药物自我处置程式训练对精神分裂症患者服药依从性及社会功能的影响

Effect of drug self-disposal training on medication compliance and social function in schizophrenic patients

目的探讨药物自我处置程式训练对病情稳定的精神分裂症患者服药依从性、症状及社会功能的作用。方法选取2014年7月~2015年6月在中山市第三人民医院住院并处于稳定期的精神分裂症患者84例,按随机数字表法分为实验组与对照组,每组各42例。两组患者均接受药物治疗+常规康复训练8周,实验组同时接受药物自我处置程式训练8周,出院后随访1年。采用药物依从性评分表、简明精神病量表(BPRS)与社会功能缺陷筛查量表(SDSS)对两组患者每3个月进行评估,评价两组患者在服药依从性、复发率与社会功能的差异。结果两组入组时服药依从性差异无统计学意义(P>0.05);出院时两组与入院时比较,差异有统计学意义(P<0.05),实验组的服药依从性高于对照组(P<0.05);实验组6、9、12个月的依从性与出院时比较,差异有统计学意义(P<0.05);对照组3、6、9、12个月的服药依从性与出院时比较,差异有统计学意义(P<0.05)。实验组复发率(16.67%)低于对照组(30.95%),差异有统计学意义(P<0.05)。实验组患者在6、9、12个月时的BPRS评分均优于对照组(P<0.05)。实验组患者在6、9、12个月SDSS评分均优于对照组(P<0.05);实验组患者出院后BPRS评分及SDSS评分差异无统计学意义(P>0.05);对照组患者BPRS评分出院后高于出院时(P<0.05),SDSS评分在6、9、12个月时低于出院时(P<0.05)。结论药物自我处置程式训练可以有效提高精神分裂症患者出院后的服药依从性,维持病情的稳定,降低疾病复发率,防止社会功能恶化。

Objective To explore the effect of drug self-disposal training on medication compliance, symptoms and social function in schizophrenic patients. Methods from July 2014 to June 2015, in Third People’s Hospital of Zhongshan City, 84 schizophrenic patients in steady phase hospitalized were selected, randomly divided into the experimentaion group and the control group according to the random number table method, with 42 cases were in each group. Both groups received drug therapy and routine rehabilitation training for 8 weeks, in addition, the experimentaion group received drug self-disposal training for 8 weeks. These patients were followed-up for one year after discharging. Medication compliance, relapse rate and social function were assessed by medication compliance rating scale, Brief Psychiatric Rating Scale（BPRS） and Social Disability Screening Schedule（SDSS） in every three months. Results The difference between two groups in medication compliance was not statistically significant at baseline（P 〉 0.05）; the medication compliance in two groups were improved after rehabilitation training, the difference was statistically significant（P 〈0.05）; but the medication compliance in experimentaion group was higher than that in the control group, the difference was statistically significant（P 〈 0.05）; the medication compliance of the experimentaion group after 6, 9, 12 months was lower than that of the control group, the difference was statistically significant（P 〈 0.05）. The recurrence rate of the experimentaion group was lower than that of the control group, the the difference was statistically significant（P 〈 0.05）.The BPRS scores of the experimentaion group after 6, 9, 12 months were lower than those of the control group（P 〈 0.05）.The SDSS scores of the experimentaion group after 6, 9, 12 months were lower than those in the control group（P 〈0.05）. The BPRS scores and SDSS scores of the experimentaion group were not altered obviously after discharge（P 〉0.05）. The BPRS scores of the control group were higher after discharge（P〈 0.05）, and the SDSS scores of the control group after 6, 9, 12 months were higher after discharge（P 〈 0.05）. Conclusion The drug self-disposal training can effectively improve the medication compliance in schizophrenic patients after discharge, maintain the stability of the symptoms, reduce the relapse rate and prevent the social function deterioration.