阳性强化法在肇事肇祸精神病患者行为矫正中的应用

The Application of Positive Reinforcement on Behavior Modification in Troublemaking Psychiatric Patients

目的探讨阳性强化法对肇事肇祸精神病患者行为的影响。方法选择2013年9月-2014年12月南通市某医院收治的100例肇事肇祸精神病患者,随机分为观察组和对照组,每组50例。对照组患者采用常规药物治疗和护理;观察组在对照组的基础上,采用阳性强化法进行治疗。应用90项症状清单(SCL-90)和护士用住院患者观察量表(NOSIE)对2组患者的矫正治疗效果进行评分,并对评分结果进行比较。结果观察组患者治疗后SCL-90中躯体化、人际关系敏感、敌对、精神病性4个因子的得分分别为0.40±0.69,1.80±1.98,0.20±0.63,1.30±0.82,对照组患者这4个因子的得分分别为2.67±2.95,1.22±1.30,1.22±1.48,2.56±2.65,2组比较差异有统计学意义(P<0.05)。观察组患者治疗后NOSIE中总积极因子得分及病情总分分别为79.56±10.23,170.00±15.96,对照组患者总积极因子得分及病情总分分别为41.58±25.65,103.25±32.70,2组比较差异有统计学意义(P<0.05);2组患者社会能力、个人整洁、激惹、精神病表现、迟缓5个因子的得分差异有统计学意义(P<0.05)。结论阳性强化法可有效帮助肇事肇祸精神病患者改变不良行为,增强社会适应能力,有利于其及早回归社会。

Objective To investigate the effects of positive reinforcement on the behavior of troublemaking psy- chiatric patients. Method 100 cases of troublemaking psychiatric patients received in a hospital of Nantong City from September 2013 to December 2014 were randomly divided into an observation group and a control group, 50 cases in each group. Patients in the control group were treated with conventional medication and care while patients in the observation group were given positive reinforcement based on the same treatment of the control group. The modification effects of patients in both groups were scored and analyzed with 90 Symptom Checklist （SCL-90） and Nursing Observation Scale for Inpatient Evaluation （NOSIE）. Results After their treatment, scores of somatization, interpersonal sensitivity, hostility and psychosis of SCL-90 were 0.40 ± 0.69, 1.80±1.98,0.20±0.63 and 1.30±0.82 in the observation group; scores of the four factors in the control group were respectively 2.67±2.95,1.22! 1.30,1.22±1.48 and 2.56±2.65 ; the differences of the two groups were statistically significant （P〈0.05）. Scores of overall positive factors and total illness scores of NOSIE in the observation group were 79.56±10.23 and 170.00± 15.96, those of the control group were 41.58±25.65 and 103.25 ±32.70 and the difference was statistically significant （P 〈 0.05）. The differences of scores in the five factors of social capacity, personal cleanliness, irritability, psychotic manifestation and tardiness were also statistically significant in both groups （P〈0.05）. Conclusion Positive reinforcement can effectively help trou- blemaking psychiatric patients to change their bad behavior and improve their social adaptability so that they can return to society early.