对社区精神分裂症患者实施医院专业治疗、护理、社区康复于一体的管理模式的效果研究

The effect of the management model implementation of specialized hospital treat-ment, care, community-based rehabilitation on the community patients with schiz-ophrenia

目的：探讨运用以医院专业治疗、护理、社区康复健康指导于一体的社区精神分裂症干预模式的效果，为开展社区精神分裂症康复管理提供依据。方法将临床“痊愈”出院的精神分裂症患者80例分为研究组（42例）和对照组（38例），研究组建立以社区卫生服务中心为依托的精神病防治点，对社区精神分裂症患者实施医院专业治疗、护理、社区康复健康指导，观察时间为1年。对照组实施自我护理措施，给予常规形式的社区医疗护理干预。采用阳性和阴性症状量表（PANSS）、社会功能缺陷筛查量表（SDSS）、复发率进行效果评估。结果出院时，两组PANSS和SDSS总分评定无明显差异（ P〉0.05），出院6个月、9个月及1年后，研究组患者PANSS和SDSS总分以及复发率均低于对照组，差异有显著统计学意义（ P〈0.01）。结论对社区精神分裂症患者实施医院专业治疗、护理、社区康复健康指导能够稳定患者病情，改善其社会功能，降低复发，对促进患者良好康复具有积极的作用。

Objective To investigate the use of specialized hospital treatment, care, community-based reha-bilitation health guidance for the way community intervention model of schizophrenia, provide the basis for the develop-ment of community rehabilitation management of schizophrenia. Methods A total of 160 cases of schizophrenia patients discharged from the division were randomly divided into observation group （84 cases） and control group （76 cases） by a coin toss. To establish a community health service centers as the basis of mental illness prevention point community pa-tients with schizophrenia and implementing in-hospital professional treatment, care, community rehabilitation and health guidance in observation group. The observation time of 1 year. Patients in the control group received self-care meas-ures, were given the conventional forms of community health nursing intervention. The recurrence rate and impact evalu-ation were detected by Positive and Negative Syndrome Scale （ PANSS ） , the Social Disability Screening Scale （ SDSS） . Results At discharge, there were no significant differences in PANSS and SDSS score assessment of two groups （P〉0. 05）. Discharge 6 months, 9 months and 1 year, PANSS and SDSS total score and the recurrence rate of observation group were lower than those of the control group , the differences were statistically significant （ P〈0. 01 ） . Conclusions Implementation of specialized hospital treatment, nursing, community rehabilitation and health guidance can stabilize the patient＇s condition, improve social function and reduce relapse, which plays an active role to promote the good rehabilitation of patients with schizophrenic patients.