出院精神分裂症患者实施居家优质护理管理的效果分析

The analysis of the effectiveness of implementing high-quality home nursing management for discharged patients with schizophrenia

目的:探讨居家优质护理管理对出院精神分裂症患者的效果。方法:120例出院精神分裂症患者随机分为干预组和对照组各60例,两组均采用常规出院护理模式,干预组增加由临床医生、护士、心理咨询师组成的团队参与社区管理,设定干预项目,通过网络、短信、电话等进行护理干预,并采用日常生活能力量表(ADL)、精神分裂症患者生活质量量表(SQLS)、中文版一般自我效能感量表(GSES)及自拟"居家护理服务满意度调查表"在干预前、干预3个月、6个月和12个月后对两组进行评估,并在日常生活能力、生活质量、自我效能感及满意度方面进行比较。结果:重复测量方差分析显示,两组ADL及GSES评分组间主效应有统计学意义(F=975.78,P<0.001;F=7.84,P=0.006);ADL、SQLS及GSES评分时间主效应有统计学意义(F=20.02,F=36.62,F=43.14;P均<0.001)。干预组干预前后患者满意度时间主效应有统计学意义(F=68.83,P<0.001)。结论:对出院精神分裂症患者实施居家优质护理管理可明显加强日常生活能力、改善生活质量、提高自我效能感及满意度。

Objective：To evaluate the effects of the high-quality home nursing management among dis-charged patients with schizophrenia. Method：One hundred and twenty cases of discharged patients with schizophrenia were randomly divided into control group and intervention group,each group contained 60 cases. Both groups were used the routine discharge nursing model. The team composed of clinical doctors,nurses and psychologist was added into the intervention group to participate in community management and set intervention programs. In addition,through the network,text messages,phone calls and other forms of intervention,activity of daily living scale（ADL）,schizophrenia quality of life questionnaire（SQLS）,general self-efficacy scale（GSES） in Chinese version and home nursing service satisfaction survey were adopted to assess two groups. These assess-ments were done before the intervention,3 months,6 months and then 12 months after the intervention. Further-more,to compare the status between two groups in terms of the daily living ability,life quality,self efficacy and the home nursing service satisfaction. Results：Data from repeated measures variance analysis showed that the main effects between the two groups in ADL and GSES score were statistically significant（F = 975. 78,P 〈0. 001;F = 7. 84,P = 0. 006）;the main time effects in ADL,SQLS and GSES score were statistically significant （F = 20. 02,F = 36. 62,F = 43. 14;P 〈 0. 001）;the main time effects of patient satisfaction before and after in-tervention were statistically significant（F = 68. 83,P 〈 0. 001）. Conclusion：The high-quality home nursing management implemented to the discharged patients with schizophrenia can significantly strengthen their daily living ability,improve their life quality,and increase self-efficacy and satisfaction.