社区精神分裂症患者综合性康复干预的效果评价

Efficacy of comprehensive rehabilitation intervention on the schizophrenia patients in community

目的:探讨综合性康复干预对社区精神分裂症患者的效果。方法:随机抽取无锡市滨湖区在册管理的104例慢性精神分裂症患者为研究对象,随机分为干预组和对照组各52例,干预组给予"医院、社区、家庭"综合性康复,对照组接受常规社区精神卫生服务。分别在干预前、干预1年末采用阳性与阴性症状量表(PANSS)、华文认知能力量表(CCAS)、精神分裂症患者生活质量量表(SQLS)、家庭负担会谈量表(FIS)评估患者病情、认知功能、生存质量以及家庭负担。结果:与治疗前比较,干预组1年末PANSS、CCAS、SQLS总分及各因子分、FIS总分均明显改善(P<0.05,0.01);对照组PANSS总分及精神病理因子分、SQLS症状/副作用因子分较治疗前明显改善(P<0.05,0.01),但其他各评分指标较前无明显变化。组间比较,干预组PANSS总分及阴性因子分、CCAS操作因子分、SQLS总分及心理社会、精力/动机因子分、FIS总分改善程度均优于对照组(P<0.05,0.01)。干预1年末,两组复发率、住院率比较差异无统计学意义。结论:综合性康复干预在改善精神分裂症患者病情的同时,能促进认知功能恢复,提高患者生存质量和降低家庭照料负担,是理想的社区康复模式。

Objective：To investigate the efficacy of comprehensive rehabilitation intervention on schizophrenia pa-tients in community.Methods：All 104 patients with chronic schizophrenia were randomly divided into intervention group （receiving a combined hospital,community and family comprehensive rehabilitation intervention）and control group （receiving regular community mental health services）.All patients were followed up for one year and assessed with the Positive and Negative Syndrome Scale （PANSS）,the Chinese Cognitive Ability Scale （CCAS）,the Schizo-phrenia Quality of Life Scale （SQLS）and the Family Interview Schedule （FIS）before and one year after the follow-up.Results：At the end of 1 year after treatment,the total and each factor scores of PANSS,CCAS,SQLS,SDSS and FIS score in intervention group were all improved significantly as compared with those before treatment （P 〈0.05,or 〈0.01 ）.The total and general mental pathological factor scores of PANSS,and of the two factors of SQLS including psychosocial facet and motivation and energy in the control group were improved significantly （P 〈0.05,or 〈0.01）,while the other scores had no obvious change.The total and negative factor scores of PANSS, operating factor scores of CCAS,the total scores of SQLS and two factors including psychosocial facet and motiva-tion and energy in the intervention group were all significantly improved as compared with those in the control group after 1-year treatment （P 〈0.05,or 〈0.01）.At the same time,there were no statistical differences in the relapse and hospitalization rate between the two groups.Conclusion：Comprehensive rehabilitation intervention can signifi-cantly improve the clinical symptoms and promote the cognitive function,at the same time can improve the quality of life,and reduce the family burden of schizophrenia patients in community.