匹配的对照组。所有的参与者在随访的一年内保持原先的用药,不做更改。在基线和登记注册后的第3个、第6个和第12个月分别对两组使用自知力与治疗态度问卷(Insight and Treatment Attitude Questionnaire,ITAQ)、社会功能缺陷筛选量表(Social Disability Screening Schedule,SDSS)、生活质量综合评定问卷—74(Generic Quality of Life Inventory-74,GQOLI-74)、和阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)进行评估。结果:在干预组中,每次随访的ITAQ、SDSS、GQOLI-74和PANSS评分都显著优于基线水平,有统计学意义。此外,干预组的改善趋势显著快于对照组。结论:"阳光心园"康复训练项目增进了患者对他们疾病的了解,并提高他们的社会功能和生活质量。对于这种方法,我们需要进一步研究,以评估是否必要将这种方法推广至中国的其它地区。

Background： The ＇Sunshine Soul Park＇ is a network of social welfare institutions that provides community- based rehabilitation services for individuals with mental illness. Aims： Assess the effectiveness of the rehabilitation services provided at the ＇Sunshine Soul Park＇ on the psychotic symptoms and social functioning of individuals with schizophrenia and, based on these findings, provide a theoretical model of community-based rehabilitation. Methods： Sixty individuals with schizophrenia in the Huangpu District of Shanghai volunteered for the rehabilitation training program provided at six ＇Sunshine Soul Park＇ community centers that involves day treatment, medication monitoring, biweekly rehabilitation training, and other recreational, social, and intellectual activities. A matched control group was recruited from individuals with schizophrenia registered on the Huangpu District registry of the ＇Severe Mental Illness Prevention and Rehabilitation System＇. All participants continued their medication without change for the full year of follow-up. Both groups were assessed at baseline, and 3, 6, and 12 months after enrollment using the Insight and Treatment Attitude Questionnaire （ITAQ）, Social Disability Screening Schedule （SDSS）, Generic Quality of Life Inventory-74 （GQOLI-74）, and Positive and Negative Syndrome Scale （PANSS）. Results： In the intervention group the ITAQ, SDSS, GQOLI-74, and PANSS scores showed statistically significant improvement compared to baseline at each follow-up assessment. Moreover, the trend in improvement in the interventions group is significantly faster than that in the control group. Conclusions： The ＇Sunshine Soul Park＇ rehabilitation training program enhances patients＇ knowledge about their disorder and improves their social functioning and quality of life. Further studies to assess methods for up-scaling this intervention to other areas of China are warranted.