社会工作介入重性精神病个案管理的效果研究

Effect of Case Management Intervened With Social Work in Severe Psychiatric

目的探讨重性精神病患者社区康复中社会工作介入个案管理的效果。方法选取2013年5月—2014年12月经佛山市顺德区伍仲珮纪念医院精神病科确诊的重性精神病患者18例,通过实施个案管理与社会工作分工合作,对其进行18个月的个案监管治疗。社会工作者采取不同于医生的工作方式,在关注精神病患者药物治疗情况、配合药物治疗的同时,重点帮助痊愈或病情稳定的精神病患者心理和社会方面的康复。采用个人与社会表现量表(PSP)、社会支持量表(SSRS)、社会功能缺陷筛查量表(SDSS)对患者入组时及入组后9、18个月的个人与社会关系、社会支持及社会功能进行评定。结果 18例患者社会工作介入个案管理后PSP、SSRS评分逐渐升高,SDSS评分逐渐降低,差异有统计学意义(P<0.05);其中入组后9、18个月与入组前比较,差异均有统计学意义(P<0.05);而入组后18个月与入组后9个月比较,差异无统计学意义(P>0.05)。结论社会工作介入个案管理后患者的能力缺陷得到明显改善,社会支持进一步提升,社会功能逐渐好转。社会工作介入重性精神病个案管理效果明显。

Objective To explore the effect of case management intervened with social work in severe psychiatric during community rehabilitation. Methods From May 2013 to December 2014,we enrolled 18 patients with severe psychiatric who were diagnosed in psychiatry department of Wu Zhong Pei Hospital, Shunde District, Foshan City. Through the implementation of case management and social work division,the patients were treated with eighteen- month case regulatory treatment. The social workers＇ manner of working was different with doctors＇ manner of working. They focused on helping psychological and social rehabilitation of patients with mental illness, while focusing on drug treatment, combined with drug therapy. Using personal and social performance scale（ PSP）,social support revalued scale（ SSRS）,social disability screening schedule（ SDSS）,we evaluated the personal and social relationships,social support and social function before entry into the group and 9,18 months in the group. Results The scores of PSP and SSRS in 18 patients were higher and the scores of SDSS were lower after case management intervened with social work（ P〈0. 05）. Before entry into the group and 9,18 months in the group,the patients were significantly different in scores of PSP,SSRS and SDSS（ P〈0. 05）. 18 months in group and 9 months in group,the patients were not significantly different in scores of PSP,SSRS and SDSS（ P〈0. 05）. Conclusion After the case management intervened with social work,the capability defect of patients is improved obviously. The social support is further improved and the social function is improved gradually. The effect is obvious on case management intervened with social work in severe psychiatric case.