家庭医生责任制模式干预对社区精神病患者康复效果的影响

Effect of Family Doctor Responsibility System Model on Rehabilitation of Community Mental Patients

目的:探讨家庭医生对社区精神病患者管理的实践及对策。方法:选取2013年5月-2014年7月龙岗中心医院社区健康服务中心收治的病程>1年的社区精神病患者178例作为研究对象,按照随机数字表法分为干预组82例和对照组96例。对照组给予常规出院指导和药物维持治疗,干预组在对照组的基础上联用家庭医生责任制模式进行康复治疗,采用阳性与阴性症状量表(PANSS)、加州大学圣地亚哥分校基于任务的生活能力测验(UPSA)、Zairt照顾者负担量表中文版(ZBI)对两组患者的精神症状改善情况、生活技能及主要照顾者负担情况进行评价,另采取调查问卷方式评价患者对疾病相关知识的知晓情况。结果:出院1年后,干预组PANSS、UPSA、ZBI评分、对照组ZBI评分及两组对疾病相关知识的知晓情况均优于出院时,且干预组优于对照组,比较差异均有统计学意义(P<0.05)。结论:家庭医生责任制模式联合常规药物维持治疗可有效改善社区精神病患者临床症状,提高生活技能和对疾病的认知,同时减轻照顾者的负担。

Objective：To discuss the family doctor practice and countermeasures in the management of community patients with mental disease.Method：From May 2013 to July 2014,178 cases of community mental disease in the community health service center of Longgang Central Hospital were selected as the research objects,they were divided into the intervention group of 82 cases and the control group of 96 cases according to the random number table.The control group was given routine discharge guidance and drug maintenance treatment,the intervention group combined with family doctors responsibility system for rehabilitation on basis of the control group,the mental symptoms improvement,life skills,primary caregiver burden in two groups were evaluated by positive and negative syndrome scale（PANSS）,task based life skills test of University of California at San Diego（UPSA） and Zairt caregiver burden scale Chinese version（ZBI）,another questionnaire was used to evaluate the awareness of the disease related knowledge.Result：One years after discharge,the intervention group PANSS,UPSA,ZBI score,ZBI score of the control group and two groups of disease related knowledge were better than discharge,the intervention group was better than the control group,the differences were statistically significant（P〈0.05）.Conclusion：Family doctor responsibility system model combined with conventional drugs maintenancetherapy can significantly improve the clinical symptoms of patients with community mental,life skills and awareness degree of disease knowledge,and reduce the burden on caregivers.